Ellestad-Sayed J J, Haworth J C
Am J Clin Nutr. 1977 May;30(5):698-703. doi: 10.1093/ajcn/30.5.698.
Twenty-eight Sioux and 29 Saluteaux Indians from a southern and an isolated northern Manitoban community were screened for lactose malabsorption; 55 were also screened for sucrose tolerance. Sixty percent of the subjects were lactose malabsorbers; the incidence increased with age. Lactase deficiency appeared, on the average, between 8 and 15 years of age. About 45% of the subjects were lactose intolerant. Malabsorbers who did not regularly drink milk had the highest symptom scores. The northern subjects consumed significantly more lactose and sucrose than the southern subjects. Two Sioux children were sucrose malabsorbers. It was hypothesized that the significantly greater sucrose consumption by the Saulteaux subjects were responsible for their markedly higher blood glucose curve following the sucrose tolerance tests. Dietary sucrose increases jejunal sucrase activity and the intestinal transport of glucose and fructose. Three of eight children less than 4 years were lactose malabsorbers; hence, medical personnel treating noninjective diarrhea in Indian children should examine for lactase deficiency. It was recommended that vitamin D fortified milk supplements to Indian school children be continued and that the milk be treated so as to reduce abdominal symptoms in the intolerant individuals.
对来自马尼托巴省南部一个社区和北部一个偏远社区的28名苏族印第安人和29名索尔托克斯印第安人进行了乳糖吸收不良筛查;其中55人还进行了蔗糖耐量筛查。60%的受试者存在乳糖吸收不良;发病率随年龄增长而增加。乳糖酶缺乏平均出现在8至15岁之间。约45%的受试者乳糖不耐受。不经常喝牛奶的吸收不良者症状评分最高。北部受试者摄入的乳糖和蔗糖明显多于南部受试者。两名苏族儿童存在蔗糖吸收不良。据推测,索尔托克斯受试者摄入的蔗糖量显著更多,这是他们在蔗糖耐量试验后血糖曲线明显更高的原因。膳食蔗糖会增加空肠蔗糖酶活性以及葡萄糖和果糖的肠道转运。8名4岁以下儿童中有3名存在乳糖吸收不良;因此,治疗印第安儿童非感染性腹泻的医务人员应检查是否存在乳糖酶缺乏。建议继续为印第安学童提供添加维生素D的牛奶补充剂,并对牛奶进行处理,以减轻不耐受个体的腹部症状。