Scientific Opinion on lactose thresholds in lactose intolerance and galactosaemia

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Article
Panel on Dietetic Products, Nutrition and Allergies
EFSA Journal
EFSA Journal 2010;8(9):1777 [29 pp.].
doi
10.2903/j.efsa.2010.1777
Panel members at the time of adoption
Carlo Agostoni, Jean-Louis Bresson, Susan Fairweather-Tait, Albert Flynn, Ines Golly, Hannu Korhonen, Pagona Lagiou, Martinus Løvik, Rosangela Marchelli, Ambroise Martin, Bevan Moseley, Monika Neuhäuser-Berthold, Hildegard Przyrembel, Seppo Salminen, Yolanda Sanz, Sean (J.J.) Strain, Stephan Strobel, Inge Tetens, Daniel Tomé, Hendrik van Loveren and Hans Verhagen
Acknowledgements

The Panel wishes to thank the members of the Working Group on Infant Formulae for the preparatory work on this scientific opinion: Carlo Agostoni, Jean-Louis Bresson, Hildegard Przyrembel, Seppo Salminen and Stephan Strobel.

Contact
Type
Opinion of the Scientific Committee/Scientific Panel
On request from
European Commission
Question Number
EFSA-Q-2008-307
Adopted
10 September 2010
Published in the EFSA Journal
24 September 2010
Affiliation
European Food Safety Authority (EFSA), Parma, Italy
Note
Abstract

This Opinion of the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) deals with lactose thresholds in lactose intolerance and galactosaemia. LACTASE DEFICIENCY AND LACTOSE INTOLERANCE: Primary lactase deficiency, also referred to as lactase-nonpersistence (LNP), is genetically determined and a normal, developmental phenomenon characterised by the down-regulation of lactase activity. In adults with LNP, undigested lactose reaches the colon where it can elicit symptoms of lactose intolerance. Lactose tolerance varies widely among individuals with lactose maldigestion. A single threshold of lactose for all lactose intolerant subjects cannot be determined owing to the great variation in individual tolerances. Symptoms of lactose intolerance have been described after intake of less than 6 g of lactose in some subjects. The vast majority of subjects with lactose maldigestion will tolerate up to 12 g of lactose as a single dose with no or minor symptoms. Higher doses may be tolerated if distributed throughout the day. GALACTOSAEMIA: Galactosaemia is caused by three different genetic enzyme defects in the metabolism of galactose. Severe galactosaemia, if untreated, is accompanied by a potentially fatal impairment of hepatic and renal function and with cataracts in the newborn and the young infant. The dietetic principle in the management of all types of galactosaemia is the elimination of all sources of galactose, including human milk, as far as possible. Dietetic management is started with lactose free infant and later follow-on formulae with a lactose content ≤10 mg/100 kcal. In older infants, children and adults, foods containing milk or milk products or lactose as an ingredient must be avoided, as far as possible, so that the overall daily lactose intake will be about 25 mg/100 kcal. A precise threshold for galactose/lactose intake below which adverse effects are not elicited cannot be given.

Keywords
Lactose, lactase, lactase-nonpersistence, galactosaemia, intolerance, threshold
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Number of Pages
29