title: [Lactose intolerance: past and present. Part II].
abstract: The author summarises the interrelations between lactose intolerance, calcium and vitamin D metabolism and osteoporosis. Lactose intolerance enhances the risk of forearm and hip fractures in some patients. Lactase gene genotype and fracture risk are related in some populations. Calcium and vitamin D supplementation increase bone mineral content and they are justified in children, during pregnancy and lactation, and in postmenopausal women. The intake of milk and milk products could increase the risk of ovarian carcinoma. CC genotype of the lactase gene increased the risk of colorectal carcinoma in Finns; no such effect was observed in British, Spanish and Italian patients. Even small quantities of lactose in drugs (10-750 mg) could elicit intolerance symptoms due to individual susceptibility. In spite of public knowledge and advertising, controlled studies did not prove the beneficial effect of either a lactose-free diet, enzyme supplementation or probiotics in an evidence-based manner. While accepted guidelines are lacking, a personalised therapy is mandatory. In spite of increasing public interest in lactose intolerance, many unknown factors must still be studied.
authors.affiliation: Ferencvárosi Egészségügyi Szolgáltató Kiemelten Közhasznú Nonprofit Kft. Budapest, Mester u. 45., 1095.
authors.forename: György Miklós
authors.initials: GM
authors.lastname: Buzás
mesh_terms: D000818:Animals; D015519:Bone Density / Q000187:drug effects; D002136:Calcium, Dietary / Q000008:administration & dosage / Q000378:metabolism*; D003611:Dairy Products / Q000009:adverse effects; D019587:Dietary Supplements; D004066:Digestive System Diseases / Q000188:drug therapy; D016527:Drug Costs; D019317:Evidence-Based Medicine; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D006814:Hungary; D043322:Lactase / Q000627:therapeutic use*; D007785:Lactose / Q000008:administration & dosage / Q000009:adverse effects*; D007787:Lactose Intolerance / Q000150:complications* / Q000188:drug therapy* / Q000191:economics / Q000209:etiology / Q000378:metabolism; D058866:Osteoporotic Fractures / Q000209:etiology / Q000378:metabolism* / Q000517:prevention & control; D010051:Ovarian Neoplasms / Q000209:etiology; D057285:Precision Medicine; D012307:Risk Factors; D012952:Societies; D014807:Vitamin D / Q000008:administration & dosage / Q000378:metabolism*
chemical_list: D002136:Calcium, Dietary; D014807:Vitamin D; D043322:Lactase; D007785:Lactose
keywords: daganatok; enzimpótlás; enzyme supplementation; lactose; laktóz; osteoporosis; probiotics; probiotikumok; tumours