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Comparison of the impact of bovine milk beta-casein variants on digestive comfort in females self-reporting dairy intolerance: a randomized controlled trial
Univ Auckland, New Zealand.
Univ Auckland, New Zealand.
Linköping University.
Linköping University.
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2020 (English)In: American Journal of Clinical Nutrition, ISSN 0002-9165, E-ISSN 1938-3207, Vol. 111, no 1, p. 149-160Article in journal (Refereed) Published
Abstract [en]

Background: Lactose malabsorption (LM) is a major cause of digestive discomfort from dairy products. Recently. a role for bovine beta-casein A1 has been proposed. Objectives: We examined whether there are distinct symptoms of digestive discomfort due to either lactose or differing bovine beta-casein types. Methods: Women (n = 40; age: 25.2 +/- 05 y) with self-reported varying dairy tolerance underwent a 50-g lactose challenge. Based on postchallenge LM and digestive discomfort, participants were classified as either lactose intolerant (LI; n = 10, self-reported intolerant, diagnosed lactose intolerant), nonlactose dairy intolerant (NLDI; n = 20, self-reported intolerant, diagnosed lactose tolerant), or dairy tolerant (DT: n = 10, self-reported tolerant, diagnosed lactose tolerant). In a double-blinded randomized sequence, participants consumed 750 mL conventional milk (CON; containing Al and A2 beta-casein and lactose), a2 Milk (A2M; exclusively containing A2 beta-casein with lactose), or lactose-free conventional milk (LF-CON; containing Al and A2 beta-casein without lactose). Subjective digestive symptoms and breath hydrogen (measuring LM) were recorded regularly over 3 h, and further ad hoc digestive symptoms over 12 h. Results: LI subjects experienced prolonged digestive discomfort with CON milk. A2M reduced (P amp;lt; 0.05) some symptoms (nausea: A2M 8 +/- 3 mm compared with CON 15 +/- 3mm: fecal urgency: A2M 4 +/- 1 compared with CON 10 +/- 3 mm), and attenuated the rise in breath hydrogen over 3 h, relative to CON milk (A2M 59 +/- 23 compared with CON 98 +/- 25 ppm at 150 min; P amp;lt; 0.01). In contrast, NLDI subjects experienced rapid-onset, transient symptoms (abdominal distension, bloating, and flatulence) without increased breath hydrogen, irrespective of milk type. Conclusions: In LI individuals, LM and digestive comfort with lactose-containing milks was improved with milk containing exclusively A2 beta-casein. Furthermore, self-reported dairy intolerance without LM (NLDI) is characterized by early-onset digestive discomfort following milk ingestion, irrespective of lactose content or beta-casein type.

Place, publisher, year, edition, pages
Oxford University Press, 2020. Vol. 111, no 1, p. 149-160
Keywords [en]
lactose malabsorption; lactose intolerance; dairy intolerance; A2 beta-casein; A1 beta-casein; digestive comfort
National Category
Food Science
Identifiers
URN: urn:nbn:se:liu:diva-163224DOI: 10.1093/ajcn/nqz279ISI: 000505964300020PubMedID: 31773165Scopus ID: 2-s2.0-85077665879OAI: oai:DiVA.org:liu-163224DiVA, id: diva2:1390989
Note

Funding Agencies|New Zealand Ministry of Business, Innovation, and Employment (MBIE) through the High-Value Nutrition National Science Challenge (HVN); a2 Milk Company Ltd (a2MC)

Available from: 2020-02-03 Created: 2020-02-03 Last updated: 2020-02-14Bibliographically approved

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Karlstrom, Helga J.Martinsson, Jakob A.Nilsson, Nils J.
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