Authorised EU health claims related to the management of lactose intolerance: Reduced lactose content, dietary lactase supplements and live yoghurt cultures

Foods, Nutrients and Food Ingredients with Authorised EU Health Claims

Volumn 1, Issue , 2014, Pages 177-211

  Kies, A K ^a  

^a DSM BIOTECHNOLOGY CENTER   (Netherlands)

Author keywords

Lactase; Lactose intolerance (LI); Lactose reduced dairy; Yoghurt cultures

Indexed keywords

EID: 84943739593     PISSN: None     EISSN: None     Source Type: Book    
DOI: 10.1533/9780857098481.3.177     Document Type: Chapter

References (128)

1. Adolfsson O., Meydami S.N., Russell R.M. Yoghurt and gut function. Am J Clin Nutr 2004, 80:245-256.
2. Alavi A.K., Squillante E., Mehta K.A. Formulation of enterosoluble microparticles for an acid labile protein. J Pharm Pharmaceut Sci 2002, 5:234-244.
3. Atkinson F.S., Foster-Powell K., Brand-Miller J.C. International tables of glycemic index and glycemic load values: 2008. Diab Care 2008, 31:2281-2283.
4. Barillas C., Solomons N.W. Effective reduction of lactose maldigestion in preschool children by direct addition of beta-galactosidases to milk at mealtime. Pediatrics 1987, 79:766-772.
5. Bayoumi R.A.L., Flatz S.D., Kühnau W., Flatz G. Beja and Nilotes: nomadic pastoralist groups in the Sudan with opposite distributions of the adult lactase phenotypes. Am J Phys Anthropol 1982, 58:173-178.
6. Bedine M.S., Bayless T.M. Intolerance of small amounts of lactose by individuals with low lactase levels. Gastroenterology 1973, 65:735-743.
7. Berg N.O., Dahlqvist A., Lindberg T., Studnitz W. Severe familial lactose intolerance - a gastrogen disorder?. Acta Paediatr Scand 1969, 58:525-527.
8. Biller J.A., King S., Rosenthal A., Grand R.J. Efficacy of lactase-treated milk for lactose-intolerant pediatric patients. J Pediatr 1987, 111:91-94.
9. Bindslev-Jensen C., Skov P.S., Roggen E.L., Hvass P., Brinch D.S. Investigation on possible allergenicity of 19 different commercial enzymes used in the food industry. Fd Chem Toxicol 2006, 44:1909-1915.
10. Binkley K.E. Allergy to supplemental lactase enzyme. J Allergy Clin Immunol 1996, 97:1414-1416.
11. Bolin T.D., Davis A.E. Primary lactase deficiency: genetic or acquired?. Am J Dig Dis 1970, 15:679-692.
12. 2) in the study of carbohydrate absorption. Dig Dis 1977, 22:379-382.
13. Bourlioux P., Pochart P. Nutritional and health properties of yogurt. Wld Rev Nutr Dietetics 1988, 56:217-258.
14. Brand J.C., Holt S. Relative effectiveness of milks with reduced amounts of lactose in alleviating milk intolerance. Am J Clin Nutr 1991, 34:54-60.
15. Brandstetter R.D., Conetta R., Glazer B. Lactose intolerance associated with Intal capsules. N Engl J Med 1986, 315:1613-1614.
16. Briet F., Pochart P., Marteau P., Flourie B., Arrigoni E., Rambaud J.C. Improved clinical tolerance to chronic lactose ingestion in subjects with lactose intolerance: a placebo effect?. Gut 1997, 41:632-635.
17. Burton J.P., Tannock G.W. Properties of porcine and yogurt Lactobacilli in relation to lactose intolerance. J Dairy Sci 1997, 80:2318-2324.
18. Byers K.G., Savaiano D.A. The myth of increased lactose intolerance in African-Americans. J Am Coll Nutr 2005, 24:569S-573S.
19. Campbell A.K., Waud J.P., Matthews S.B. The molecular basis of lactose intolerance. Sci Progress 2009, 92:241-287.
20. Conway P.L., Gorbach S.L., Goldin B.R. Survival of lactic acid bacteria in the human stomach and adhesion to intestinal cells. J Dairy Sci 1987, 70:1-12.
