Vesa T H, Marteau P R, Briet F B, Boutron-Ruault M C, Rambaud J C
INSERM U290, Hôpital St. Lazare, Paris, France.
J Nutr. 1997 Dec;127(12):2316-20. doi: 10.1093/jn/127.12.2316.
Lactose digestion improves when the energy content of a meal is raised, perhaps due to delayed gastric emptying; however, this has not been demonstrated directly. It is not known whether lactose-intolerant subjects should consume full-fat or high energy milk instead of half-skimmed milk. In this study, breath 13CO2 and hydrogen (H2) measurements were combined to assess simultaneously the effect of increasing milk energy content on gastric emptying, digestion, and tolerance of lactose. On two separate days, 11 adult lactose maldigesters ingested, in the fasting state, a single dose of 710 kJ half-skimmed milk or 1970 kJ high energy milk. Both contained 18 g lactose and were supplemented with 100 mg 13C-glycine for breath 13CO2 measurement. For 6 h after milk ingestion, samples of expired breath were collected, and subjects scored their symptoms on a four-grade questionnaire. Gastric emptying was measured from excretion of breath 13CO2. The mean gastric emptying half-time was significantly longer after ingestion of high energy milk than after half-skimmed milk (84 +/- 4 vs. 64 +/- 4 min, P = 0.004). The mean area under the breath H2 excretion curve measured for 6 h was 330 +/- 61 microL/L after subjects consumed high energy milk vs. 470 +/- 82 microL/L after they consumed half-skimmed milk (P = 0.07). Mean symptom scores did not differ after ingestion of the two milks, but only two subjects experienced disturbing symptoms after high energy milk ingestion compared with five subjects after ingestion of half-skimmed milk (P = 0.56). Although ingestion of high energy milk delayed the gastric emptying of lactose for significantly longer than the ingestion of half-skimmed milk (P < 0.01), it did not lead to significant improvement in symptoms and reflected only a trend toward improved lactose digestion (P = 0.07), as measured by the area under the breath H2 excretion curve. These results indicate that it is not beneficial for most lactose-intolerant subjects to replace consumption of half-skimmed milk by milk with a higher energy content.
当一餐的能量含量增加时，乳糖消化会得到改善，这可能是由于胃排空延迟所致；然而，这一点尚未得到直接证实。目前尚不清楚乳糖不耐受的受试者是应该饮用全脂或高能量牛奶，还是饮用半脱脂牛奶。在本研究中，结合测量呼出气体中的13CO2和氢气（H2），以同时评估增加牛奶能量含量对乳糖胃排空、消化和耐受性的影响。在两个不同的日子里，11名成年乳糖消化不良者在空腹状态下，分别单次摄入710千焦的半脱脂牛奶或1970千焦的高能量牛奶。两种牛奶均含有18克乳糖，并添加了100毫克13C-甘氨酸用于呼出气体13CO2测量。在摄入牛奶后的6小时内，收集呼出气体样本，受试者根据四级问卷对自身症状进行评分。通过呼出气体13CO2的排出情况来测量胃排空。摄入高能量牛奶后的平均胃排空半衰期显著长于摄入半脱脂牛奶后（84±4分钟对64±4分钟，P = 0.004）。受试者饮用高能量牛奶后，测量6小时的呼出气体H2排出曲线下的平均面积为330±61微升/升，而饮用半脱脂牛奶后为470±82微升/升（P = 0.07）。摄入两种牛奶后的平均症状评分没有差异，但饮用高能量牛奶后只有两名受试者出现不适症状，而饮用半脱脂牛奶后有五名受试者出现不适症状（P = 0.56）。尽管摄入高能量牛奶比摄入半脱脂牛奶显著延迟了乳糖的胃排空时间（P < 0.01），但症状并未得到显著改善，且仅通过呼出气体H2排出曲线下的面积测量显示出乳糖消化改善的趋势（P = 0.07）。这些结果表明，对于大多数乳糖不耐受的受试者而言，用能量含量更高的牛奶替代半脱脂牛奶并无益处。
