TY  - JOUR
T1  - LAKTOZ İNTOLERANSIN PREVALANSI, TEŞHİSİ VE LAKTOZSUZ BESLENME TAVSİYELERİ
TT  - THE PREVALENCE AND DIAGNOSTIC METHODS OF LACTOSE INTOLERANCE AND LACTOSE-FREE DIET RECOMMENDATIONS
AU  - Demirgül, Furkan
AU  - Demirgül, Recep
PY  - 2019
DA  - October
DO  - 10.3153/FH19028
JF  - Food and Health
JO  - Food Health
PB  - Özkan ÖZDEN
WT  - DergiPark
SN  - 2602-2834
SP  - 281
EP  - 290
VL  - 5
IS  - 4
LA  - tr
AB  - Laktoz,sadece sütte bulunan bir disakkarit olup, emmeyi bıraktıktan sonra çoğu kişidelaktozu parçalayan laktaz enziminin sentezi durmakta veya azalmaktadır. Laktozintolerans olarak bilinen bu durum sütün sindirilememesiyle sonuçlanmakta vedünyada çok sık görülmektedir. Laktaz geni üzerinde meydana gelen tek nükleotitpolimorfizmleri nedeniyle bazı kişilerde laktaz enzimi yaşam boyusentezlenebilmektedir. Laktaz kalıcılığı olarak adlandırılan bu durumunprevalansı etnik gruplara göre değişmektedir. Laktoz intoleransın teşhisindeçeşitli yöntemler uygulanmasına rağmen, çoğu zaman semptomların gözlenmesihastalık teşhisi için yeterli olmaktadır. Laktoz intolerans olanlar ömür boyusürecek laktozsuz bir diyet uygulamalıdır. Süt kalsiyum gibi bazı önemli besinöğeleri açısından zengin bir kaynak olduğu için, laktoz intolerans hastalarınınkalsiyum gibi ihtiyaçlarını peynir ve yoğurt gibi laktoz içeriği düşük olangıdalardan karşılamaları önemlidir. Bu çalışmada, laktoz intolerans hakkındabilgi verilerek, laktoz intoleransın prevalansı ve teşhis yöntemleri ilelaktozsuz beslenme üzerinde durulmuştur. Bu çalışma ile laktoz intoleransfarkındalığının hem hastalar tarafından hem de gıda endüstrisinin paydaşlarıtarafından arttırılması hedeflenmektedir.
KW  - Süt
KW  - Laktoz intolerans
KW  - Laktaz kalıcılığı
KW  - Laktozsuz beslenme
N2  - Lactose is a disaccharide found only in milk, andafter weaning, the synthesis of lactase, which breaks down lactose, stops ordecreases in most individuals. This condition, known as lactose intolerance,results in the inability of the digestion of milk and is very common in theworld. Because of the single nucleotide polymorphisms occurring on the lactasegene, the lactase enzyme can be synthesized for life in some individuals. Theprevalence of this condition called lactase persistence varies according toethnic groups. Although there are various methods for the diagnosis of lactoseintolerance, observation of symptoms is often sufficient for the diagnosis ofthe disease. Those who have lactose intolerance should apply a life-longlactose-free diet. Since milk is a rich source of some important nutrients suchas calcium, it is important for lactose intolerance patients to meet theirneeds like calcium from foods with low lactose content such as cheese andyogurt. In this study, information about lactose intolerance was given andlactose intolerance prevalence, diagnosis methods, and lactose-free diet wereexamined. This study aims to increase the lactose intolerance awareness of bothpatients and food industry stakeholders.