21. Corazza G.R., Benati G., Sorge M., Strocchi A., Calza G., Gasbarrini G. β-galactosidase from Aspergillus niger in adult lactose malabsorption: a double-blind crossover study. Aliment Pharmacol Therap 1992, 6:61-66.
22. Curry B., Crow V. Lactobacillus spp. General characteristics. Encyclopedia of dairy sciences 2003, 1479-1484. Academic Press, Amsterdam. H. Roginski, J.W. Fuquay, P.F. Fox (Eds.).
23. Desai A.B., Gandhi R.A., Vani G.B. Lactose intolerance. Indian Pediatr 1969, 6:457-462.
24. De Vrese M., Stegelmann A., Richter B., Fenselau S., Laue C., Schrezenmeir J. Probiotics - compensation for lactase insufficiency. Am J Clin Nutr 2001, 73(suppl):421S-429S.
25. Dewit O., Boudraa G., Touhami M., Desjeux J.F. Breath hydrogen test and stools characteristics after ingestion of milk and yogurt in malnourished children with chronic diarrhoea and lactase deficiency. J Trop Pediatr 1987, 33:177-180.
26. Dewit O., Pochart P., Desjeux J.F. Breath hydrogen concentration and plasma glucose, insulin and free fatty acid levels after lactose, milk, fresh or heated yogurt ingestion by healthy young adults with or without lactose malabsorption. Nutrition 1988, 4:131-135.
27. DFS DELVO®YOG: A refreshingly versatile approach to yoghurt cultures DSM Food Specialties, leaflet. From, (accessed 2 November, 2012). http://www.dsm.com/le/en_US/foodspecialties/html/dairy_cultures_page_.htm.
28. Dipalma J.A., Collins M.S. Enzyme replacement for lactose malabsorption using a beta-D-galactosidase. J Clin Gastroenterol 1989, 11:290-293.
29. Drouault S., Anba J., Corthier G. Streptococcus thermophilus is able to produce a beta-galactosidase active during its transit in the digestive tract of germ-free mice. Appl Environm Microbiol 2002, 68:938-941.
30. Durand P. Intolérance au lactoseInsuffisante hydrolyse intestinale du lactose. Pediatrie 1960, 15:407-409. [in French].
31. During M.J., XU R., Young D., Kaplitt M.G., Sherwin R.S., Leone P. Peroral gene therapy of lactose intolerance using an adeno-associated virus vector. Nature Med 1998, 4:1131-1135.
32. Eadala P., Waud J.P., Matthews S.B., Green J.T., Campbell A.K. Quantifying the "hidden" lactose in drugs used for the treatment of gastrointestinal conditions. Aliment Pharmacol Ther 2008, 31:922-928.
33. EC EU Register of nutrition and health claims made on foods European Commission, Online:. http://www.ec.europa.eu/nuhclaims.
34. EFSA Scientific Opinion on the substantiation of health claims related to lactase enzyme and breaking down lactose (ID 1697, 1818). EFSA J 2009, 7(9):1236. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA);, Online:. http://www.efsa.europa.eu.
35. EFSA Scientific Opinion on the substantiation of health claims related to live yoghurt cultures and improved lactose digestion (ID 1143, 2976). EFSA J 2010, 8(10):1763. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA);, Online:. http://www.efsa.europa.eu.
36. EFSA Scientific Opinion on lactose thresholds in lactose intolerance and galactosaemia. EFSA J 2010, 8(9):1777. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA);, Online:. http://www.efsa.europa.eu.
37. EFSA Scientific Opinion on the substantiation of health claims related to foods with reduced lactose content and decreasing gastro-intestinal discomfort caused by lactose intake in lactose intolerant individuals (ID 646, 1224, 1238, 1339). EFSA J 2011, 9(6):2236. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA);, Online:. http://www.efsa.europa.eu.
