Milk-induced malabsorption in malnourished African patients.
Fifty malnourished rural African patients were randomly assigned to whole milk (50 g lactose/L), acidified milk (24 g lactose/L), or a commercial lactose-free diet (LFD) as a constant nasogastric infusion for 3 d, starting at 2 L/d and increasing to 3 L/d if tolerated. During the first 2 d mild symptoms of intolerance developed in 63% of patients on whole milk, 37% on acidified milk, and 54% on LFD whereas severe intolerance, necessitating withdrawal, was encountered in 22% receiving whole milk and none receiving LFD. Stool weights and fat excretion on day 3 were greater (P less than 0.02) in the remaining milk-fed patients whereas nitrogen balance remained strongly positive in all three groups. Eighty-seven percent of patients were methane producers, and high excretion rates were associated with better milk tolerance. The results suggest that although undiluted cow milk will not form a suitable tube feed for malnourished African patients, products such as acidified milk may prove cost effective.
O'Keefe
S J
SJ
Nutrition Unit, Groote Schuur Hospital, South Africa.
O'Keefe
E A
EA
Burke
E
E
Roberts
P
P
Lavender
R
R
Kemp
T
T
D000328:Adult; D000368:Aged; D000818:Animals; D001944:Breath Tests; D002446:Celiac Disease / Q000209:etiology; D004750:Enteral Nutrition; D005243:Feces / Q000737:chemistry; D005260:Female; D006801:Humans; D006859:Hydrogen / Q000032:analysis; D007787:Lactose Intolerance / Q000150:complications*; D007789:Lactose Tolerance Test; D008297:Male; D008697:Methane / Q000032:analysis; D008875:Middle Aged; D008892:Milk / Q000009:adverse effects*; D009748:Nutrition Disorders / Q000150:complications* / Q000178:diet therapy; D012424:Rural Population; D013019:South Africa
D006859:Hydrogen; D008697:Methane