Torún B, Solomons N W, Viteri F E
Arch Latinoam Nutr. 1979 Dec;29(4):445-94.
A total of 194 publications related to lactose malabsorption or intolerance were reviewed. The poor correlation between lactose malabsorption and intolerance to the amounts of milk ordinarily ingested in a meal, indicates that the assumption of milk tolerance by many populations is exaggerated. The methods for the diagnosis of these conditions were critically evaluated and it is suggested that, a) "physiological" doses of lactose be used; b) milk is the vehicle of choice; c) tests of intolerance be double-blind, and d) analysis of breath hydrogen be used for malabsorption. Most of the evidence indicates that milk consumption allows adequate growth of children, even when they are malnourished and have diarrhea. Nevertheless, it is recommended to substitute temporarily non-human milk by other good sources of dietary protein and energy during episodes of severe diarrhea, and to reintroduce milk to the diet gradually during convalescence. Breast feeding, however, should not be interrupted. These is not enough scientific nor epidemiological support to justify discouraging the use of milk in food supplementation programs, but several aspects that must be considered in such programs are outlined.
共查阅了194篇与乳糖吸收不良或不耐受相关的文献。乳糖吸收不良与一餐中通常摄入的牛奶量不耐受之间的相关性较差，这表明许多人群对牛奶耐受性的假设被夸大了。对这些病症的诊断方法进行了严格评估，并建议：a）使用“生理”剂量的乳糖；b）牛奶是首选载体；c）不耐受测试应采用双盲法；d）采用呼气氢分析来检测吸收不良。大多数证据表明，即使儿童营养不良且患有腹泻，饮用牛奶也能使其充分生长。然而，建议在严重腹泻期间暂时用其他优质的膳食蛋白质和能量来源替代母乳，并在康复期间逐渐将牛奶重新引入饮食中。不过，母乳喂养不应中断。目前尚无足够的科学或流行病学依据来支持在食物补充计划中不鼓励使用牛奶，但文中概述了此类计划中必须考虑的几个方面。