38. EFSA Scientific Opinion on the substantiation of health claims related to the substantiation of health claims related to various microorganisms and [...] improved lactose digestion (ID 1030, 2956, 2958, 2961, 2963, 2966, 2970), [...]. EFSA J 2012, 10(8):2858. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA);, Online:. http://www.efsa.europa.eu.
39. Enattah N.S., Sahi T., Savilahti E., Terwilliger J.D., Peltonen L., Järvelä I. Identification of a variant associated with adult-type hypolactasia. Nature Genetics 2002, 30:233-237.
40. EP Report on the proposal for a regulation of the European Parliament and of the Council on food intended for infants and young children and on food for special medical purposes. European Parliament, report A7-0059/2012 Online:. http://www.europarl.europa.eu.
41. EU COM Proposal for a regulation of the European Parliament and of the Council on food intended for infants and young children and on food for special medical purposes COM(2011) 353. Online:. http://www.ec.europa.eu/food/food/labellingnutrition/nutritional/.
42. FCC Food Chemicals Codex 2010, US Pharmacopeial Convention, Rockville, MD, USA. 7th edition.
43. Fox P.F., Mcsweeney P.L.H. Dairy chemistry and biochemistry 1998, Blackie Academic & Professional, London.
44. Gao K.-P., Mitsui T., Fujiki K., Ishiguro H., Kondo K. Effect of lactase preparations in asymptomatic individuals with lactase deficiency - gastric digestion of lactose and breath hydrogen analysis. Nagoya J Med Sci 2002, 65:21-28.
45. Gilliland S.E., Kim H.S. Effect of viable starter culture bacteria in yogurt on lactose utilization in humans. J Dairy Sci 1984, 67:1-6.
46. Gudmand-Høyer E. The clinical significance of disaccharide maldigestion. Am J Clin Nutr 1994, 59:735S-741S.
47. Gudmand-Høyer E., Simony K. Individual sensitivity to lactose in lactose malabsorption. Am J Dig Dis 1977, 22:177-181.
48. Guzek M., Stojek M., Wierzbowski J., Sulkowska A., Smoczyński M. Tolerance of low-lactose milk and supplemental lactase obtained from Aspergillus oryzae in persons with lactose intolerance. Gastroenterol Polska 2008, 15:305-308.
49. Harju M., Kallioinen H., Tossavainen O. Lactose hydrolysis and other conversions in dairy products: technological aspects. Int Dairy J 2012, 22:104-109.
50. He T. Lactose intolerance: the role of colonic metabolism 2006, Rijksuniversiteit Groningen, the Netherlands, PhD thesis.
51. Headon D.R., Walsh G. The industrial production of enzymes. Biotech Adv 1994, 12:635-646.
52. Hertzler S.R., Kim Y., Khan R., Asp M., Savaiano D. Intestinal disaccharidase depletions. Modern nutrition in health and disease 2005, 1189-1200. Lippincott, Williams and Wilkins, Philadelphia. 10th ed. M.E. Shils (Ed.).
53. Honkanen R., Kroger H., Alhava E., Turpeinen P., Tuppurainen M., Saarikoski S. Lactose intolerance associated with fractures of weight-bearing bones in Finnish women aged 38-57 years. Bone 1997, 21:473-477.
54. Hošková A., Šabacký J., Mrskoš A., Pospíšil R. Severe lactose intolerance with lactosuria and vomiting. Arch Dis Child 1980, 55:304-305.
55. Ingram C.J.E., Mulcare C.A., Itan Y., Thomas M.G., Swallow D.M. Lactose digestion and the evolutionary genetics of lactase persistence. Hum Genet 2009, 124:579-591.
56. Itan Y., Jones B.L., Ingram C.J.E., Swallow D.M., Thomas M.G. A worldwide correlation of lactase persistence phenotype and genotypes. BMC Evol Biol 2010, 10:36.
57. Jones D.V., Latham M.C. Lactose intolerance in young children and their parents. Am J Clin Nutr 1974, 27:547-549.
58. Kligerman A.E. Relative efficiency of a commercial lactase tablet. Am J Clin Nutr 1990, 51:890-892.
59. Kolars J.C., Levitt M.D., Aouji M., Savaiano D.A. Yogurt - an autodigesting source of lactose. New Engl J Med 1984, 310:1-3.
