Prevalence of lactose intolerance and malabsorption among children of two ethnic groups from the urban areas of Malaysia and its relation to calcium intake and bone health status.

Lactase insufficiency could develop into lactose intolerance (LI) and disrupt the intake of calcium, which is a core nutrient for bone development in children. However, data regarding the prevalence of LI and bone health status (BHS) among Malaysian children are scarcely reported. PURPOSE: This study aimed to determine the prevalence of LI and lactose malabsorption (LM) in Malay and Chinese children and examine its relationship with calcium intake (CI) and BHS. METHODS: A total of 400 children participated in this study. The prevalence of lactose tolerance (LT) was assessed using hydrogen breath test, LT test, and visual analogue scales. Assessment of CI was performed using a 24-h dietary recall interview (24-h DR) and food frequency questionnaire (FFQ). Calcaneal broadband ultrasound attenuation (BUA) was measured using a quantitative ultrasonometer. RESULTS: The prevalence of LI among Chinese children (37%) was significantly higher (p = 0.002) than among Malay children (22.5%). However, 61.5% of Malay and 54.5% of Chinese children were found to have LM. CI of the children fulfilled 30.5% and 33.9% of the Malaysian recommended CI (1300 mg/day) for 24-h DR and FFQ, respectively. The BUA score of Malay children was significantly higher (p < 0.001) than that of Chinese children. However, LT and CI were not correlated with BHS (p > 0.05, respectively). CONCLUSIONS: LI was diagnosed among Malay and Chinese children. However, the higher prevalence of LM is rather worrying as it could develop to LI. The prevalence possibly has been worsened by insufficient CI. Thus, effective approaches to increase CI are highly needed as bone development occurs rapidly at this age and is important for the attainment of the optimum peak bone mass during late adolescence.

Association of calcium intake, lactose intolerance and physical activity with bone health assessed via quantitative ultrasound among young adults of a Malaysian university.

Lactose intolerance has been proposed to cause poor bone health. This study found the prevalence of lactose intolerance was high among Malaysian young adults, but not associated with bone health status, unlike calcium intake. This is the first study that investigated the association of lactose intolerance and bone health status in Malaysia. PURPOSE: The aims of this study were to determine the prevalence of lactose intolerance, calcium intake and physical activity level and to investigate the association between these variables with bone health status among young adults. METHODS: This cross-sectional study consisted of 300 Malay, Chinese and Indian students from Universiti Kebangsaan Malaysia with mean age of 22.5 ± 3.2 years. Determination of lactose tolerance status was performed using hydrogen breath test, lactose tolerance test and visual analogue scales. Calcium intake and physical activity level were evaluated using Food Frequency Questionnaire and International Physical Activity Questionnaire, respectively. Bone health status was assessed on calcaneal bone, using quantitative ultrasound. RESULTS: Lactose intolerance was highly reported among the Malay subjects (72%) followed by Chinese (59%) and Indians (42%). The mean calcium intake was 542.9 ± 365.2 mg/day whilst the mean physical activity was 2757.6 ± 2007.2 MET-min/week. The bone assessment showed that 91% of the subjects had a low risk of developing osteoporosis. Only calcium intake showed a significant association with bone health status (ß = 0.006; p = 0.033), whilst no association was shown for lactose intolerance and physical activity level. CONCLUSIONS: Malaysian young adults showed a high prevalence of lactose intolerance. Calcium intake is associated with increased bone health status. In contrast, lactose intolerance and physical activity level did not directly influence bone health status. Nutrition education promoting adequate calcium intake should be implemented among young adults due to high lactose intolerance prevalence and low calcium intake among subjects.