LACTOSE DIGESTION CAPACITY AND PERCEIVED SYMPTOMATIC RESPONSE AFTER DAIRY PRODUCT CONSUMPTION IN TOKELAU ISLAND MIGRANTS

When lactose-malabsorbing individuals use dairy products decreased lac tase activity and the subsequent reduction in hydrolysis of ingested l actose can result in gastrointestinal and gaseous symptoms (lactose in tolerance). This article examines lactose malabsorption, perceived gas trointestinal symptoms, and dairy product consumption in a Tokelau Isl and migrant population in New Zealand. Questionnaire data were collect ed and lactose digestion capacity was determined for 58 individuals 15 -71 years of age. Additional questionnaire data were collected for 137 Tokelau migrants, 18-50 years of age. Breath hydrogen analysis indica ted that 63.8% (CI = 51.4-76.2%) of Tokelau migrants were lactose mala bsorbers, while 22.4% (11.7-33.1%) can absorb lactose [results are inc onclusive for 13.8% (4.9-22.7%) of the population]. This was consisten t with results reported for other Polynesian populations. Tokelau Isla nd migrants reported relatively low levels of gastrointestinal distres s after the consumption of dairy products. Less than 50% of those with lactose malabsorption perceived gastrointestinal symptoms after a 50 g of lactose in 300 mi of water, while one third of this group reporte d symptoms after approximately 240 mi (one glass) or less of milk. How ever without confirmation by double-blind studies, it is difficult to state the extent to which symptoms are actually due to lactose. Neithe r the ability to absorb lactose nor perceived gastrointestinal symptom s are associated with the frequency or quantity of dairy product consu mption (P > 0.05). Patterns of dairy product consumption are just as l ikely due to other physiological, psychological, cultural, and social factors. (C) 1997 Wiley-Liss, Inc.