60. Kuchay R.A.H., Thapa B.R., Mahmood A., Mahmood S. Effect of C/T-13910 cis-acting regulatory variant on expression and activity of lactase in Indian children and its implication for early genetic screening of adult-type hypolactasia. Clin Chim Acta 2011, 412:1924-1930.
61. Kwak H.-S., Lee W.-J., Lee M.-R. Revisiting lactose as an enhancer of calcium absorption. Int Dairy J 2012, 22:147-151.
62. Labayen I., Forga L., Gonzalez A., Lenoir-Wijnkoop I., Nutr R., Martinez J.A. Relationship between lactose digestion, gastrointestinal transit time and symptoms in lactose malabsorbers after dairy consumption. Alim Pharmacol Ther 2001, 15:543-549.
63. Lami F., Callegari C., Tatali M., Graziano L., Guidetti C., Miglioli M., Barbara L. Efficacy of addition of exogenous lactase to milk in adult lactase deficiency. Am J Gastroenterol 1988, 83:1145-1149.
64. Lebenthal E., Antonowicz I., Shwachman H. Correlation of lactose activity, lactose tolerance and milk consumption in different age groups. Am J Clin Nutr 1975, 28:595-600.
65. Leonardi M., Gerbault P., Thomas M.G., Burger J. The evolution of lactase persistence in Europe. A synthesis of archeological and genetic evidence. Int Dairy J 2012, 22:88-97.
66. Lerebours E., N'Djitoyap Ndam C., Lavoine A., Hellot M.F., Antoine J.M., Colin R. Yogurt and fermented-then-pasteurized milk: effects of short-term and longterm ingestion on lactose absorption and mucosal lactase activity in lactase-deficient subjects. Am J Clin Nutr 1989, 49:823-827.
67. Levitt M.D. Production and excretion of hydrogen gas in man. New Engl J Med 1969, 281:122-127.
68. Levitt M.D., Bond J.H. Volume, composition, and source of intestinal gas. Gastroenterol 1970, 59:921-929.
69. Levitt M.D., Ingelfinger F.J. Hydrogen and methane production in man. Ann NY Ac Sci 1968, 150:75-81.
70. Lieb J., Kazienko D.J. Lactose filler as a cause of 'drug-induced' diarrhea. New Engl J Med 1978, 299:314.
71. Lin M.-Y., Dipalma J.A., Martini M.C., Gross C.J., Harlander S.K., Savaiano D.A. Comparative effects of exogenous lactase (beta-galactosidase) preparations on in vivo lactose digestion. Dig Dis Sci 1993, 38:2022-2027.
72. Lisker R., Lopez-Habib G., Daltabuit M., Rostenberg I., Arroyo P. Lactase deficiency in a rural area of Mexico. Am J Clin Nutr 1974, 27:756-759.
73. Marteau P., Flourie B., Pochart P., Chastang C., Desjeux J.F., Rambaud J.C. Effect of the microbial lactase (EC 3.2.1.23) activity in yoghurt on the intestinal absorption of lactose: an in vivo study in lactase-deficient humans. Br J Nutr 1990, 64:71-79.
74. Martini M.C., Bollweg G.L., Levitt M.D., Savaiano D.A. Lactose digestion by yogurt β-galactosidase: influence of pH and microbial cell integrity. Am J Clin Nutr 1987, 45:432-436.
75. Martini M.C., Smith D.E., Savaiano D.A. Lactose digestion from flavored and frozen yogurts, ice milk, and ice cream by lactase-deficient persons. Am J Clin Nutr 1987, 46:636-640.
76. Martini M.C., Kukielka D., Savaiano D.A. Lactose digestion from yogurt: influence of a meal and additional lactose. Am J Clin Nutr 1991, 53:1253-1258.
77. Martini M.C., Lerebours E.C., Lin W.J., Harlander S.K., Berrada N.M., Antoine J.M., Savaiano D.A. Strains and species of lactic acid bacteria in fermented milks (yogurts): effect on in vivo lactose digestion. Am J Clin Nutr 1991, 54:1041-1046.
