Prevalence of Primary Adult Lactose Malabsorption in Pakistan

Siddique, M.; Flatz, G.

doi:10.1159/000153439

Cited by 7 publications

(2 citation statements)

References 13 publications

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“…Similar results were obtained with the lactose tolerance test where 88.2% Southern Indians and 66.2% Northern Indians ( P = 0.001) were lactase deficient . An earlier published study conducted on northern “Indian” patients in Panjab, Pakistan, showed similar results, with a prevalence of LD of 60% . This difference has some genetic basis as many Northern Indians have a Caucasian background compared to Southern Indians, who are mainly Dravidians.…”

Section: Discussionsupporting

confidence: 79%

Lactase deficiency and lactose intolerance in a multiracial Asian population in Malaysia

2018

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Background and AimsThere have been few reports on lactase deficiency (LD) and lactose intolerance (LI) in Malaysia, which has a peculiar mix of three distinct major Asian races—Malay, Chinese, and Indian. The aim of this study was to determine the prevalence of LD and LI in a young multiethnic Malaysian population.MethodsLactase activity was measured with a 13CO2 lactose breath test using an infrared spectrometer. Each subject took 25 g of lactose naturally enriched in 13CO2 together with 250 mL of water after an overnight fast. Breath samples were collected at baseline and at 15‐min intervals for 180 min. Subjects were asked to report gastrointestinal (GI) symptoms following ingestion of the lactose test meal.ResultsOf the 248 subjects tested, 216 (87.1%) were lactase deficient. We found no significant differences in the presentation of LD between gender and races. LD was found in 87.5% of males and 86.8% of females (P = 0.975) and in different races: Chinese (88.5%) versus Malay (83.1%) (P = 0.399), Indian (90.5%) versus Malay (P = 0.295), and Chinese versus Indian (P = 0.902). LI was diagnosed in only 49 (19.8%) subjects; 35 patients had diarrhea, while the remainder had at least two other GI symptoms after the lactose meal.ConclusionThe prevalence of LD was high in all three major ethnic groups—Malays, Chinese, and Indians. Ironically, the prevalence of LI was low overall.

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Section: Discussionsupporting

confidence: 79%

Lactase deficiency and lactose intolerance in a multiracial Asian population in Malaysia

2018

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“…After milk-based pastoralism had been adopted as a means of subsistence, high LDC would have enabled adults to consume more fresh milk and to derive a nutritional benefit from the lactose component of fresh milk, and so be selected for. The initial frequency of the cultural trait of milk consumption may therefore be virtually 100%, which could reduce the selection coefficient required Rab and Baseer (1976), Ahmad and Flatz (1984), Abbas and Ahmad (1983) Russians ( Pena Yanez et al (1971Yanez et al ( , 1972 Swazi ( Cook and Dahlquist (1968), Cook and Kajubi (1966), Cox and Elliott (1974), Elliott et al (1973) Xhosa ( for the lactase persistence gene to reach observed frequencies in the time available. In this case these traits would not be truly coevolutionary, because selection for milk consumption would not depend on the gene for lactase persistence.…”

Section: Selective Pressures For Drinking Milkmentioning

confidence: 99%

Phylogenetic Analysis of the Evolution of Lactose Digestion in Adults

2009

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In most of the world's population the ability to digest lactose declines sharply after infancy. High lactose digestion capacity in adults is common only in populations of European and circum-Mediterranean origin and is thought to be an evolutionary adaptation to millennia of drinking milk from domestic livestock. Milk can also be consumed in a processed form, such as cheese or soured milk, which has a reduced lactose content. Two other selective pressures for drinking fresh milk with a high lactose content have been proposed: promotion of calcium uptake in high-latitude populations prone to vitamin-D deficiency and maintenance of water and electrolytes in the body in highly arid environments. These three hypotheses are all supported by the geographic distribution of high lactose digestion capacity in adults. However, the relationships between environmental variables and adult lactose digestion capacity are highly confounded by the shared ancestry of many populations whose lactose digestion capacity has been tested. The three hypotheses for the evolution of high adult lactose digestion capacity are tested here using a comparative method of analysis that takes the problem of phylogenetic confounding into account. This analysis supports the hypothesis that high adult lactose digestion capacity is an adaptation to dairying but does not support the hypotheses that lactose digestion capacity is additionally selected for either at high latitudes or in highly arid environments. Furthermore, methods using maximum likelihood are used to show that the evolution of milking preceded the evolution of high lactose digestion.

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Genetics of Lactose Digestion in Humans

Flatz

1987

Advances in Human Genetics

106

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Prevalence of Primary Adult Lactose Malabsorption in Pakistan

Cited by 7 publications

References 13 publications

Lactase deficiency and lactose intolerance in a multiracial Asian population in Malaysia

Lactase deficiency and lactose intolerance in a multiracial Asian population in Malaysia

Phylogenetic Analysis of the Evolution of Lactose Digestion in Adults

Genetics of Lactose Digestion in Humans

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