Suarez F L, Savaiano D A, Levitt M D
Department of Food Science and Nutrition, University of Minnesota, Minneapolis, USA.
Aliment Pharmacol Ther. 1995 Dec;9(6):589-97. doi: 10.1111/j.1365-2036.1995.tb00427.x.
While about 50 million Americans malabsorb lactose, the colonic metabolism of this disaccharide may prevent the symptomatic state known as lactose intolerance. Elucidation of the clinical importance of lactose malabsorption requires comparison of symptoms after ingestion of lactose with those following an identical appearing lactose-free control. This paper reviews the extensive literature concerning lactose-induced symptoms and the value of lactose digestive aids. Poorly controlled studies have suggested that a cup of milk results in appreciable symptoms in the majority of lactase-deficient subjects. In contrast, controlled trials in unselected lactose malabsorbers of subjects claiming severe lactose intolerance indicate that symptoms from a cup of milk are no greater than that with a lactose-hydrolyzed control. An increasing fraction of subjects experience symptoms as the lactose load is increased, with the majority having symptoms when the equivalent of 1 L of milk is ingested as a single dose. Further studies are required to determine the tolerance to several cups of milk taken throughout the day. Available digestive aids include pre-hydrolyzed milk and lactase preparations that can be added to milk (which is then incubated) or ingested with milk. While these products are effective in reducing symptoms, it should be emphasized that there appears to be no need for these preparations when the dosage of milk is limited to one cup per day.
虽然约5000万美国人存在乳糖吸收不良的情况，但这种双糖在结肠的代谢过程可能会预防乳糖不耐受这种症状状态。要阐明乳糖吸收不良的临床重要性，需要比较摄入乳糖后与摄入外观相同的无乳糖对照物后的症状。本文综述了有关乳糖诱发症状及乳糖消化辅助剂价值的大量文献。控制不佳的研究表明，一杯牛奶会使大多数乳糖酶缺乏的受试者出现明显症状。相比之下，在未经挑选的自称严重乳糖不耐受的乳糖吸收不良受试者中进行的对照试验表明，一杯牛奶引起的症状并不比乳糖水解对照物更严重。随着乳糖摄入量增加，出现症状的受试者比例也在上升，当一次性摄入相当于1升牛奶的乳糖量时，大多数人都会出现症状。还需要进一步研究来确定一天内饮用几杯牛奶时的耐受性。现有的消化辅助剂包括预先水解的牛奶和乳糖酶制剂，这些制剂可以添加到牛奶中（然后进行孵育）或与牛奶一起服用。虽然这些产品在减轻症状方面有效，但应该强调的是，当牛奶摄入量限制在每天一杯时，似乎不需要这些制剂。
