Bayless Theodore M, Brown Elizabeth, Paige David M
Meyerhoff Digestive Diseases-Inflammatory Bowel Disease Center, Gastroenterology Division, Johns Hopkins University School of Medicine, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD, 21287, USA.
, 800 A Southerly Road, # 1122, Towson, MD, 21286, USA.
Curr Gastroenterol Rep. 2017 May;19(5):23. doi: 10.1007/s11894-017-0558-9.
To evaluate the clinical and nutritional significance of genetically determined lactase non-persistence and potential lactose and milk intolerance in 65-70% of the world's adult population.
Milk consumption is decreasing in the USA and is the lowest in countries with a high prevalence of lactase non-persistence. The dairy industry and Minnesota investigators have made efforts to minimize the influence of lactose intolerance on milk consumption. Some lactose intolerant individuals, without co-existent irritable bowel syndrome, are able to consume a glass of milk with a meal with no or minor symptoms. The high frequency of lactase persistence in offspring of Northern European countries and in some nomadic African tribes is due to mutations in the promoter of the lactase gene in association with survival advantage of milk drinking. Educational and commercial efforts to improve calcium and Vitamin D intake have focused on urging consumption of tolerable amounts of milk with a meal, use of lowered lactose-content foods including hard cheeses, yogurt, and lactose-hydrolyzed milk products.
评估全球65% - 70%成年人口中由基因决定的乳糖酶不持续性以及潜在的乳糖和牛奶不耐受的临床和营养意义。
美国的牛奶消费量正在下降,在乳糖酶不持续性患病率高的国家中牛奶消费量最低。乳制品行业和明尼苏达的研究人员已努力将乳糖不耐受对牛奶消费的影响降至最低。一些没有同时患有肠易激综合征的乳糖不耐受个体,能够在进餐时饮用一杯牛奶而不出现症状或仅有轻微症状。北欧国家的后代以及一些非洲游牧部落中乳糖酶持续性的高频率是由于乳糖酶基因启动子的突变与饮用牛奶的生存优势相关。为提高钙和维生素D摄入量所做的教育和商业努力集中在敦促进餐时饮用适量可耐受的牛奶、使用低乳糖含量的食物,包括硬奶酪、酸奶和乳糖水解奶制品。