CR  - Adolfsson, O., Meydani, S.N., Russell, R.M. (2004). Yogurt and gut function. Am J Clin Nutr., 80, 245-56. https://doi.org/10.1093/ajcn/80.2.245
CR  - Bersaglieri, T., Sabeti, P., Patterson, N., Vanderploeg, T., Schaffner, S., Drake, J., Rhodes, M., Reich, D.E., Hirschhorn, J.N. (2004). Genetic signatures of strong recent positive selection at the lactase gene. The American Journal of Human Genetics, 74(6), 1111-20. https://doi.org/10.1086/421051
CR  - Brown-Esters, O., Mc Namara, P., Savaiano, D., (2012). Dietary and biological factors influencing lactose intolerance. International Dairy Journal, 22, 98-103. https://doi.org/10.1016/j.idairyj.2011.09.01
 
Campbell, A.K., Matthews, S.B., Vassel, N., Cox, C.D., Naseem, R., Chaichi, J., Holland, I.B., Green, J., Wann, K.T. (2010). Bacterial metabolic 'toxins': A new mechanism for lactose and food intolerance, and irritable bowel syndrome. Toxicology, 278, 268-276. https://doi.org/10.1016/j.tox.2010.09.0010
CR  - Campbell, A.K., Waud, J.P., Matthews, S.B. (2005). The molecular basis of lactose intolerance. Science Progress, 88(3), 157-202. https://doi.org/10.3184/003685005783238408
CR  - Chandan, R.C., Shah, N.P. (2006). Functional Foods and Disease Prevention. Manufacturing Yogurt and Fermented Milks Edited by Ramesh C. Chandan, Blackwell Publishing, 311-325. https://doi.org/10.1002/9780470277812.ch20
CR  - Cook, C.J. (2014). The role of lactase persistence in precolonial development. Journal of Economic Growth, 19, 369-406. https://doi.org/10.1007/s10887-014-9109-5
CR  - Corgneau, M., Scher, J., Ritié-Pertusa, L., Le, D.T.L., Petit, J., Nikolova, Y., Banon, S., Gaiani, C. (2015). Recent advances on lactose ıntolerance: Tolerance thresholds and currently available solutions. Critical Reviews in Food Science and Nutrition, 57(15), 3344-3356. https://doi.org/10.1080/10408398.2015.1123671
CR  - de Vrese, M., Stegelmann, A., Richter, B., Fenselau, S., Laue, C., Schrezenmeir, J. (2001). Probiotics-compensation for lactase insufficiency. The American Journal of Clinical Nutrition, 73(2), 421-29. https://doi.org/10.1093/ajcn/73.2.421s
CR  - Demirgül, F., Sağdıç, O. (2018). Fermente süt ürünlerinin insan sağlığına etkisi. Avrupa Bilim ve Teknoloji Dergisi, 13, 45-53. https://doi.org/10.31590/ejosat.377798
CR  - Di Rienzo, T., D'angelo, G., D'aversa, F., Campanale, M.C., Cesario, V., Montalto, M., Gasbarrini, A., Ojetti, V. (2013). Lactose intolerance: from diagnosis to correct management. European Review for Medical and Pharmacological Sciences, 17(Suppl 2), 18-25.
CR  - Enattah N.S., Jensen, T.G., Nielsen, M., Lewinski, R., Kuokkanen, M., Rasinpera, H., El-Shanti, H., Seo, J.K., Alifrangis, M., Khalil, I.F., Natah, A., Ali, A., Natah, S., Comas, D., Mehdi, S.Q., Groop, L., Vestergaard, E.M., Imtiaz, F., Rashed, M.S., Meyer, B., Troelsen, J., Peltonen L. (2008). Independent introduction of two lactase-persistence alleles into human populations reflects different history of adaptation to milk culture. The American Journal of Human Genetics, 82, 57-72. https://doi.org/10.1016/j.ajhg.2007.09.012
CR  - Flatz, G., Rotthauwe, H.W. (1973). Lactose nutrition and natural selection. The Lancet, 302(7820), 76-77. https://doi.org/10.1016/S0140-6736(73)93267-4
CR  - Gaskin, D.J., Ilich, J.Z., (2009). Lactose maldigestion revisited: diagnosis, prevalence in ethnic minorities, and dietary recommendations to overcome it. American Journal of Lifestyle Medicine, 3(3), 212-218.  https://doi.org/10.1177/1559827609331555
