Lactose malabsorption in Bangladeshi village.pdf

1962 The American Journal ofCinical Nutrition 32: SEPTEMBER 1979, pp. 1962-1969. Printed in U.S.A. editor: Robert B. Bradfield, iD., Ph.D. international nutrition Lactose malabsorption in Bangladeshi village children: relation with age, history of recent diarrhea, nutritional status, and breast feeding13 Kenneth H. Brown, M.D., Lynn Parry, B.Sc., Makhduma Khatun, B.Sc., and Md. Giashuddin Ahmed, M. Sc. ABSTRACT The prevalence of lactose mahabsorption (LM) among Bangladeshi village chil- dren has been determined using the recently developed breath hydrogen test. Initial hospital-based comparison studies showed general agreement between the breath hydrogen test and a modified lactose tolerance test. Two hundred thirty-four children, stratified by age, nutritional status, and history of recent diarrhea then participated in the field study. LM was diagnosed in more than 80% of children over 36 months of age but in none of the children under 6 months. Rates of LM were significantly increased in children with a history of recent diarrhea and a greater proportion of children in some age groups evidenced malabsorption in association with acute undernutrition. In the weanhing age group children who were still breast feeding had a lower rate of LM than fully weaned subjects. Am. .1 Clin. Nutr. 32: 1962-1969, 1979. Human or animal milk is usually the ma- jor, and often the only food source of infants and young children. Successful utilization of milk nutrients depends in part on the ability to digest and absorb the milk carbohydrate, lactose (I, 2). Normally, dietary lactose is hydrolyzed by the gut brush border enzyme, lactase, and is absorbed as glucose and galac- tose (3). However, primary low lactase activ- ity, the presumably genetically determined decline oflactase, occurs in many populations of children beyond 3 to 5 years of age (4). Secondary lactase deficiency, occurring as a consequence of acute infectious diarrhea, se- vere protein-calorie malnutrition, or other to