Nutritional supplements used in weight-reduction programs increase intestinal gas in persons who malabsorb lactose.
OBJECTIVE
To determine if ingestion of 2 doses of milk-based dietary supplements produce gaseous symptoms in subjects who malabsorb lactose.


METHODS
Randomized, controlled, crossover trial.


METHODS
Ten community-based subjects who malabsorb lactose.


METHODS
Ingestion of 2 standard servings of milk-based supplements (a powder reconstituted in fat-free milk or a ready-to-drink preparation) or low-lactose control preparations.


METHODS
Frequency of flatus passage and subjective impression of bloating, flatulence, and abdominal discomfort.


METHODS
Wilcoxon signed-rank test.


RESULTS
The high lactose content (27 g) of 2 servings of the powder-based supplement ingested without other food resulted in a marked increase in daily flatus passages from the basal level of 9.7+/-8.2 to 30+/-14 (mean+/-SD), and a significant increase in the subjects' perception of gas. In contrast, the lower lactose content (18.4 g) of 2 servings of a ready-to-drink supplement resulted in a flatus frequency of 17+/-10 (P=.14 vs baseline) and no significant increase in the perception of increased gas. Neither supplement resulted in a significant increase in bloating, abdominal pain, or diarrhea. The lactose content of the liquid supplement was reduced by 80% following overnight incubation with an over-the-counter lactase preparation.


CONCLUSIONS
Persons who malabsorb lactose should be aware that sizable increases in rectal gas commonly occur when milk-based powders reconstituted in milk are used as meal replacements. In contrast, gas problems probably will be minor following ingestion of 2 doses of a ready-to-drink, milk-based supplement. The lactose content of these supplements can be markedly reduced by overnight incubation with over-the-counter lactase preparations, and this manipulation should be beneficial for subjects troubled by the increased gas caused by the consumption of lactose-containing supplements.
Suarez
F L
FL
Ross Products Division, Abbott Laboratories, Columbus, Ohio, USA.
Zumarraga
L M
LM
Furne
J K
JK
Levitt
M D
MD
D015746:Abdominal Pain; D000328:Adult; D000818:Animals; D001944:Breath Tests; D018592:Cross-Over Studies; D004038:Diet, Reducing / Q000379:methods; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005414:Flatulence / Q000209:etiology*; D005526:Food, Formulated / Q000009:adverse effects*; D006801:Humans; D043322:Lactase; D007785:Lactose / Q000378:metabolism*; D007787:Lactose Intolerance / Q000503:physiopathology*; D008875:Middle Aged; D008892:Milk / Q000378:metabolism; D013025:Glycine max / Q000378:metabolism; D018709:Statistics, Nonparametric; D001616:beta-Galactosidase / Q000008:administration & dosage*
D043322:Lactase; D001616:beta-Galactosidase; D007785:Lactose