CR  - Hertzler, S.R., Savaiano, D.A. (1996). Colonic adaptation to daily lactose feeding in lactose maldigesters reduces lactose intolerance. The American Journal of Clinical Nutrition, 64(2), 232-236. https://doi.org/10.1093/ajcn/64.2.232
CR  - Hertzler, S.R., Savaiano, D.A., Dilk, A., Jackson, K.A., Bhriain, S.N., Suarez, F.L. (2017). Chapter 40 - Nutrient Considerations in Lactose Intolerance. Nutrition in the Prevention and Treatment of Disease, Fourth Edition, 875-892. https://doi.org/10.1016/B978-0-12-802928-2.00040-0
CR  - Ingram, C.J., Elamin, M.F., Mulcare, C.A., Weale, M.E., Tarekegn, A, T.O., Raga, Bekele, E., Elamin, F.M., Thomas, M.G., Bradman, N., Swallow, D.M. (2007). A novel polymorphism associated with lactose tolerance in Africa: multiple causes for lactase persistence? Human Genetics, 120(6), 779-788. https://doi.org/10.1007/s00439-006-02
CR  - Ingram, C.J., Mulcare, C.A., Itan, Y., Thomas, M.G., Swallow, D.M. (2009). Lactose digestion and the evolutionary genetics of lactase persistence. Human Genetics, 124(6), 579-591. https://doi.org/10.1007/s00439-008-0593-691-1
CR  - Itan, Y., Jones, B.L., Ingram, C.J.E., Swallow, D.M., Thomas, M.G. (2010). A worldwide correlation of lactase persistence phenotype and genotypes. BMC Evolutionary Biology, 10, 36. https://doi.org/10.1186/1471-2148-10-36
CR  - Itan, Y., Powell, A., Beaumont, M.A., Burger, J., Thomas, M.G. (2009). The origins of lactase persistence in Europe. PLoS Computational Biology, 5(8), e1000491. https://doi.org/10.1371/journal.pcbi.1000491
CR  - Jacobi, A. (1901). Milk-sugar in infant feeding. Transactions of the American Pediatric Society, 13, 150-160.
CR  - Johnson, A.O., Semenya, J.G., Buchowski, M.S., Enwonwu, C.O., Scrimshaw, N.S. (1993). Adaptation of lactose maldigesters to continued milk intakes. The American Journal of Clinical Nutrition, 58(6), 879-881. https://doi.org/10.1093/ajcn/58.6.879
CR  - Kuhn, N.J., White, A. (2009). The topography of lactose synthesis. Journal of Mammary Gland Biology and Neoplasia, 14(3), 213-220. https://doi.org/10.1007/s10911-009-9136-6
CR  - Laland, K.N., Odling-Smee, J., Myles, S. (2010). How culture shaped the human genome: bringing genetics and the human sciences together. Nature Reviews | Genetics, 11, 137-148. https://doi.org/10.1038/nrg2734
CR  - Lewinsky, R.H., Jensen, T.G., Moller, J., Stensballe, A., Olsen J., Troelsen, J.T. (2005). T-13910 DNA variant associated with lactase persistence interacts with Oct-1 and stimulates lactase promoter activity in vitro. Human Molecular Genetics,14(24), 3945-3953. https://doi.org/10.1093/hmg/ddi418
CR  - Liebert, A., López, S., Jones, B.L., Montalva, N., Gerbault, P., Lau, W., Thomas, M.G., Bradman, N., Maniatis, N., Swallow, D.M. (2017). World wide distributions of lactase persistence alleles and the complex effects of recombination and selection. Human Genetics, 136, 1445-1453. https://doi.org/10.1007/s00439-017-1847-y
CR  - Lomer, M.C.E., Parkes, G.C., Sanderson, J.D. (2007). Review article: Lactose intolerance in clinical practice - myts amd realities. Alimentary Pharmacology and Therapeutics, 27(2), 93-103. https://doi.org/10.1111/j.1365-2036.2007.03557.x
CR  - Mądry, E., Fidler, E., Walkowiak, J. (2010). Lactose intolerance-current state of knowledge. Acta Scientiarum Polonorum Technologia Alimentaria, 9(3), 343-350.
