There are two principal microbial sources of β-galactosidase (lactase): (i) yeast (Kluyveromyces lactis) and (ii) fungi (Aspergillus niger and A. oryzae). From these sources, several over-the-counter lactase supplements have been prepared and introduced into the US market. Controlled clinical trials have shown that these lactose digestive aids are effective. However, the results have been vari able. A consistent observation in many of these is that there may be a subpopulation with very low levels of endogenous residual lactase. These people might need much higher levels of oral supplements than currently recommended. Generally, the products are expensive and research should be directed toward reducing the cost of these oral supplements.
Barillas C. and Solomons N.W. (1987). Effective reduction of lactose maldigestion in preschool children by direct addition of β-galactosidase to milk at meal time. Pediatrics79: 766-772.
2.
DiPalma J.A. and Collins M.S. (1989). Enzyme replacement for lactose malabsorption using beta-D-galactosidase. Journal of ClinicalGastroenterology11: 290-329.
3.
Kobayashi A., Kawai S., Ohbe Y. and Nagashima Y. (1975). Effects of dietary lactose and a lactase preparation on the intestinal absorption of calcium and magnesium in normal infants. Journal of ClinicalNutrition28: 681-683.
4.
Lin M., DiPalma J.A., Martini M.C., Gross C.J., Harlander S.K. and Savaiano D.A. (1993). Comparative effects of exogenous lactase (β-galactosidase) preparations in vivo lactose digestion. Digestive DiseasesScience38: 2022-2027.
5.
Mizote H., Terasaki S., Ryu T. et al. (1978). Clinical study of lactose intolerance after gastrectomy. Kuremi Medical Journal25: 295-300.
6.
Moskovitz M., Curtis C. and Gavalier, J. (1987). Does oral enzyme replacement therapy reverse intestinal lactose malabsorption?American Journal of Gastroenterology82: 632-635.
7.
Onwulata C.I., Rao D.R. and Vankineni C.P. (1989). Relative efficiency of yogurt, sweet acidophilus milk, hydrolyzed-lactose milk and a commercial lactase tablet in alleviating lactose maldigestion. American Journal of Clinical Nutrition49: 1233-1237.
8.
Ramirez F., Lee K. and Graham D. (1994). All lactase preparations are not the same: Results of a prospective, randomized, placebo-controlled trial. American Journal of Gastroenterology89: 566-570.
9.
Rand A.G., Jr. (1981). Enzyme technology and the development of lactose-hydrolyzed milk. In: Paige D.M. and Baylesa T.M. (eds), Lactose digestion: Clinical and nutritional implications. Baltimore: Johns Hopkins University. pp. 219-30.
10.
Rao D.R., Pulusani S.R. and Chawan C.B. (1985). Role of fermented milk products in milk intolerance and other clinical conditions. Advances in Nutrition Research7: 203-219.
11.
Rosado J.L., Solomons N.W., Lisker R. and Bourges, C.H. (1984). Enzyme replacement therapy for primary adult lactase deficiency: Effective reduction of lactose malabsorption and milk intolerance by direct addition of β-galactosidase at meal time. Gastroenterology87: 1072-1082.
12.
Sahi T., (1994). Hypolactasia and lactase persistence: Historical review and the terminology. Scandinavian Journal ofGastroenterology , 29 (suppl. 202): 1-6.
13.
Simoons F.J., (1970). Primary adult lactose intolerance and the milking habit: A problem in biological and cultural interrelations. II. A cultural historical hypothesis. American Journal of Digestive Diseases15: 695-710.
14.
Solomons N.W., Guerrero A.M. and Torun B. (1982). In vivo intragastric hydrolysis of milk by a β-galactosidase: A potential approach to symptomatic milk intolerance in primary lactase deficiency (abstract)Federal Proceedings41: 750.
15.
Solomons N.W., Guerrero A.M. and Torun B. (1985). Effective in vivo hydrolysis of lactose by beta-galactosidase in the presence of solid foods. American Journal of Clinical Nutrition41: 222-227.
16.
Suarez F.L., Savaiano D.A. and Levitt M.D. (1995). A comparison of symptoms after the consumption of milk or lactose-hydrolyzed milk by people with self-reported severe lactose intolerance. New England Journal of Medicine333: 1-4.