78. Mater D.D.G., Drouault-Holowacz S., Oozeer R., Langella P., Anba J., Corthier G. β-Galactosidase production by Streptococcus thermophilus is higher in the small intestine than in the caecum of human-microbiota-associated mice after lactose supplementation. Br J Nutr 2006, 96:177-181.
79. Mattar R., De Campos Mazo D.F., Carrilho F.J. Lactose intolerance: diagnosis, genetic, and clinical factors. Clin Exp Gastroenterol 2012, 5:113-121.
80. Mcdonough F.E., Hitchins A.D., Wong N.P., Wells P., Bodwell C.E. Modification of sweet acidophilus milk to improve utilization by Iactose-intolerant persons. Am J Clin Nutr 1987, 45:570-574.
81. Medow M.S., Thek K.D., Newman L.J., Berezin S., Glassman M.S., Schwarz S.M. Beta-galactosidase tablets in the treatment of lactose intolerance in pediatrics. Am J Dis Child 1990, 144:1261-1264.
82. Montalto M., Nucera G., Santoro L., Curigliano V., Vastola M., Covino M., Cuoco L., Manna R., Gasbarrini A., Gasbarrini G. Effect of exogenous β-galactosidase in patients with lactose malabsorption and intolerance: a crossover double-blind placebo-controlled study. Eur J Clin Nutr 2005, 59:489-493.
83. Montalto M., Gallo A., Santoro L., D'Onofrio F., Curigliano V., Covino M., Cammarota G., Grieco A., Gasbarrini A., Gasbarrini G. Low-dose lactose in drugs neither increases breath hydrogen excretion nor causes gastrointestinal symptoms. Aliment Pharmacol Ther 2008, 28:1003-1012.
84. Moskovitz M., Curtis C., Gavaler J. Does oral enzyme replacement therapy reverse intestinal lactose malabsorption?. Am J Gastroenterol 1987, 82:632-635.
85. O'Connell S., Walsh G. A novel acid-stable, acid-active β-galactosidase potentially suited to the alleviation of lactose intolerance. Appl Microbiol Biotechnol 2010, 86:517-524.
86. Ojetti V., Gigante G., Gabrielli M., Ainora M.E., Mannocci A., Lauritano E.C., Gasbarrini G., Gasbarrini A. The effect of oral supplementation with Lactobacillus reuteri or tilactase in lactose intolerant patients: randomized trial. Eur Rev Med Pharmacol Sci 2010, 14:163-170.
87. Onwulata C.I., Rao D.R., Vankineni P. Relative efficiency of yogurt, sweet acidophilus milk, hydrolyzed-lactose milk, and a commercial lactase tablet in alleviating lactose maldigestion. Am J Clin Nutr 1989, 49:1233-1237.
88. Paige D.M., Bayless T.M., Huang S.-S., Wexier R. Lactose hydrolyzed milk. Am J Clin Nutr 1975, 28:818-822.
89. Pelletier X., Laure-Boussuge S., Donazzolo Y. Hydrogen excretion upon ingestion of dairy products in lactose-intolerant male subjects: importance of the live flora. Eur J Clin Nutr 2001, 55:509-512.
90. Petrini L., Usai P., Caradonna A., Cabula R., Mariotti S. Lactose intolerance following antithyroid drug. J Endocrin Invest 1997, 20:569-570.
91. Plimmer R.H.A. On the presence of lactase in the intestines of animals and on the adaptation of the intestine to lactose. J Physiol 1906, 35:20-31.
92. Pochart P., Dewit O., Desjeux J.-F., Bourlioux P. Viable starter culture, β-galactosidase activity, and lactose in duodenum after yoghurt ingestion in lactase-deficient humans. Am J Clin Nutr 1989, 49:828-831.
93. Portincasa P., DI Ciaula A., Vacca M., Montelli R., Wang D.Q.-H., Palasciano G. Beneficial effects of oral tilactase on patients with hypolactasia. Eur J Clin Invest 2008, 38:835-844.