CR  - Mattar, R., Mazo, D.F.C., Carrilho, F.J. (2012). Lactose intolerance: diagnosis, genetic, and clinical factors. Clinical and Experimental Gastroenterology, 5, 113-121. https://doi.org/10.2147/CEG.S32368
CR  - Matthews, S.B., Waud, J.P., Roberts, A.G., Campbell, A.K. (2005). Systemic lactose intolerance: a new perspective on an old problem. Postgraduate Medical Journal, 81, 167-173.
CR  - Misselwitz, B., Pohl, D., Frühauf, H., Fried, M., Vavricka, S.R., Fox, M. (2013). Lactose malabsorption and intolerance: pathogenesis, diagnosis and treatment. United European Gastroenterology Journal, 1(3), 151-159. https://doi.org/10.1177/2050640613484463
 
Mulcare, C.A. (2006). The evolution of the lactase persistence phenotype. London: University of London, The Centre for Genetic Anthropology, The Galton Laboratory, Department of Biology, PhD Thesis.
CR  - Mulcare, C.A., Weale, M.E., Jones, A.L., Connell, B., Zeitlyn, D., Tarekegn, A., Swallow, D.M., Bradman, N., Thomas M.G. (2004). The T allele of a single-nucleotide polymorphism 13.9 kb upstream of the lactase gene (LCT) (C-13.9kbT) does not predict or cause the lactase-persistence phenotype in Africans. American Journal of Human Genetics, 74(6), 1102-1110. https://doi.org/10.1086/421050
CR  - Silanikove, N., Leitner, G., Merin, U. (2015). The interrelationships between lactose intolerance and the modern dairy industry: global perspectives in evolutional and historical backgrounds. Nutrients, 7, 7312-7331.  https://doi.org/10.3390/nu7095340
 
Swagerty, D.L., Walling, A.D., Klein, R.M. (2002). Lactose intolerance. American Family Physician, 65(9), 1845-1850.
CR  - Szilagyi, A. (2015). Adaptation to lactose in lactase non persistent people: effects on ıntolerance and the relationship between dairy food consumption and evalution of diseases. Nutrients, 7, 6751-6779. https://doi.org/10.3390/nu7085309
CR  - Tishkoff, S.A., Reed, F.A., Ranciaro, A., Voight, B.F., Babbitt, C.C., Silveman, J.S., Powell, K., Mortensen, H.M., Hirbo, J.B., Osman, M., Ibrahim, M., Omar, S.A., Lema, G., Nyambo, T.M., Ghori, J., Bumpstead, S., Pritchard, J.K., Wray, G.A., Deloukas, P. (2007). Convergent adaptation of human lactase persistence in Africa and Europe. Nature Genetics, 39(1), 31-40. https://doi.org/10.1038/ng1946
CR  - Topçu, A., Saldamli, I. (2006). Proteolytical, chemical, textural and sensorial changes during the ripening of Turkish white cheese made of pasteurized cows' milk. International Journal of Food Properties, 9(4), 665-678. https://doi.org/10.1080/10942910500542238
CR  - Ugidos-Rodriguez, S., Matallana-Gonzalez, M.C., Sanchez-Mata, M.C. (2018). Lactose malabsorption and intolerance: a review. Food & Function, 9(8), 4056-4068. https://doi.org/10.1039/C8FO00555A
CR  - Vesa, T.H., Marteau, P., Korpela, R. (2000). Lactose intolerance. Journal of the American College of Nutrition, 19:sup2, 165-175. https://doi.org/10.1080/07315724.2000.10718086
CR  - Yıldırım, D., Özen, H. (2017). Laktoz intoleransı tıbbi beslenme tedavisi olgu sunumu. Beslenme ve Diyet Dergisi, 45(3), 294-297.
UR  - https://doi.org/10.3153/FH19028
L1  - https://dergipark.org.tr/en/download/article-file/809175
ER  -