Dairy products: try them–you’ll like them?

Osteoporosis in postmenopausal women may be reduced in both incidence and severity by a calcium intake of 1500 mg/d (1). Dairy products represent the richest natural food source for calcium, but a major impediment to the intake of dairy products is the desire to avoid symptoms attributable to lactose intolerance. These symptoms include excessive flatus, bloating, abdominal pain, nausea, and feelings of fullness. At least 30% of the US population maldigests lactose (2). In this issue of the Journal, Suarez et al (3) compared symptoms in women consuming diets containing 1300 mg Ca, but either unmodified in lactose content or with the lactose content extensively reduced through enzymatic hydrolysis. In each diet, the amount of lactose or reduced lactose ranged from 34 to 2 g. Women were divided equally between those who digested lactose and those who did not as determined by breath-hydrogen testing. Women with lactose maldigestion reported no significant differences in bloating, abdominal pain, diarrhea, or their perception of overall symptom severity whether ingesting the conventional dairy-rich diet or the lactose-hydrolyzed diet. Women with lactose maldigestion did, however, report increased flatus frequency and subjective impression of rectal gas during the period of high lactose intake. Not surprisingly, women who digested lactose reported no significant differences for any symptom during ingestion of conventional or lactose-hydrolyzed dairy products. Because on balance the women with lactose maldigestion tolerated the “high” lactose diet, the authors concluded that “the symptoms resulting from lactose maldigestion are not a major impediment to the ingestion of a dairy-rich diet supplying