Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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An Electronic Questionnaire Survey Evaluating the Perceived Prevalence and Practices of Lactose Intolerance in 1 to 5 Year Old Children in South East Asia

  • Received : 2017.09.06
  • Accepted : 2018.01.11
  • Published : 2018.07.15
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Abstract

Purpose: Lactose intolerance (LI) is perceived to be frequent in Asia and has been reported to have considerable impact on dietary intake, nutritional status and the quality of life. We aimed to gather information from healthcare professionals on the perceived incidence, diagnosis and management of LI in 1 to 5 year old children in Southeast Asia. Methods: An anonymous electronic survey was sent randomly among healthcare professionals registered in the database of the pediatric societies in Thailand, Indonesia, and Singapore between June and October 2016. Results: In total, 259 health care professionals responded of which 45.5% (n=118) were from Thailand, 37.4% (n=97) from Indonesia and 16.9% (n=44) from Singapore. Of the participants who responded (n=248), primary LI prevalence among children 1 to 3 years of age was estimated to be less than 5% by 56.8%. However, about 18.9% (n=47) answered they did not know/unsure. Regarding secondary LI, 61.6% of respondents (n=153) estimated the prevalence to be less than 15%. But again, 10.8% (n=27) answered they did not know or unsure. Rotavirus gastroenteritis was ranked as the top cause for secondary LI. There was considerable heterogeneity in the diagnostic methods used. The majority of respondents (75%) recommended lactose-free milk to manage primary and secondary LI. Conclusion: More education/training of pediatricians on this topic and further epidemiological studies using a more systematic approach are required.

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References

  1. Heyman MB; Committee on Nutrition. Lactose intolerance in infants, children, and adolescents. Pediatrics 2006;118:1279-86. https://doi.org/10.1542/peds.2006-1721
  2. Lukito W, Malik SG, Surono IS, Wahlqvist ML. From 'lactose intolerance' to 'lactose nutrition'. Asia Pac J Clin Nutr 2015;24 Suppl 1:S1-8.
  3. Wahlqvist ML. Lactose nutrition in lactase nonpersisters. Asia Pac J Clin Nutr 2015;24 Suppl 1:S21-5.
  4. Perino A, Cabras S, Obinu D, Cavalli Sforza L. Lactose intolerance: a non-allergic disorder often managed by allergologists. Eur Ann Allergy Clin Immunol 2009;41: 3-16.
  5. EFSA Panel on Dietetic Products NaAN. Scientific opinion on lactose thresholds in lactose intolerance and galactosaemia. EFSA Journal 2010;8:1777. https://doi.org/10.2903/j.efsa.2010.1777
  6. Harvey L, Ludwig T, Hou AQ, Hock QS, Tan ML, Osatakul S, et al. Prevalence, cause and diagnosis of lactose intolerance in children aged 1-5 years: a systematic review of 1995-2015 literature. Asia Pac J Clin Nutr 2018;27:29-46.
  7. Hegar B, Widodo A. Lactose intolerance in Indonesian children. Asia Pac J Clin Nutr 2015;24 Suppl 1:S31-40.
  8. Braithwaite D, Emery J, De Lusignan S, Sutton S. Using the Internet to conduct surveys of health professionals: a valid alternative? Fam Pract 2003;20:545-51. https://doi.org/10.1093/fampra/cmg509
  9. GBD 2015 SDG Collaborators. Measuring the healthrelated Sustainable Development Goals in 188 countries: a baseline analysis from the Global Burden of Disease Study 2015. Lancet 2016;388:1813-50. https://doi.org/10.1016/S0140-6736(16)31467-2
  10. Myo-Khin, Bolin TD, Khin-Mar-Oo, Tin-Oo, Kyaw-Hla S, Thein-Myint T. Ineffectiveness of breath methane excretion as a diagnostic test for lactose malabsorption. J Pediatr Gastroenterol Nutr 1999;28:474-9. https://doi.org/10.1097/00005176-199905000-00006
  11. Yang Y, He M, Cui H, Bian L, Wang Z. The prevalence of lactase deficiency and lactose intolerance in Chinese children of different ages. Chin Med J (Engl) 2000; 113:1129-32.
  12. Gonzalez-Galan V, Sanchez-Fauqier A, Obando I, Montero V, Fernandez M, Torres MJ, et al. High prevalence of community-acquired norovirus gastroenteritis among hospitalized children: a prospective study. Clin Microbiol Infect 2011;17:1895-9. https://doi.org/10.1111/j.1469-0691.2011.03506.x
  13. Hu Y, Gui L, Chang J, Liu J, Xu S, Deng C, et al. The incidence of infants with rotavirus enteritis combined with lactose intolerance. Pak J Pharm Sci 2016;29(1 Suppl):321-3.
  14. Fischer Walker CL, Black RE. Rotavirus vaccine and diarrhea mortality: quantifying regional variation in effect size. BMC Public Health 2011;11 Suppl 3:S16. https://doi.org/10.1186/1471-2458-11-S3-S16
  15. Vandenplas Y. Lactose intolerance. Asia Pac J Clin Nutr 2015;24 Suppl 1:S9-13.
  16. Newcomer AD, McGill DB, Thomas PJ, Hofmann AF. Prospective comparison of indirect methods for detecting lactase deficiency. N Engl J Med 1975;293:1232-6. https://doi.org/10.1056/NEJM197512112932405
  17. Schirru E, Corona V, Usai-Satta P, Scarpa M, Cucca F, De Virgiliis S, et al. Decline of lactase activity and c/t-13910 variant in Sardinian childhood. J Pediatr Gastroenterol Nutr 2007;45:503-6. https://doi.org/10.1097/MPG.0b013e31805b5899
  18. Gremse DA, Greer AS, Vacik J, DiPalma JA. Abdominal pain associated with lactose ingestion in children with lactose intolerance. Clin Pediatr (Phila) 2003;42:341-5. https://doi.org/10.1177/000992280304200406
  19. Wiley AS. Consumption of milk, but not other dairy products, is associated with height among US preschool children in NHANES 1999-2002. Ann Hum Biol 2009;36:125-38. https://doi.org/10.1080/03014460802680466

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