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Article Type

Review

Abstract

Objectives The aim of the study was to perform systematic review to summarize the investigation and management of lactose intolerance among children. Data sources Medline, articles in Medscape, AAFP, and PubMed were searched. The search was performed on 1 April 2014 and included all articles with no language restrictions. Study selection The initial search presented 320 articles. The number of studies that met the inclusion criteria was 15. The articles included lactose intolerance and health common clinical presentation, investigation to confirm the diagnosis, dietary modification and its impact on bone health, supplementation using different formula, and manifestation of lactose intolerance. Data extraction Data from each eligible study were independently abstracted in duplicate using a data collection form to capture information on study characteristics, interventions, and quantitative results reported for each outcome of interest. Data synthesis There was heterogeneity in the collected data. It was not possible to perform meta-analysis. Significant data were collected. Thus, a structured review was performed. Conclusion Five articles were review articles and one systematic review summarized the clinical presentation, investigation, and management. Two studies showed the effect of lactose intolerance on bone and serum calcium and zinc as lactose intolerance prevents the achievement of an adequate peak bone mass; calcium absorption was significantly greater from the lactose-containing formula than from the lactose-free formula, whereas zinc absorption showed no difference. Six studies showed the relationship between ingested formula and clinical manifestation and relationship with methane production, which recommended the supplementation using small frequent doses or gradual increasing dose to produce adaptation. One study showed that the LCT(T/C-13910) polymorphism was associated with subjective milk intolerance and reduced bone mineral density (BMD) that may predispose to bone fractures.

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