Milk intolerance in Manitoba Indian school children

The breath H2 test was used to determine the prevalence of milk intolerance in Indian schoolchildren, 5 to 19 years old. One hundred four children were randomly assigned to one of six groups: 1) reconstituted skimmed milk powder (SMP); 2) SMP and sandwich; 3) SMP and lactase; 4) diluted (1:1) evaporated whole milk (EM); 5) EM and sandwich; and 6) EM and lactase. Samples of expired air were collected 2 hr after ingestion of 245 ml of milk. Five children had H2 levels suggestive of appreciable lactose malabsorption; two had symptoms. The mean H2 excretion levels of the subjects on SMP were significantly higher than those on EM. The group on SMP alone excreted significantly more H2 than any other group except those receiving SMP and a sandwich. The relatively low prevalence of milk intolerance in this populatin group should not preclude continuation and promotion of milk programs in their schools. However, preference should be given to the use of EM rather than SMP. The needs of children who cannot hydrolyze lactose must also be considered in the planning of food supplement programs.