Inadequate intestinal digestion of lactose

"Milk makes me sick but my body needs it": conflict and contradiction in the establishment of authoritative knowledge

This article takes lactose intolerance as a topic for exploring clashes of power, authority, and knowledge in clinical interactions and interpretations of laywomen. In clinics providing maternal and child care, staff and clients jointly produced authoritative knowledge, most often a version of biomedicine. The Euroamerican staff tended to give advice that was biologically appropriate for them but not for many of their patients, a process reflecting what we refer to as biocentrism. Resulting information given to pregnant and lactating women and diagnoses of children's growth patterns were inappropriate in some cases, with potentially serious legal and health implications. Clinic staff often unwittingly ignored the efforts of their clients to begin a discussion of discrepancies between their bodily knowledge and clinic advice. Some women created their own syntheses, which supported the ascendancy of biomedical knowledge but were not in the interests of their own health.

Anomerization and hydrolysis of lactose by beta-galactosidase from Saccharomyces lactis

Beta-Galactosidase from Saccharomyces lactis was found to be able to catalyze both the anomerization of alpha-lactose and the hydrolysis of beta-lactose; the rate of hydrolysis appeared to be four times higher with a 1:1 mixture of alpha and beta lactose than with a freshly prepared solution of alpha-lactose. The enzyme was also found to be unable to hydrolyze alpha-lactose. Thus, it appears that beta-galactosidase from S. lactis has its hydrolytic activity on lactose adapted only to the naturally more abundant beta-lactose.

Carbohydrate intolerance in infants with acute diarrhoea and its complications

Two hundred and seventy-one infants with acute diarrhoea were studied for the presence of carbohydrate malabsorption and 110 infants (40.6%) were found to have carbohydrate intolerance. Malnutrition and severe diarrhoea were found to increase the predisposition to carbohydrate intolerance. The incidence of major complications, protracted diarrhoea and mortality were significantly higher in the carbohydrate intolerant infants as compared to those with carbohydrate tolerance.

Effect of diet on disaccharidase activity in the chick

1. The influence of diets, particularly dietary carbohydrate, on the development of the intestinal disaccharidases of the chick was studied.

2. The maltase activity in the small intestine was similar in groups of 25-d-old chicks that had been fed, from hatching, on diets containing either starch, glucose, maltose, sucrose, or a mixture of 50% glucose + 50% lactose, as the source of carbohydrate. The sucrase activity in the small intestine was also similar in the different groups, as was the palatinase (the enzyme that hydrolyses palatinose, i.e. 6-o-α-D-glucopyranosyl-D-fructose) activity. The maltase activity in the large intestine of the group receiving the starch-containing diet was significantly increased. The lactase activity in the large intestine was significantly higher in the group receiving the 50% glucose + 50% lactose and in the group receiving glucose than in the other groups. Body- weights were similar with all the diets.

3. The fasting of chicks for a period of 3 d caused a marked decrease in the activity of the disaccharidases and in the protein content of the homogenates of the small intestine.

4. The maltase activity was similar in the small intestine of chicks that had been fasted for 3 d and subsequently given diets containing either starch, glucose, maltose, sucrose or fructose for 5 d. The sucrase activity, the isomaltase activity and the palatinase activity were also similar in the small intestine of the chicks given the different diets. Feeding with a fat-free or protein-free diet did not affect the development of disaccharidases in the small intestine, but feeding with a carbohydrate-free diet resulted in reduced disaccharidase activity.

5. The results suggest that, in the chick, dietary carbohydrate is necessary for the development of the disaccharidases but the form of the carbohydrate is not important. None of the sugars tested had a specific effect on a particular disaccharidase.

Lactose absorption and mucosal disaccharidases in convalescent pellagra and kwashiorkor children

Oral lactose and glucose/galactose loading tests were done in Bantu children convalescing from kwashiorkor and pellagra. Small bowel biopsies and disaccharidase estimations were performed in all except 2 patients. Lactose absorption was more impaired and intestinal lactase levels were lower in the pellagra than in the kwashiorkor group. The fact that diarrhoea after admission to hospital was less common in pellagra than kwashiorkor was ascribed to a lesser lactose load due to the early introduction of a mixed diet in the former group, in comparison with milk feeds only in the latter group. The absence of troublesome diarrhoea while on moderate quantities of lactose in the diet, in the presence of low intestinal lactase levels, but evidence of lactose malabsorption after loading, has a bearing on preventive and therapeutic nutrition programmes in non-Caucasian children. Lactase deficiency is not necessarily synonymous with symptomatic lactose intolerance if the threshold is not exceeded. Concern is expressed that excessive caution against the use of milk may lead to a worsening of infantile malnutrition in developing countries.