NIH consensus development conference statement: Lactose intolerance and health.
OBJECTIVE
To provide health care providers, patients, and the general public with a responsible assessment of currently available data on lactose intolerance and health.


METHODS
A non-DHHS, nonadvocate 14-member panel representing the fields of internal medicine, pediatrics, pediatric and adult endocrinology, gastroenterology, hepatology, neonatology and perinatology, geriatrics, racial/ethnic disparities, radiology, maternal and fetal nutrition, vitamin and mineral metabolism, nutritional sciences, bone health, preventive medicine, biopsychology, biostatistics, statistical genetics, epidemiology, and a public representative. In addition, 22 experts from pertinent fields presented data to the panel and conference audience.


METHODS
Presentations by experts and a systematic review of the literature prepared by the University of Minnesota Evidence-based Practice Center, through the Agency for Healthcare Research and Quality. Scientific evidence was given precedence over anecdotal experience.


METHODS
The panel drafted its statement based on scientific evidence presented in open forum and on published scientific literature. The draft statement was presented on the final day of the conference and circulated to the audience for comment. The panel released a revised statement later that day at http://consensus.nih.gov. This statement is an independent report of the panel and is not a policy statement of the NIH or the Federal Government.


CONCLUSIONS
• Lactose intolerance is a real and important clinical syndrome, but its true prevalence is not known. • The majority of people with lactose malabsorption do not have clinical lactose intolerance. Many individuals who think they are lactose intolerant are not lactose malabsorbers. • Many individuals with real or perceived lactose intolerance avoid dairy and ingest inadequate amounts of calcium and vitamin D, which may predispose them to decreased bone accrual, osteoporosis, and other adverse health outcomes. In most cases, individuals do not need to eliminate dairy consumption completely. • Evidence-based dietary approaches with and without dairy foods and supplementation strategies are needed to ensure appropriate consumption of calcium and other nutrients in lactose-intolerant individuals. • Educational programs and behavioral approaches for individuals and their healthcare providers should be developed and validated to improve the nutrition and symptoms of individuals with lactose intolerance and dairy avoidance.
Suchy
Frederick J
FJ
Jack and Lucy Clark Department of Pediatrics, Mount Sinai School of Medicine of New York University, Mount Sinai Kravis Children’s Hospital, New York, New York , USA.
Brannon
Patsy M
PM
Carpenter
Thomas O
TO
Fernandez
Jose R
JR
Gilsanz
Vicente
V
Gould
Jeffrey B
JB
Hall
Karen
K
Hui
Siu L
SL
Lupton
Joanne
J
Mennella
Julie
J
Miller
Natalie J
NJ
Osganian
Stavroula Kalis
SK
Sellmeyer
Deborah E
DE
Wolf
Marshall A
MA
D035843:Biomedical Research / Q000639:trends; D003611:Dairy Products / Q000009:adverse effects; D019317:Evidence-Based Medicine; D005247:Feeding Behavior; D006304:Health Status; D006801:Humans; D007787:Lactose Intolerance / Q000178:diet therapy / Q000453:epidemiology / Q000517:prevention & control; D009315:National Institute of Mental Health (U.S.); D010024:Osteoporosis / Q000517:prevention & control; D010353:Patient Education as Topic; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States / Q000453:epidemiology