94. Ramirez F.C., Lee K., Graham D.Y. All lactase preparations are not the same: results of a prospective, randomized, placebo-controlled trial. Am J Gastroenterol 1994, 89:566-570.
95. Rasinperä H., Savilahti E., Enattah N.S., Kuokkanen M., Tötterman N., Lindahl H., Järvelä I., Kolho K.-L. A genetic test which can be used to diagnose adult-type hypolactasia in children. Gut 2004, 53:1571-1576.
96. Rask Pedersen E., Jensen B.H., Jensen H.J., Keldsbo I.L., Hylander Moller E., Norby Rasmussen S. Lactose malabsorption and tolerance of lactose-hydrolyzed milk. A double-blind controlled crossover study. Scand J Gastroenterol 1982, 17:861-864.
97. Reasoner J., Maculan T.P., Rand A.G., Thayer W.R. Clinical studies with low-lactose milk. Am J Clin Nutr 1981, 34:54-60.
98. Rizkalla S.W., Luo J., Kabir M., Chevalier A., Pacher N., Slama G. Chronic consumption of fresh but not heated yogurt improves breath-hydrogen status and short-chain fatty acid profiles: a controlled study in healthy men with or without lactose maldigestion. Am J Clin Nutr 2000, 72:1474-1479.
99. Rosado J.L., Solomons N.W., Lisker R., Bourges H. Enzyme replacement therapy for primary adult lactase deficiency. Effective reduction of lactose malabsorption and milk intolerance by direct addition of beta-galactosidase to milk at mealtime. Gastroenterology 1984, 87:1072-1082.
100. Rosado J.L., Deodhar A.D., Bourges H., Solomons N.W. The effect of the digestion products of lactose (glucose and galactose) on its intraintestinal, in vivo hydrolysis by exogenous microbial beta-D-galactosidase. J Am Coll Nutr 1986, 5:281-290.
101. Rosado J.L., Solomons N.W., Allen L.H. Lactose digestion from unmodified, low-fat and lactose-hydrolyzed yogurt in adult lactose-maldigesters. Eur J Clin Nutr 1992, 46:61-67.
102. Sanders S.W., Tolman K.G., Reitberg D.P. Effect of a single dose of lactase on symptoms and expired hydrogen after lactose challenge in lactose-intolerant subjects. Clin Pharm 1992, 11:533-538.
103. Sandler R.B., Slemenda C.W., Laporte R.E., Cauley J.A., Schramm M.M., Barresi M.L., Kriska A.M. Postmenopausal bone density and milk consumption in childhood and adolescence. Am J Clin Nutr 1985, 42:270-274.
104. Savaiano D.A., Abouelanouar A., Smith D.E., Levitt M.D. Lactose malabsorption from yogurt, pasteurized yogurt, sweet acidophilus milk, and cultured milk in lactase-deficient individuals. Am J Clin Nutr 1984, 40:1219-1223.
105. Savaiano D.A., Boushey C.J., McCabe G.P. Lactose intolerance symptoms assessed by meta-analysis: a grain of truth that leads to exaggeration. J Nutr 2006, 136:1107-1113.
106. Schirru E., Corona V., Usai-Satta P., Scarpa M., Cucca F., De Virgiliis S., Rossino R., Frau F., Macis M.D., Jores R.-D., Congia M. Decline of lactase activity and C/T-13910 variant in sardinian childhood. J Ped Gastroenterol Nutr 2007, 45:503-506.
107. Scrimshaw N.S., Murray E.B. The acceptability of milk and milk products in populations with a high prevalence of lactose intolerance. Am J ClinNutr 1988, 48:1079-1159.
108. Semenza G. Intestinal oligosaccharidases and disaccharidases. Handbook of physiology 1968, Vol. 5:2543-2566. Section 6, American Physiological Society/Williams and Wilkins, Alimentary canal, Baltimore. C.F. Code, W. Heidel (Eds.).
109. Shaukat A., Levitt M.D., Taylor B.C., Macdonald R., Shamliyan T.A., Kane R.L., Wilt T.J. Systematic review: effective management strategies for lactose intolerance. Ann Intern Med 2010, 152:797-803.
