title: A combination of acid lactase from Aspergillus oryzae and yogurt bacteria improves lactose digestion in lactose maldigesters synergistically: A randomized, controlled, double-blind cross-over trial.
abstract: OBJECTIVE
  Lactose digestion can be improved in subjects with impaired or completely absent intestinal lactase activity by administration of lactase preparations and particularly of acid lactase, which is active in the stomach, or by yogurt containing live lactic acid bacteria. It is the question, if lactose digestion can be further enhanced by combining these two approaches.
  
  
  METHODS
  We investigated in a randomised, placebo-controlled, double-blind, 5-arm crossover study on 24 lactose malabsorbers with variable degrees of lactase deficiency if different lactase preparations and freeze-dried yogurt culture affect gastrointestinal lactose digestion after consuming moderate amounts of lactose (12.5 g) by assessing hydrogen exhalation over 6 h. Furthermore, symptoms of lactose intolerance (excess gas production, abdominal pain, diarrhoea or nausea) were assessed using validated questionnaires.
  
  
  RESULTS
  All preparations increased lactose digestion and reduced peak hydrogen exhalation by -27% (yogurt), -29/-33% (3300/9000 FCC(1) ((1) One FCC hydrolyses about 5 or 1.7-2.5 mg lactose in aquous solution or in (artificial) chyme, respectively, according to the FCC-III method of the Committee on Codex Specifications, Food and Nutrition Board, National Research Council. Food Chemicals Codex, 3rd edition. Washington, DC, National Academy Press, 1981 It cannot precisely be defined how much lactose can be hydrolysed in vivo by the consumption of a certain number of FCC units.) units acid lactase from Aspergillus oryzae) or -46%, respectively (3300 FCC units lactase plus yogurt culture combined), as compared with placebo (p < 0.001, Friedman test). The combination preparation had not only the strongest effect, but also showed the lowest variance in H(2)-exhalation values (less malabsorbers with no reduction of H(2)-exhalation) Apart from this, both the higher dose lactase and the combination preparation significantly reduced the symptoms most closely associated with H(2)-exhalation, namely flatulences and abdominal pain, respectively.
  
  
  CONCLUSIONS
  The combined administration of freeze-dried yogurt cultures and acid lactase increases lactose digestion more than either freeze-dried yogurt cultures or acid lactase alone, and more lactose malabsorbers benefited from this effect.
authors.affiliation: Institute of Microbiology and Biotechnology, Max Rubner-Institut, Federal Research Centre for Nutrition and Food, Hermann-Weigmann-Straße 1, 24103 Kiel, Germany. Electronic address: michael0devrese@googlemail.com.
authors.forename: Michael
authors.initials: M
authors.lastname: de Vrese
authors.affiliation: Tecura GmbH, Schauenburgerstr. 116, 24118 Kiel, Germany; Clinical Research Center Kiel (CRC), Schauenburgerstr. 116, 24118 Kiel, Germany.
authors.forename: Christiane
authors.initials: C
authors.lastname: Laue
authors.affiliation: Clinical Research Center Kiel (CRC), Schauenburgerstr. 116, 24118 Kiel, Germany.
authors.forename: Birte
authors.initials: B
authors.lastname: Offick
authors.affiliation: Tecura GmbH, Schauenburgerstr. 116, 24118 Kiel, Germany.
authors.forename: Edlyn
authors.initials: E
authors.lastname: Soeth
authors.affiliation: Institute of Microbiology and Biotechnology, Max Rubner-Institut, Federal Research Centre for Nutrition and Food, Hermann-Weigmann-Straße 1, 24103 Kiel, Germany.
authors.forename: Frauke
authors.initials: F
authors.lastname: Repenning
authors.affiliation: Institute of Microbiology and Biotechnology, Max Rubner-Institut, Federal Research Centre for Nutrition and Food, Hermann-Weigmann-Straße 1, 24103 Kiel, Germany.
authors.forename: Angelika
authors.initials: A
authors.lastname: Thoß
authors.affiliation: Clinical Research Center Kiel (CRC), Schauenburgerstr. 116, 24118 Kiel, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Schrezenmeir
mesh_terms: D000328:Adult; D001236:Aspergillus oryzae / Q000201:enzymology*; D001419:Bacteria / Q000201:enzymology*; D018592:Cross-Over Studies; D004063:Digestion; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006859:Hydrogen / Q000378:metabolism; D006868:Hydrolysis; D043322:Lactase / Q000378:metabolism*; D007785:Lactose / Q000378:metabolism*; D007787:Lactose Intolerance / Q000628:therapy*; D008297:Male; D015014:Yogurt / Q000382:microbiology*; D055815:Young Adult
chemical_list: D006859:Hydrogen; D043322:Lactase; D007785:Lactose
keywords: Acid lactase; Lactose digestion; Lactose intolerance; Microbial lactase; Yogurt culture