Whole Cow’s Milk but Not Lactose Can Induce Symptoms inPatients with Self-Reported Milk Intolerance: Evidence of Cow’s Milk Sensitivity in Adults

Background: Lactose intolerance is the most frequent food intolerance, but many subjects with self-reported milk intolerance (SRMI) are asymptomatic at lactose hydrogen breath test (LHBT). The aim of this study was to evaluate the frequency of lactose intolerance in SRMI patients and their clinical characteristics. Methods: In a retrospective study, the clinical records of 314 SRMI patients (259 females, mean age: 39.1 ± 13.5 years) were reviewed; 102 patients with irritable bowel syndrome (IBS) served as controls. In a prospective study, 42 SRMI patients, negatives at the LHBT, underwent a double-blind, placebo-controlled (DBPC) whole cow’s milk challenge. Results: In the retrospective study, only 178 patients (56%) were lactose maldigesters and intolerant at LHBT; 68% of the subjects with SRMI were suffering from IBS; 74% reported dyspepsia (p = 0.0001 vs. IBS controls); and weight loss was recorded in 62 SRMI patients (20%) (p = 0.01 vs. IBS controls). Duodenal histology showed intra-epithelial lymphocytosis in about 60% of cases. In the prospective study, 36 patients (86%) experienced symptoms during the DBPC cow’s milk challenge, and only 4 patients (9%) reacted to placebo (p = 0.0001). Conclusions: A percentage of SRMI patients were not suffering from lactose intolerance. DBPC revealed that SRMI patients had clinical reactions when exposed to whole cow’s milk.

Prevalence of Irritable Bowel Syndrome, Functional Dyspepsia and their Overlap in Bulgaria: a Population-Based Study

Aims: We aimed to evaluate the prevalence of irritable bowel syndrome (IBS), functional dyspepsia (FD), and their overlap syndrome (OS) in the Bulgarian population and to assess the risk factors associated with these disorders. Methods: We sent an internet-based survey to Bulgarian adults. The survey collected data on socio- demographic, behavioral and lifestyle characteristics, and diagnostic questions following the Rome IV criteria to assess IBS, FD and their overlap occurrence. Results: Data was collected from 1,896 individuals (mean age = 35.5 years, 18-65, SD=11.7), 73.1% females. The prevalence of IBS was 20% (14% were with predominant constipation, 32% with predominant diarrhea, 52% had IBS with mixed bowel habits, and 2% unclassified IBS). Gender (p=0.005), age (p<0.001), marital status (p=0.009), occupation (p=0.001), alcohol consumption (p=0.013), sexual problems (p<0.001), FD (p<0.001), and milk intolerance (p<0.001) were significantly associated with IBS. Females (p=0.032; OR: 1.50), patients with FD (p<0.001; OR: 104.98), sexual problems (p= 0.001; ОR: 1.55 ), and milk intolerance (p<0.001; OR: 2.22) are at a higher risk of having IBS. The prevalence of FD was 12.7% (39% had postprandial distress syndrome, 33% epigastric pain syndrome, and 28% had the overlapping variant). Patients with IBS (p<0.001; OR: 127.88) and milk intolerance (p<0.001) were significantly associated with FD prevalence. The prevalence of OS was 11.7%. Gender (p=0.013), milk intolerance (p<0.001, OR: 1.65), urinary (p=0.035) and sexual problems (p<0.001, ОR: 1.80) were associated with OS prevalence. Conclusion: This is the first study to estimate the prevalence of IBS, FD, and their OS and assess the behavioral and demographic risk factors associated with these disorders in the Bulgarian population. Our results are valuable in filling in the epidemiological data gap regarding IBS, FD, and OS in Eastern Europe.

Development of Non Dairy Milk Alternative Using Soymilk and Almond Milk

Non dairy milk alternative represents the milk substitute for people suffering from milk intolerance and allergy. The present study was carried thus out to standardize the process for development of plant based milk alternative using soymilk and almond milk. Formulations for manufacture of soymilk and almond milk were optimized on the basis of their sensory as well as nutritional properties. Optimized milks were thereafter blended for the preparation of different non dairy milk alternatives in different ratios as T01 (soymilk), T02 (almond milk), T1 (60% soymilk + 40% almond milk), T2 (50% soymilk + 50% almond milk), T3 (40% soymilk + 60% almond milk) while cow milk (T0) served as control. The soymilk, almond milk and the blends of both were analysed for their proximate as well as sensory properties. Among the plant based milks, soymilk displayed higher moisture, pH and protein content while the values of total solids, titratable acidity, ash, fat, iron and calcium were higher for almond milk. Sensory score revealed that soy-almond milk blend prepared with 60% almond milk and 40% soymilk was recorded highest of all the milks analyzed. The selected milk blend (T3) though had lower sensory score than control but rated quite good in terms of acceptability. With regards to nutrient profile of milk blend in comparison to control, the results indicated that concentration of all the nutrients were higher in milk blend (T3) except for Ca & protein which were recorded higher in control. Therefore, based on nutrient and sensory profile, it can be implied that soy almond milk blend suits well as a candidate for use as non dairy milk alternative

Evaluation of bovine beta casein polymorphism in two dairy farms located in northern Italy

Bovine beta casein A1 is one of the most common variants in dairy cattle breeds; it is considered a risk factor in milk intolerance and in other important human diseases, because of the bioactive peptide beta casomorphin-7 (BCM7) produced by raw or processed A1-milk, but not by A2- milk, during digestion. The aim of this study was to perform a cheap and rapid method to investigate beta casein polymorphism in copious animals. The study included 2 dairy farms with a totally of 1230 cows. Beta casein genotypes were estimated evaluating Exon 7 region of bovine beta casein gene (CSN2) by sequences analysis. In the population included in the study 5 variants (A1, A2, B, F, I) and 13 genotypes (A1A1, A1A2, A1B, A1F, A1I, A2A2, A2B, A2F, A2I, BB, BF, BI, FI) were detected. The method showed high sensibility and specificity, resulted low-cost and few time consuming.