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Lactose maldigestion: increased age-related prevalence in institutionalized children
1Department of Pediatrics and Child Health, Faculty of Medicine, University of Natal, Durban, Republic of South Africa.
Insights
Institutionalized children show a significantly higher prevalence of lactose maldigestion compared to controls, even in younger age groups. This condition persisted and had no nutritional impact despite regular milk intake.
Area of Science:
- Pediatrics
- Gastroenterology
- Nutritional Science
Background:
- Lactose maldigestion prevalence increases with age in healthy children.
- Institutionalized children may have different nutritional and health profiles.
- Previous malnutrition does not exclude children from this study.
Purpose of the Study:
- To determine if age-related lactose maldigestion prevalence is higher in healthy institutionalized children.
- To compare lactose maldigestion rates between institutionalized and control children.
- To assess the nutritional impact of lactose maldigestion in institutionalized children.
Main Methods:
- Fasting breath hydrogen tests were conducted after oral lactose administration (1 g/kg).
- Lactose maldigestion was defined as a breath hydrogen increase ≥ 20 ppm.
- Anthropometric measurements compared institutionalized children with controls.
Main Results:
- 39 of 49 institutionalized children (78.8%) and 22 of 44 controls (50%) were lactose maldigesters (p < 0.01).
- Institutionalized children under 5 had a significantly higher prevalence (78.8%) than controls in the same age group.
- Lactose maldigestion was persistent in most study children and had no nutritional impact.
Conclusions:
- Institutionalized children exhibit an elevated prevalence of lactose maldigestion, irrespective of age.
- The distinction between acquired and primary lactose maldigestion is not practically significant in this population.
- Persistent lactose maldigestion did not negatively affect nutritional status in institutionalized children with regular milk intake.
Abstract:
A study was performed to determine whether the age-related prevalence of lactose maldigestion is increased in healthy institutionalized children. Previous malnutrition did not exclude children from study. The control children had no prior history of malnutrition or hospital admissions for diarrhea. The anthropometric comparison showed the institutionalized children to be shorter and lighter than the controls, but they were of normal weight by stature, suggesting a normal recent nutritional state. Fasting breath hydrogen tests were performed following an oral dose of lactose 1 g/kg, given as a 10% solution. A rise of breath hydrogen of greater than or equal to 20 ppm was considered to indicate lactose maldigestion. Twenty-two of 44 controls and 39 of 49 study children were lactose maldigesters (p less than 0.01). The control children showed an age-related increase in the prevalence of lactose maldigestion, from 31.6% at age less than 5 years to 75% at age greater than 9 years. The institutionalized children, by comparison had an increased prevalence of 78.8% in the group under 5 years of age (p = 0.002). Equally high prevalence rates were found at all ages tested. At follow-up, lactose maldigestion was persistent in the majority of the study children. This had no nutritional impact despite a regular milk intake. The distinction between acquired and primary lactose maldigestion is of no practical significance in these children.