Lactose Intolerance - Health Implications, Incidence in Different Populations - Essay Example

Lactose intolerance Name: Institution: Date: Introduction It is a well documented fact that dairy products are essential to the overall human health. In particular, nutrients such as potassium, vitamin D and calcium have often remained and continue to remain a major public-health concern. With the intake of dairy products not being a problem to some individuals, it has remained a challenge and a deterrent to better health among particular individuals with the condition of lactose intolerance (Theresa et al, 2009). Lactose intolerance, while fairly common, is undoubtedly one of the most significant health concerns. This health condition is widespread globally with the subjects constantly avoiding milk along with other milk products in order to alleviate suffering due to its symptoms. Lactose intolerance is often experienced when an individual’s body lacks adequate lactase, a condition referred to as hypolactasia. Hypolactasia is estimated to be prevalent in 70% of global population where it frequently remains undiagnosed hence having more potentials of causing morbidity. Lactase basically helps with the hydrolysis of lactose, thus providing the body with the nutritional benefits during absorption. While the disaccharide’s uniqueness cannot be ruled out, the disaccharide’s presence in human milk can be equated to 3.6g/50mL.It similarly measures 2.35g/50mL in the milk of cows while being negligible in particular marine mammals. Since this disaccharide is present in mammalian milk, individuals with the condition of lactose intolerance often opt to neglect and avoid dairy products irrespective of the inherent health consequences. Lactose intolerance has thus turned out into a common problem and a major challenge globally. The value of enhanced understanding regarding lactose intolerance and its health implications including its prevalence across populations can thus not be dismissed. This particular paper discusses lactose intolerance and implications in depth. Lactose Intolerance Lactose intolerance can be described as the inability of the body to digest Lactose, a disaccharide present in milk including milk products (Bailey et al, 2013; Law et al., 2010). Rubin & strayer (2012) highlight how malabsorption really affects most individuals significantly. The significance of lactose within the body is much more especially considering its role in enhancing the absorption of various minerals including magnesium, zinc and calcium (Shaukat et al, 2010). Normally, when an individual consumes any lactose-containing food, the enzyme lactase disintegrates the lactose into glucose and galactose, the simpler forms of sugar. As a consequence, these simple sugars become easily absorbed in the bloodstream thereby being converted into energy for the body’s use. Considering this, individuals with lactose intolerance often fail to produce adequate lactase enzyme for breaking down the disaccharide lactase. Alternatively, the undigested lactose stays within the individual’s gut where bacterial breaks it down, leading to various symptoms. The inability to produce adequate lactase results in lactase deficiency which may be categorized under 3 groups. Primary lactase deficiency is basically autosomal recessive and is also reffered to as the adult-type hypolactacia or the hereditary lactase deficiency. This develops at different stages. The secondary lactase deficiency often results from damaged intestinal mucosa and is associated with bacterial gastroenteritis and chemotherapy. Developmental lactase deficiency is often found among the premature babies (often below 34 gestation weeks) but improves with the baby’s maturity. Abdominal pain is a typical symptom of this condition. Additional symptoms include diarrhea, bloating and borborygmi. On particular occasions, lactose intolerance presents itself inform of nausea, vomiting and flatulus. To a lesser extent there is always a decrease in the gastrointestinal motility hence subjects may have constipation mostly as a result of the production of methane. Through animal models, there is the evidence that a significant decrease in gut’s main migratory reflexes is realized when methane is infused, hence slowing of gut transit. Bloating and the abdominal pain often occur as a result of the colonic unabsorbed-lactose fermentation by bacterial microflora. This consequently translates into the production/formation of methane, carbon dioxide, SCFA (short chained fatty acids), and hydrogen which increase the time of gut transit in addition to raising the intracolonic pressure. The colonic content acidification and the high osmotic load due to unabsorbed lactose result in increased electrolyte and fluid secretion besides speeding the transit time hence leading to loose stools or diarrhea. Lactose intolerance has often been confused with milk allergy which is just the body’s reaction to particular milk proteins Boyce et al (2010). Lactose intolerance is often genetically determined. However particular causes include congenital which is basically the major cause and which is characterized by unusual low levels of lactase. Similarly, gastroenteritis is another cause as it has the potential of stripping lactase from the intestines for a particular period. Parasitic infection may also reduce the levels of lactase temporarily while iron deficiency may lead to interference with the digestion of lactose. Age is a crucial factor in determining who is more susceptible to lactose intolerance Wooten (2009). Actually, as the age increases, the body often discontinues lactase production hence most people being lactose intolerant with time. Despite this