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Developmental changes of lactose malabsorption in normal Chinese children: a study using breath hydrogen test with a
1Division of Pediatric Gastroenterology, National Yang-Ming Medical College, Taipei, Taiwan, R.O.C.
Insights
Lactose malabsorption increases with age in Chinese children, affecting over 70% of adolescents. Preschoolers tolerate lactose well, but school-aged children and teens experience increasing rates of malabsorption and intolerance.
Area of Science:
- Pediatrics
- Gastroenterology
- Human Nutrition
Background:
- Lactose malabsorption is common globally, but prevalence varies significantly across ethnic groups and age demographics.
- Understanding age-related changes in lactose digestion is crucial for pediatric nutrition and managing gastrointestinal discomfort.
- Previous studies on Chinese children's lactose absorption capacity have yielded varied results, necessitating further investigation.
Purpose of the Study:
- To determine the prevalence of lactose malabsorption in healthy Chinese children aged 3–18 years.
- To identify age-specific trends and critical periods for the development of lactose malabsorption.
- To assess the incidence and symptoms of lactose intolerance in different pediatric age groups.
Main Methods:
- A cohort of 726 healthy Chinese children aged 3–18 years participated in the study.
- Lactose malabsorption was assessed using the breath hydrogen test following a physiological lactose load (0.5 g/kg body weight).
- Data on age, malabsorption rates, and reported symptoms of lactose intolerance were collected and analyzed.
Main Results:
- Lactose malabsorption prevalence increased significantly with age, from <15% in preschoolers to ~60% in older school-aged children and ~70% in adolescents.
- A critical age-related shift occurred between 6–7 years, with malabsorption rates rising from 12% to 43%.
- Lactose intolerance incidence was 27% in teenagers and 33% in adolescents, primarily presenting as mild abdominal pain; no intolerance was observed in children under 9 years.
Conclusions:
- Preschool Chinese children can physiologically digest lactose without adverse effects.
- Lactose malabsorption is a significant issue for approximately half of school-aged children and two-thirds of adolescents in China.
- Age-appropriate dietary recommendations regarding lactose intake are essential for Chinese children, particularly from early school age onwards.
Abstract:
The malabsorption of a physiological dose of lactose (0.5 g/kg body weight) was studied in 726 healthy Chinese children, ranging in age from 3 to 18 years, using the breath hydrogen test. The prevalence of lactose malabsorption was found to increase with age; it occurred in less than 15% of preschool-age children and in approximately 45% of younger school-age and 60% of older school-age children. Approximately 70% of adolescents measured showed malabsorption. The critical period of change was from 6 to 7 years of age, with the lactose malabsorption rate rising abruptly from 12 to 43%. The incidence of lactose intolerance in teenagers and adolescents was 27 and 33%, respectively. The great majority of them had only dull abdominal pain. No case of lactose intolerance was seen in children less than 9 years of age. These results indicated that preschool Chinese children can absorb a physiological dose of lactose (equivalent to the average amount of milk consumed daily) without any adverse effects. In contrast, one half of school-age children and two thirds of adolescents were malabsorbers.