Lactose Intolerance versus Cow's Milk Allergy in Infants: A Clinical Dilemma

Cow milk protein allergy mimics in infancy

Cow milk protein allergy (CMPA) is a prevalent food allergy in infancy. It often presents with symptoms that overlap with other conditions, such as gastroesophageal reflux disease, lactose intolerance, food protein-induced enterocolitis syndrome, and eosinophilic esophagitis. This diagnostic overlap makes distinguishing CMPA from its mimics difficult, resulting in potential misdiagnoses and unnecessary dietary restrictions. This review aims to comprehensively analyze CMPA and its mimicking conditions, highlighting their clinical presentations, diagnostic approaches, and management strategies to enhance diagnostic accuracy and optimize patient care. A systematic literature search was conducted using PubMed, Scopus, Web of Science, and Google Scholar, focusing on studies published within the last 20 years. Articles addressing CMPA and its mimicking conditions were selected, with data synthesized into comparative analyses of diagnostic methods and management strategies. Accurate differentiation between CMPA and its mimics requires a thorough clinical evaluation supported by diagnostic tests such as skin prick tests, serum-specific IgE, and oral food challenges. Misdiagnosis can lead to nutritional deficiencies, psychological stress, and increased healthcare costs. Emerging diagnostic technologies, including component-resolved diagnostics and cytokine profiling, offer promising avenues for improving accuracy. A multidisciplinary approach involving pediatricians, allergists, and dietitians is essential for precise diagnosis and effective management. Ongoing research and education are crucial to enhancing clinical outcomes and reducing the burden on families.

Benefits of Camel Milk over Cow and Goat Milk for Infant and Adult Health in Fighting Chronic Diseases: A Review

The nutritional composition, antimicrobial properties, and health benefits of camel milk (CAM), cow milk (COM), and goat milk (GOM) have been extensively studied for their roles in managing diabetes and cardiovascular diseases (CVD). This review compares these milk types' nutritional and therapeutic properties, emphasizing their applications in chronic disease management. CAM is rich in insulin-like proteins, vitamins, minerals, and bioactive compounds that benefit glycemic control and cardiovascular health. It also exhibits potent antioxidants, anti-inflammatory, and lipid-lowering effects, which are crucial for managing diabetes and reducing CVD risk factors. While COM and GOM provide essential nutrients, their impact on metabolic health differs. GOM is known for its digestibility and antihypertensive properties, whereas COM's higher lactose content may be less suitable for diabetic patients. CAM's unique nutritional profile offers distinct therapeutic benefits, particularly for diabetes and CVD management. Further research is needed to clarify its mechanisms of action and optimize its clinical application for chronic disease prevention and management.

Advancements in emulsion systems for specialized infant formulas: Research process and formulation proposals for optimizing bioavailability of nutraceuticals

With the rapid advancements in nutrition and dietary management, infant formulas for special medical purposes (IFSMPs) have been developed to cater to the unique nutraceutical requirements of infants with specific medical conditions or physiological features. However, there are various challenges in effectively preserving and maximizing the health benefits of the specific nutraceuticals incorporated in IFSMPs. This review provides an overview of the nutritional compositions of various IFSMPs and highlights the challenges associated with the effective supplementation of specific nutraceuticals for infants. In addition, it emphasizes the promising potential of emulsion delivery systems, which possess both encapsulation and delivery features, to significantly improve the solubility, stability, oral acceptance, and bioavailability (BA) of nutraceutical bioactives. Based on this information, this work proposes detailed strategies for designing and developing model IFSMP emulsions to enhance the BA of specially required nutraceuticals. Key areas covered include emulsion stabilization, selective release mechanisms, and effective absorption of nutraceuticals. By following these proposals, researchers and industry professionals can design and optimize emulsion-based IFSMPs with enhanced health benefits. This review not only outlines the developmental states of IFSMP formulations but also identifies future research directions aimed at improving the physiological health benefits of IFSMPs. This effort lays the theoretical groundwork for the further development of emulsion-type IFSMP in infant formula (IF) industry, positioning the IF industry to better meet the complex needs of infants requiring specialized nutrition.

Quality and Quantity of School Lunch in Nanjing: Based on Data from the Sunshine Restaurant Supervision Platform

School lunch plays an important role in children's healthy growth. Previous investigations revealed many problems with school lunches, including unreasonable dietary structure and insufficient micronutrients. This study aimed to assess the dietary structure and nutritional quality of lunches in Nanjing primary and middle schools. A stratified cluster random sampling method was used to select 44 schools that supply lunch in 12 districts in Nanjing, with two primary and two middle schools in each district. Twenty-four primary and twenty middle schools were selected. The Mann-Whitney U test was used to explore the influencing factors. Findings revealed a serious shortage of milk and fruit in school lunches; supply of eggs, fish, shrimp, and shellfish was less than half of the recommended quantity; livestock and poultry supply exceeded the recommended level by over four times. Energy and nutrition intake were suboptimal. Provision of energy, carbohydrates, vitamins (A, B1, B2, and C), calcium, and iron in urban primary schools was significantly higher than that in non-urban primary schools. The same pattern of significantly higher nutrients was equally seen in urban middle schools compared with non-urban middle schools, indicating that food supply was affected by regional economies. Therefore, it is urgent to improve the quality of lunches, with a particular focus on those in non-urban areas.

Risks of dairy derived excipients in medications for lactose intolerant and cow milk protein allergic patients

The use of lactose and cow milk protein (CMP) as potential allergens in pharmaceuticals and their ability to cause allergic reactions remains a significant concern in medicine. Lactose, a common pharmaceutical excipient due to its inert, inexpensive, and stable properties, is found in many prescription-only and over-the-counter medications. However, despite their widespread use, individuals with lactose intolerance (LI) or cow milk protein allergy (CMPA) may experience adverse reactions to these excipients. This study investigated the prevalence of lactose and other dairy-derived ingredients in pharmaceuticals marketed in Portugal. Using the Summary of Product Characteristics (SmPC) from the INFOMED database, various medications, including analgesics, antipyretics, non-steroidal anti-inflammatory drugs (NSAIDs), and antiasthmatics, were analyzed. Results showed a high prevalence of dairy-derived excipients, particularly in antiasthmatic drugs (62.6%) and NSAIDs (39%). Although CMP are not explicitly mentioned in SmPCs, the presence of lactose as an ingredient poses a risk of cross-contamination. The findings emphasize the need for healthcare professionals to be aware of potential allergens in medications and the importance of developing lactose-free alternatives to ensure the safety of patients with LI and CMPA. Further research is required to assess the safety and implications of lactose in medicines for these populations.