condition being frequently diagnosed in adults than children, all individuals with given risk factors may become lactose intolerant. The risk factors for lactose intolerance also include ethnicity where particular ethnic groups tend to present its symptoms at a tender age. Problems within an individual’s digestive tract may also be a potential cause since individuals with celiac and crohn’s disease present reduced lactase enzyme levels. Certain medications, and especially antibiotics, may as well trigger the condition temporarily by hindering the ability of the intestine to produce lactase. Infections such as infectious diarrhea also cause temporary lactose intolerance among young children. Health Implications The health implication of lactose intolerance is quite serious. In fact, calcium deficiency stands out as the most important long term consequence of it (Theresa et al, 2009). Calcium deficiency is often the precursor to the osteoporosis condition where low calcium level is a major risk factor. Since dairy products serve as an important source of calcium, studies exploring the correlation between lactose intolerance, bone health condition and calcium intake indicate that individuals presented with the lactose intolerance condition have higher risks of developing osteoporosis. In osteoporosis, bones are often less dense compared to normal ones hence presenting individuals with increased chances having bone fractures. In some countries such as the U.S, over 40,000,000 people are already with osteoporosis or have higher risks associated with reduced/low bone mass. Despite being preventable, osteoporosis is often regarded as the silent disease given that if it is undetected then a progress in bone loss can be experienced for several years with no symptoms to a level that fractures are experienced. This is often equated to a childhood disease having old-age consequences due to the fact that the development of healthy bones among youths often prevents the condition including potential fractures during old age (NIHORBD, 2015) Lactose intolerance has also been identified as associated with the Irritable Bowel Syndrome (IBS). Irritable bowel syndrome is indicated as affecting approximately 9% to 12% of the world population including patients with symptoms such as abdominal pain and diarrhea. Regardless of lactose intolerance not being the cause of the irritable bowel syndrome, it often increases the effects. The presence of the lactose intolerance makes such patients have a higher visceral sensitivity to luminal lactose effects in comparison to the healthy subjects. With such, the significance of questions regarding various lactose-induced symptoms in patient management cannot be totally ruled out. In fact, most individuals with the deficiency of lactase often suffer a little less in comparison to babies or infants with serious deficiency and who need nutritious diets that exclude lactose. It is also noted that transient lactase deficiency often affects a number of babies/infants presented with severe gastroenteritis or diarrhea. This implies that lack of advance proper feeding with the lactose-containing products and failure to recognize lactose malabsorption often translates to malnutrition, chronic diarrhea and lactose intolerance cases. In addition to this, the presence of lactose intolerance tends to increase the risks of metabolic disorders. in fact, given that milk and the associated milk products posses beneficial health effects leading to better health outcomes, their role in preventing metabolic syndrome and reducing risk of colorectal cancer, risk of hypertension and risk of diabetes has been well documented (Bailey et al, 2013). The inability to consume dairy products therefore translates to poor health outcomes. In a multi-ethnic survey within the U.S, it was observed that individuals who had self-perceived lactose intolerance not only had higher diabetic rates but also high hypertension rates. In a study, self reported lactose intolerance cases were 7% in whites, 22% among blacks and 10% among Hispanics (Theresa et al, 2009) Incidence in different populations Lactose intolerance affects all sexes equally. Whereas the decreased lactase expression often reaches its climax during childhood, lactose intolerance is highlighted as less common among little children. This has often been indicated as occurring later during adolescence. However, Lactose intolerance is basically common among adults whereby its incidence in older people is even higher (Suchy et al, 2010). Notwithstanding this, ethnic origin has been noted as significantly affecting lactose intolerance frequency among people. Some specific ethnic groups are significantly affected with the lactose intolerance condition. Particular ethnic groups as well as racial populations have basically been identified as presenting higher cases of lactose intolerance in comparison to others. In specific, Australasians, the white northern Europeans, and the northern Americans present lowest rates of lactose intolerance, from 5 percent in Britain’s population to about 17% in the finish population and northern France’s population. In Africa, the southern part of U.S (South America), and Asia, more than 50 percent of the inhabitants have lactase non-persistence while in given Asian nations this rate is already threatening to reach an alarming 100% (Bailey et al, 2013). In a research study, the Chinese and the Japanese were found to loose about 80% to 90% of their lactase activity in a period of 3 to 4 years immediately after weaning. In a similar manner, The Jews and the Asians were also found to loose about 60% to 70% after many years post-weaning while the white Europeans from the north could