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No. 631

Authors :

Soontornchai S, Sirichakwal P, Puwastien P, Tontisirin K, Kruger D, Grossklaus R.

Title :

Lactitol tolerance in healthy Thai adults.

Source :

European Journal of Nutrition. 38(5):218-26, 1999(Oct).

Keywords :

Sugar alcohol, Lactitol, Breath hydrogen, Lactose malabsorption, Gastrointestinal symptoms, Diarrhea

Abstract :

The hydrogen breath analysis test was performed in healthy Thai adults to determine lactitol tolerance. The

study was conducted in 39 individuals (11 males and 28 females) aged 18-41 years. All volunteers agreed to

participate in this study after the risks and benefits had been fully explained. Subjects were requested not

to consume milk, mirk products, or high-vegetable diets for a day and to fast from 10 p.m. of the day

preceding the test day. After consumption of the test diet (12 and 20 g of lactose or lactitol, respectively,

in 250 mt water), the subjects recorded the severity of symptoms for 24 hours. Breath samples were collected

after fasting and after consumption of the test diet at 30 min intervals over the 7-hour study period. Breath

samples were analyzed for hydrogen using gas chromatography. After consumption of 12 g lactose, the

prevalence of lactose malabsorbers was established. The increment of a peak breath hydrogen level of greater

than or equal to 20 ppm above the baseline level was used as an indicator of lactose malabsorption. The

lactose malabsorbers were further classified as lactose tolerants or lactose intolerants according to the

gastrointestinal symptoms observed. All 39 healthy Thai adults could be classified into 3 groups as follows:

9 (23%) lactose absorbers (LA), 15 (38.5%) lactose malabsorber/tolerants (LMT), and 15 (38.5%) lactose

malabsorber/intolerants (LMI). Using the hydrogen breath test, 67% of the subjects were identified as

lactitol intolerants after the consumption of 12 g lactitol. The lactitol intolerants comprised 53.8% of

LMI, 34.6% of LMT, and 11.5% of LA. Among all subjects, one third of LA (33%), two thirds of LMT

(60%). and 93% of LMI were lactitol intolerant. In addition, gastrointestinal symptoms such as flatulence

and abdominal pain were most pronounced in LMI. Diarrhea was also a prominent manifestation after

consumption of 12 g lactitol. Therefore, it was finally decided that 20 g lactose or lactitol were not given

to LMI because of the risk of gastrointestinal symptoms. After high doses (20 g) of lactose and lactitol

consumption, most LMT developed more symptoms than did LA and the main symptom was diarrhea,

Consumption of 20 g lactose resulted in fewer symptoms than 20 g lactitol in both LA and LMT. On the

basis of the hydrogen breath test, most LA tolerated 12 g lactitol without gastrointestinal symptoms except

some flatulence whereas most LMT and LMI did not. Twenty glactitol was not tolerated by both LA and

LMT because there was diarrhea among the subjects, especially in LMT. Although the hydrogen breath

analysis test is the best method for identification of lactose malabsorption, it is not the best method to

identify lactitol intolerance. A hydrogen concentration of 15 ppm above the baseline level was found to be

the best cut-off point to indicate lactitol intolerance although sensitivity was 85% and specificity only 38%

in this study. It was further concluded that there is a greater susceptibility to lactitol in human lactose

malabsorbers than in lactose absorbers. Our findings might be relevant for the limited use of lactitol in

Thailand.

No. 632

Authors :

Wasantwisut E, Sungpuag P, Viriyapanich T, Sirichakwal P, Charoenkiatkul S, Chitchumroonchokchai C,

Banjong O, Rojroongwasinkul N, Dhananiveskul V, Toungsuwan S, Haskell M, Yamini S, West KP.

Title :

Effects of dietary and supplemental beta-carotene interventions on total body retinol stores in lactating Thai

woman.

Source :

Faseb Journal. 14(4):A535, 2000(Mar).

Keywords :

Dietary, Supplemental, Beta-carotene, Body retinol stores, Woman

Abstract :

The contribution of a carotenoid rich diet to vitamin A (VA) status remains controversial. This study

evaluated the efficacy of a provitamin A mid-day meal given 5 days/week for 3 months on change in total

body retinol stores (TBRS) by stable isotope dilution and in other VA status indicators among lactating

women in Northeast Thailand. From > 700 screened lactating women 1-12 mo postpartum, 85 with a serum

retinol < 25 mg/dl or low VA intake were enrolled. Subjects, matched on postpartum time and area, were

randomized to receive a meal with (A) dark green leaves and yellow/orange vegetables and fruit , (B) purified

b-carotene or (C) low carotenoid foods, providing 4.7, 3.6 and < 0.5 mg/meal, respectively. Meal fat

content was ~10 g. 71 subjects completed the trial (n1=24, 25 and 22). At home, group A seemed to consume

<? of the amount of preformed vitamin A than other groups. Serum and breast milk b-carotene increased

most in group B, followed by group A but breast milk retinol increased more in group A vs others (p=0.097).

serum retinol increased in all groups (from ~21 to ~46 mg/dl), reflecting seasonality. TBRS was comparable

at baseline (77, 81, 95 mg, p=0.87). Mean (median) TBRS decreased by 15 (5), 3 (3) and 19 (14) mg in Groups

A, B and C (p=0.4). Serum and breast milk vitamin A can increase amidst decreasing TBRS in lactating

women. Loss in TBRS may be prevented by daily b-carotene supplements but less so with increased, short-

term dietary b-carotene intake. Longer interventions and more subjects are needed to show dietary effects

on TBRS.