Prevalence of self-reported stomach symptoms after consuming milk among indigenous Sami and non-Sami in Northern- and Mid-Norway - the SAMINOR study.

OBJECTIVE: The main purpose of this work was to identify the prevalence of self-reported stomach symptoms after consuming milk among Sami and non-Sami adults. STUDY DESIGN: A cross-sectional population-based study (the SAMINOR study). Data were collected by self-administrated questionnaires. METHOD: SAMINOR is a population-based study of health and living conditions conducted in 24 municipalities in Northern Norway during 2003 and 2004. The present study included 15,546 individuals aged between 36 and 79, whose ethnicity was categorized as Sami (33.4%), Kven (7.3%) and Norwegian majority population (57.2%). RESULTS: Sami respondents had a higher prevalence of self-reported stomach symptoms after consuming milk than the Norwegian majority population. The reporting was highest among Sami females (27.1%). Consumption of milk and dairy products (yoghurt and cheese) was high among all the ethnic groups. However, significantly more Sami than non-Sami never (or rarely) consume milk or cheese, and individuals who reported stomach symptoms after consuming milk had an significant lower intake of dairy products than those not reporting stomach symptoms after consuming dairy products. Sami reported general abdominal pain more often than the majority population. The adjusted models show a significant effect of Sami ethnicity in both men and women on self-reported stomach symptoms after consuming milk. In females, the odds ratio (OR)=1.77 (p=0.001) and in males OR=1.64 (p=0.001). CONCLUSION: Our study shows that the Sami population reported more stomach symptoms after consuming milk, suggesting a higher prevalence of milk intolerance among the Sami population than the Norwegian majority population.

Growth comparison in children with and without food allergies in 2 different demographic populations.

OBJECTIVE: To examine the effects of food avoidance on the growth of children with food allergies. STUDY DESIGN: A retrospective chart review was performed for children with and without food allergies followed at 2 New York City general pediatric practices. Charts were selected based on codes from the International Classification of Diseases, 9th Revision, for well child visit, food allergy, anaphylaxis, and/or epinephrine autoinjector prescriptions. Heights and weights were obtained to calculate body mass index, height, and weight z-scores. RESULTS: Of the 9938 children seen, 439 (4.4%) were avoiding one or more foods. Of those with commercial insurance, children with food allergies were significantly shorter (mean height z-score = 0.06; P = .01) and weighed less (mean weight z-score -0.1; P = .006) than children without food allergies (mean height z-score = 0.42; mean weight z-score = 0.07). In contrast, children with food allergies and state insurance were not smaller in height or weight compared with children without food allergies. Among white subjects, there was a significant effect of food allergies on height and weight (ANOVA for height P = .012, for weight P = .0036) that was not observed for Hispanic/Latino, black, or Asian subjects. Children with allergies to milk weighed significantly less than children without milk allergies (P = .0006). CONCLUSIONS: Children with food allergies and commercial insurance have significant impairment in growth compared with those without food allergies. Additionally, children avoiding all forms of milk are shorter and weigh less than matched counterparts. Therefore, height and weight measurements should be assessed routinely in children with food allergies because there is risk for growth impairment in this population.

Perceptions of caregivers of patients with cow's milk allergy regarding the treatment / Percepção dos familiares de pacientes com alergia ao leite de vaca em relação ao tratamento

The aim of this qualitative study was to understand the perceptions of caregivers of children and adolescents with cow's milk allergy regarding the disease and its treatment. Nine caregivers were interviewed and content analysis method was used. Three categories with subcategories emerged: treatment and education of the patient and their caregivers (life experiences, bases of treatment, coping with the disease), resolution of the disease (hope, gradual improvement), quality of life (social inclusion, family daily activities, costs of dietary treatment). Caregivers experienced difficulties during the initial treatment but pointed out that the guidance given during follow-up made the adjustments easier. Family members commented on the difficulties about lack of cooperation from other family members regarding the restrictive diet, their experience coping with the allergic reaction, doubts about the treatment and gaps on knowledge about the disease by other physicians and people. Some of them believed that there is no treatment for the disease, because there are no drugs or vaccines, but they were waiting for cure. The majority of relatives were satisfied with the gradual improvement of patients observed by reduction on the severity of symptoms and tolerance of milk traces within foods. In addition, they commented on the efforts to give a normal life for their children, the changes in their daily lives and the difficulty to buy special products. Concluding, caregivers of children and adolescents with cow's milk allergy feel a great burden of the disease.(AU)