reach 18 years to 20 years before lactase activity reaches the lowest expression. Surprisingly, within the mixed ethnicity subjects, lower lactase non-persistence levels are observed whereby native ethnicity accounts for much given that, in the case, the highest prevalence is in native ethnic groups. In terms of deficiency, the primary lactase deficiency commands a significant portion of the world’s population (70%). Similarly, its prevalence widely varies with ethnic groups whereby the northern Europeans have a score of 2% compared to the Hispanic population’s 80%. This is attributed to the difference in the consumption/use of the dairy products. In terms of age presentation, the prevalence varies widely with Afro-Caribbean children, Asian children and Hispanic children presenting before attaining the age of 5 years while the northern Europeans present after reaching 5 years and beyond. Likewise, another study aimed at determining the significance of the tolerance-test determined lactose intolerance which is basically assumed as affecting many adults globally highlighted ethnic variances. Abnormality in the lactose-tolerance-test were noted in about 80 out of 98 blacks, 7 out of 59 scandinavian whites or northwestern Europe whites as well as 1 out of 3 non-European whites. In summary, lactase non-persistence and lactose intolerance affects mostly Africans, Asians, Hispanic population as well as Native American individuals. Contrarily however, this is not the case with the whites who are less susceptible to lactase non-persistence and lactose intolerance and who are also not likely to present symptoms when this occurs (Theresa et al, 2009). Lactose intolerance is therefore a clinically-relevant problem. It is obvious that the ethnic consumption of dairy and dairy products is less common among particular ethnic groups including Africans and Asians. The differences in the prevalence rates across the global population highlight that lactose intolerance and retaining of lactase persistence through to adulthood is in no way consistent across groups and the overall population. It is also clear that this occurs during adulthood but with more incidences being in the older population. A decline of lactase activity due to age advancement is quite normal. In addition, particular ethnic as well as racial populations seem to be affected more in comparison to others (Bailey et al, 2013; Wooten, 2009). Whereas it is actually rare for the Caucasians to have lactose intolerance developing among them, the condition can be regarded as quite common in the Asian, African, and Middle East populations including particular Mediterranean nations. Africans, Asians and the Hispanic population present highest percentages of prevalence while white Europeans present the lowest cases (Bailey et al, 2013; Wooten, 2009). In particular ethnic groups, the prevalence may be higher compared to others given their traditional diet that includes few dairy products. In such populations, it might be found that they inherited the genes of their forefathers who avoided dairy foods hence their body system could not digest the dairy products. This is likely the reason why lactose intolerance is attributed to genetic conditions. In fact, genetic morphisms that are responsible for the lactase persistence among the Europeans have been noted, with the distribution of these being more concentrated among the northern Europeans. The intake of dairy food is actually linked to the differences in ethnic prevalence across the disparities (Bailey et al, 2013; Wooten, 2009). On average, the ethnic groups with the highest prevalence often consume dairy products along with their nutrients in little quantities in comparison to the recommended levels. The main reason behind the intake of limited quantities of the dairy products could be the presence of perceived intolerance towards glucose or the actual intolerance towards it (Wilt et al., 2010). While the prevalence of actual/true intolerance towards glucose may be hard to determine, research points out that individuals regarding themselves as lactose intolerant are more likely to compromise their intake of dairy and other dairy products. In effect, this may consequently lead to inadequate intake of essential nutrients in addition to being highly susceptible to various chronic diseases. While dairy products may differ in terms of their association with various metabolic disorders, ethnic differences in the consumption of dairy and dairy products partially explains the ethnic disparity in the prevalence of lactose intolerance and the associated healthy complications often related to the metabolic disorders (Bailey et al, 2013; Wooten, 2009). In light of this, health authorities have agreed on the importance of lactose intolerant individuals taking dairy food while also emphasizing the possibility and the need for encouragement towards this (Shaukat et al, 2010; Bailey et al, 2013). Conclusion Lactose intolerance is undoubtedly a serious condition affecting over 70% of the world population. An understanding of lactose intolerance’s and its complexity, the complexity of lactase deficiency and the generation of symptoms is thus indispensable. From the analysis, lactose intolerance deprives its subjects from consuming any lactose-based products including dairy and its associated products. The fact that dairy products have associations with various metabolic disorders such as obesity and diabetes underscores the need for dairy consumption regardless of the condition. Despite this, the analysis has indicated the manner in which this is neglected based on actual and sometimes perceived lactose intolerance. 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