Fl. Suarez et al., Nutritional supplements used in weight-reduction programs increase intestinal gas in persons who malabsorb lactose, J AM DIET A, 101(12), 2001, pp. 1447-1452
Objective To determine if ingestion of 2 doses of milk-based dietary supple
ments produce gaseous symptoms in subjects who malabsorb lactose.
Design Randomized, controlled, crossover trial.
Subjects/setting Ten community-based subjects who malabsorb lactose.
Intervention Ingestion of 2 standard servings of milk-based supplements (a
powder reconstituted in fat-free milk or a ready-to-drink preparation) or l
ow-lactose control preparations.
Main outcome measures Frequency of flatus passage and subjective impression
of bloating, flatulence, and abdominal discomfort.
Statistical analysis Wilcoxon signed-rank test.
Results The high lactose content (27 g) of 2 servings of the powder-based s
upplement ingested without other food resulted in a marked increase in dail
y 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 con
trast, 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 su
pplement 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, vith an over-the-counter lactase preparatio
n.
Applications/conclusions Persons who malabsorb lactose should be aware that
sizable increases in rectal gas commonly occur when milk-based powders rec
onstituted 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 mar
kedly reduced by overnight incubation with over-the-counter lactase prepara
tions, and this manipulation should be beneficial for subjects troubled by
the increased gas caused by the consumption of lactose-containing supplemen
ts.