110. Shermak M.A., Saavedra J.M., Jackson T.L., Huang S.S., Bayless T.M., Perman J.A. Effect of yogurt on symptoms and kinetics of hydrogen production in lactose-malabsorbing children. Am J Clin Nutr 1995, 62:1003-1006.
111. Solomons N.W., Guerrero A.M., Torun B. Dietary manipulation of postprandial colonic lactose fermentation: II. Addition of exogenous, microbial beta-galactosidases at mealtime. Am J Clin Nutr 1985, 41:209-221.
112. Solomons N.W., Guerrero A.M., Torun B. Effective in vivo hydrolysis of milk lactose by beta-galactosidases in the presence of solid foods. Am J Clin Nutr 1985, 41:222-227.
113. Suarez F.L., Savaiano D.A. Lactose digestion and tolerance in adult and elderly Asian-Americans. Am J Clin Nutr 1994, 59:1021-1024.
114. Suarez F.L., Savaiano D.A., Levitt M.D. A comparison of symptoms after the consumption of milk or lactose-hydrolyzed milk by people with self-reported severe lactose intolerance. New Engl J Med 1995, 333:1-4.
115. Swagerty D.L., Walling A.D., Klein R.M. Lactose intolerance. Am Fam Physician 2002, 65:1845-1850.
116. Tandon R.K., Joshi Y.K., Singh D.S., Narendranathan M., Balakrishnan V., Lal K. Lactose intolerance in North and South Indians. Am J Clin Nutr 1981, 34:943-946.
117. Tari C., Ustok F.I., Harsa S. Production of food grade β-galactosidase from artisanal yogurt strains. Food Biotechnol 2010, 24:78-94.
118. Usai-Satta P., Scarpa M., Oppia F., Cabras F. Lactose malabsorption and intolerance: what should be the best clinical management?. World J Gastrointest Pharmacol Ther 2012, 3:29-33.
119. USDA National Nutrient Database for Standard Reference, Release 24 Nutrient Data Laboratory (NDL), Agricultural Research Service (ARS), US Department of Agriculture, (accessed 30 December 2011). http://www.ars.usda.gov/Services/docs.htm?docid=8964.
120. Ustok F.I., Tari C., Harsa S. Biochemical and thermal properties of β-galactosidase enzymes produced by artisanal yoghurt cultures. Food Chem 2010, 119:1114-1120.
121. Van Dam B., Revallier-Warffemius J.G., Van Dam-Schermerhorn L.C. 'Preparation of lactase from Saccharomyces fragilis. Neth Milk Dairy J 1950, 4:96-114.
122. Varela-Moreiras G., Antoine J.M., Ruiz-Roso B., Varela G. Effects of yogurt and fermented-then-pasteurized milk on lactose absorption in an institutionalized elderly group. J Am Coll Nutr 1992, 11:168-171.
123. Vesa T.H., Korpela R.A., Sahi T. Tolerance to small amounts of lactose in lactose maIdigesters. Am J Clin Nutr 1996, 64:197-201.
124. Vesa T.H., Marteau P., Korpela R. Lactose intolerance. J Am Coll Nutr 2000, 19:165S-175S.
125. Wilt T.J., Shaukat A., Shamliyan T., Taylor B.C., Macdonald R., Tacklind J., Rutks I., Schwarzenberg S.J., Kane R.L., Levitt M. Lactose intolerance and health 2010, http://www.ahrq.gov/clinic/tp/lactinttp.htm.
126. Wytock D.H., Dipalma J.A. All yogurts are not created equaI. Am J Clin Nutr 1988, 47:454-457.
127. Xenos K., Kyroudis S., Anagnostidis A., Papastathopulos P. Treatment of lactose intolerance with exogenous beta-D-galactosidase in pellet form. Eur J Drug Metab Pharmakin 1998, 23:350-355.
128. Yang Y., HE M., Cui H., Bian L., Wang Z. The prevalence of lactase deficiency and lactose intolerance in Chinese children of different ages. Chin Med J 2000, 113:1129-1132.