Comparative effects of exogenous lactase (?-galactosidase) preparations onin vivo lactose digestion

Abstract

Microbial-derived beta-galactosidase (beta-gal) enzyme preparations improve in vivo lactose digestion and tolerance through enhanced gastrointestinal digestion of lactose. Three different beta-gal preparations, Lactogest (soft gel capsule), Lactaid (caplet), and DairyEase (chewable tablet) and placebo were fed to lactose maldigesters with either 20 g or 50 g of lactose to compare the efficacy of these products and to further establish a dose-response relationship for use. All enzyme preparations dramatically reduced both the peak and total breath hydrogen production when fed with milk containing 20 g of lactose. Four capsules of Lactogest, two caplets of Lactaid, or two tablets of DairyEase (each treatment containing approx 6000 IU) reduced total hydrogen production significantly (P < 0.05) below that observed with two capsules of Lactogest (containing approx 3000 IU) in a stoichiometric manner. Symptoms were significantly (P < 0.05) less severe with all the beta-gal products. In contrast, with 50 g of lactose in water, peak and total hydrogen production was modestly, but not significantly reduced by the enzyme treatment. Furthermore, symptom scores for bloating, cramping, nausea, pain, diarrhea, and flatus were not different between treatments and the control. The 50-g lactose dose appeared to overwhelm the ability of either 3000 or 6000 IU of beta-gal to assist significantly with lactose digestion. Results from these studies demonstrate the relative equivalency of chewable, caplet, and soft-gel beta-gal products, based on IUs of enzyme fed.

Effect of exogenous β-galactosidase in patients with lactose malabsorption and intolerance: a crossover double-blind placebo-controlled study

“…Initially, this approach was judged as not practical because of the necessity to add the enzyme some hours before milk consumption (Rask Pedersen et al, 1982;Onwulata et al, 1989;Lin et al, 1993). Other studies, carried out to resolve this matter, have demonstrated the efficacy of the lactase also when added at mealtime (Solomons et al, 1985a, b;Barillas & Solomons, 1987;Corazza et al, 1992).…”

“…However, this restriction leads to a reduction of intake of substances such as calcium, phosphorus and vitamins, and may associate with decreased bone mineral density (Solomons et al, 1985a, b;Di Stefano et al, 2002). To overcome these limits, in the last years, several approaches have been studied: drugs that increase contact time between enzyme and substrate, either delaying orocoecal transit (ie loperamide) (Szilagyi et al, 1996(Szilagyi et al, , 2000 or delaying gastric emptying (ie propantheline) (Peuhkuri et al, 1999); continuous lactose consumption to induce colonic adaptation (Briet et al, 1997); substitutes for milk (Swagerty et al, 2002); yogurt and probiotics for their bacterial bgalactosidase activity (Onwulata et al, 1989;Saltzman et al, 1999); addition of exogenous lactase to the milk before its consumption (Solomons et al, 1985a, b;Barillas & Solomons, 1987;Corazza et al, 1992;Lin et al, 1993). In particular, replacement therapy resulted in an efficacious strategy; nevertheless, only few double-blind and/or placebo-controlled trials have been performed.…”

Purification and properties of a β-galactosidase with potential application as a digestive supplement

“…Digestive supplementation with exogenous lactase is the principal treatment for alleviating symptoms of lactose intolerance (2). Numerous clinical studies with such lactase supplements have reported largely limited success in treating this condition (3)(4)(5).…”

Probiotics and Lactose Intolerance

“…This effect persists after the intervention is ceased [24]. Other probiotic strains have shown beneficial effects on lactose digestion and symptoms in lactase deficient persons [12,25,26]. Further investigation with different strains of bifidobacteria or lactobacilli on symptoms of lactose intolerance showed contradictory results.…”