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vertebral fractures
J Gastroenterol 2002; 37:1014–1019
Lactose intolerance: a risk factor for reduced bone mineral density
and vertebral fractures?
Stefan Kudlacek1,2, Othmar Freudenthaler1,2, Hannelore Weissb?eck1,2, Barbara Schneider3,
and Robert Willvonseder1,2
1 KH Barmherzige Brüder, Medizinische Abteilung, Gro?e Mohrengasse 9, A-1020 Vienna, Austria
2 Ludwig Boltzmann Institute für Altersforschung, Vienna, Austria
3 Institut für Medizinische Statistik, University of Vienna, Vienna, Austria
and an apparent lactose intolerance cannot be excluded,
as a few individuals with severe lactose intolerance had
a large number of vertebral fractures.
Key words: lactose intolerance, vertebral fractures,
bone mineral density, osteoporosis
Introduction
The etiology of osteoporosis is multifactorial. In addi-
tion to hormonal factors, diminished dietary calcium
intake is a risk factor for bone loss.1 The diagnosis of
lactose intolerance is rendered difficult by the fact that
its symptoms are remarkably similar to those of irritable
bowel disease (IBD), for which there is currently no
pathophysiologic marker. IBD appears to have a preva-
lence similar to that of lactose intolerance, but the ac-
tual proportion remains uncertain.2,3 The potential role
of lactose intolerance in low bone mass and the associ-
ated risk of fracture remain unclear. The result of lac-
tose intolerance is that the delivery of lactose into the
colon causes diarrhea, excessive rectal gas, flatulence,
and abdominal cramps.
Following the clinical symptoms of lactose intoler-
ance, such as abdominal cramps and diarrhea, patients
frequently tend to avoid the ingestion of milk and milk
products. Therefore, lactose intolerance may lead to a
low calcium intake.
In fact, a recent study among Italian postmenopausal
back pain patients suspected of having osteoporosis
showed that only symptomatic lactose intolerance was
related to low calcium intake and low bone density.4
However, it is unclear whether lactose intolerance is
actually
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