Este estudo qualitativo teve como objetivo compreender as percepções de familiares de crianças e adolescentes com alergia à proteína do leite de vaca (APLV) em relação à doença e seu tratamento. Foram realizadas nove entrevistas e foi utilizado o método de análise de conteúdo. Surgiram três categorias com subcategorias: tratamento e educação do paciente e familiares (experiências vividas, base do tratamento e como lidar com a doença), resolução da doença (expectativa e melhora gradativa), qualidade de vida (inclusão social, cotidiano familiar e custo dos alimentos). Os familiares vivenciaram dificuldades durante o início do tratamento, mas revelaram que as orientações fornecidas no seguimento tornaram as adaptações à doença mais fáceis. Comentaram sobre as dificuldades em obter a colaboração de outros membros da família em relação à dieta de exclusão, suas experiências frente a uma reação alérgica, dúvidas quanto ao tratamento e lacunas do conhecimento sobre a doença entre outros médicos e na população em geral. Alguns deles acreditavam que não havia tratamento para a APLV, porque não existiam medicamentos ou vacinas, mas mantinham a esperança da descoberta de uma cura. A maioria dos familiares estava satisfeita com a melhora gradativa dos seus filhos, percebida pela redução da gravidade dos sintomas e tolerância a traços de leite. Também comentaram sobre os esforços em proporcionar uma vida normal para seus filhos, as mudanças em suas vidas e a dificuldade em comprar alimentos especiais. Em conclusão, os familiares de crianças e adolescentes com APLV sentem grande impacto da doença.(AU)

Chicken-based formula is better tolerated than extensively hydrolyzed casein formula for the management of cow milk protein allergy in infants.

The effective treatment of cow milk allergy in infants consists of elimination of cow milk protein and the introduction of formulas based on an extensively hydrolyzed protein formula or an amino acid-based formula. However, about 10% of these infants are still allergic to an extensively hydrolyzed protein formula and an amino acid-based formula is very expensive. We conducted a study to verify whether the new chicken-based formula will be better tolerated than an extensively hydrolyzed protein formula for the treatment of cow milk allergy in infants. One hundred infants, diagnosed with cow milk allergy by double-blind, placebo-controlled food challenge tests, were enrolled in a double-blind, randomized, cross-over study to compare a response to an extensively hydrolyzed protein formula and the chicken-based formula. Subjects were randomly given one of the two formulas for 2 weeks. There was a 2-week washout period of taking an amino acid-based formula before being switched to the other formula for another 2 weeks. If the subjects showed allergic symptoms during the 2 weeks of test formula, they would be announced as intolerance or allergic to that formula. Sixty seven of 80 confirmed subjects agreed to enroll their infants. Fifty-eight subjects completed the study. Twenty and 33 infants were tolerant whereas and 38 and 25 infants were intolerant to an extensively hydrolyzed protein formula and the chicken-based formula, respectively. The chicken-based formula showed significantly better tolerance than an extensively hydrolyzed protein formula in the management of cow milk allergy in infants.

Correlation of lactose maldigestion, lactose intolerance, and milk intolerance.

Lactose digestion and tolerance were evaluated in 164 African Americans ranging in age from 12 to 40 y who claimed intolerance to one cup (240 mL) or less of milk. With use of a breath-hydrogen test with 25 g lactose as test dose and the presence or absence of symptoms, 50% of the subjects were classified as lactose maldigesters and intolerant, 8% were maldigesters but tolerant, 15% were digesters but intolerant, and 27% were digesters and tolerant. Forty-five subjects from the lactose maldigesting and intolerant group were further tested for milk intolerance in a double-blind study. Sixty-seven percent of the subjects reacted appropriately to the presence or absence of lactose in ingested milk whereas 33% reported symptoms to both low-lactose milk and milk containing lactose. The results suggest that the cause of milk intolerance in as many as one-third of African Americans claiming symptoms after ingestion of a moderate amount of milk cannot be its lactose content.

[Lactase deficiency among representatives of various nationalities of Siberia]. / Laktaznaia nedostatochnost' u predstavitelei nekotorykh narodnostei Sibiri.

Some features of lactase tolerance were investigated in representatives of varying groups of indigenous population in Siberia-Mansi, Khanty, Nenets, Buryats. The indirect method was used to evaluate lactase activity. A total of 92 subjects were investigated. It was found that 32% of the representatives of the Urals population group and 53% of Buryats were capable of lactase assimilating. The data obtained correspond to the cultural-genetic hypothesis on the nature of lactase tolerance in the representatives of different ethnic groups.