Ingestão de cálcio e densidade mineral óssea em mulheres adultas intolerantes à lactose
Palabras clave:
Lactose, Leite, Osso, Sindrome de malabsorçãoResumen
Objetivo
Comparar a ingestão de cálcio e a densidade mineral óssea entre mulheres adultas portadoras de intolerância à lactose e suas congêneres não portadoras da doença.
Métodos
A amostra foi composta por 60 mulheres jovens adultas (de 20 a 40 anos), separadas em dois grupos: 30 diagnosticadas com intolerância à lactose e 30 saudáveis. A ingestão de cálcio foi avaliada por três autorregistros alimentares, e a densidade mineral óssea do colo do fêmur por absortometria radiológica de dupla energia.
Resultados
As densidades minerais ósseas do colo do fêmur (M=0,86, DP=0,13g/cm² versus M=0,77, DP=0,12g/cm²) e do fêmur total (M=1,14, DP=0,14g/cm² versus M=1,06, DP=0,12g/cm²) foram menores (p<0,05) para as portadoras de intolerância à lactose do que para o grupo-controle, mas não houve diferença significativa na densidade mineral óssea para corpo inteiro (M=1,14, DP=0,15g/cm² versus M=1,08, DP=0,09g/cm², p>0,05). Além disso, a ingestão de cálcio foi menor para intolerantes à lactose do que para o grupo-controle (M=250,5, DP=111,7mg/dia-1 vs M=659,7, DP=316,1mg/dia-1, p<0,05).
Conclusão
Os resultados do presente estudo sugerem que o aparecimento de sintomas de intolerância pode influenciar a massa óssea devido a uma redução da ingestão de cálcio.
Citas
Guéguen L, Pointillart A. The bioavailability of dietary calcium. J Am Coll Nutr. 2000; 19(2 Suppl): 119S-36S.
Roberson CM. Lactose intolerance. Ala Nurse. 2004; 31(4):23-4.
Uggini PL, Fagundes RLM. Tratamento dietético da intolerância à lactose infantil: teor de lactose em alimentos. Hig Aliment. 2006; 21(140):24-9.
Hovde O, Farup PG. A comparison of diagnostic tests of lactose malabsorption: which one is the best? BMC Gastroenterol. 2009; 9:82. doi: 10.1186/1471-230X-9-82.
Robayo-Torres CC, Nichols BL. Molecular differentiation of congenital lactase deficiency from adult-type hypolactasia. Nutr Rev. 2007; 65(2):95-8. doi: 10.1111/j.1753-4887.2007.tb00286.x.
Sibley E. Carbohydrate intolerance. Curr Opin Gastroenterol. 2004; 20(2):162-7.
Ingram CJ, Raga TO, Tarekegn A, Browning SL, Elamin MF, Bekele E, et al. Multiple rare variants as a cause of a common phenotype: several different lactase persistence associated allelesin a single ethnic group. J Mol Evol. 2009; 69(6):579-88. doi:10.1007/s00239-009-9301-y.
Di Stefano M, Terulla V, Tana P, Mazzocchi S, Romero E, Corazza GR. Genetic test for lactase non-persistence and hydrogen breath test: is genotype better than phenotype to diagnose lactose malabsorption? Dig Liver Dis. 2009; 41(7):474-9. doi: 10.1016/j.dld.2008.09.020.
Brannon PM, Carpenter TO, Fernandez JR, Gilsanz V, Gould JB, Hall KE, et al. NIH Consensus Development Conference Statement: lactose intolerance and health. NIH Consens State Sci Statements. 2010; 27(2): Epub ahead of print.
Savaiano D. Lactose intolerance: an unnecessary risk for low bone density. Nestle Nutr Workshop Ser Pediatr Program. 2011; 67:161-71. doi: 10.1159/000325582.
Montalto M, Gallo A. Sufficient evidence that 12g of lactose is tolerated by most adults with lactose malabsorption and intolerance but insufficient evidence on the effectiveness of therapeutical strategies tested so far. Evid Based Med. 2010; 15(6):172-3. doi: 10.1136/ebm1130.
Honkanen R, Kröger H, Alhava E, Turpeinen P, Tuppurainen M, Saarikoski S. Lactose intolerance associated with fractures of weight-gearing bones in finish women aged 38-57 years. Bone. 1997; 21(6): 473-7. doi: 10.1016/58756-3282/97/00172-5.
Kudlacek S, Freudenthaler O, Weissböerck H, Schneider B, Willvonseder R. Lactose intolerance: a risk factor for reduced bone mineral density and vertebral fractures? J Gastroenterol. 2002; 37(2): 1014-9. doi: 10.1007/s005350200171.
Obemayer-Pietsch MB, Gugatschka M, Reitter S, Plank W, Strele A, Walter D, et al. Adult-type hypolactasia and calcium availability: decreased calcium intake or impaired calcium absorption? Osteoporos Int. 2007; 18(4):445-51. doi: 10.1007/s00198-006-0251-6.
Corazza GR, Benati G, Di Sario A, Tarozzi C, Strocchi A, Passeri M, et al. Lactose intolerance and bone mass in postmenopausal Italian women. Br J Nutr. 1995; 73(3): 479-87. doi: 10.1079/BJN19950050.
Matlik L, Savaiano D, McCabe G, Vanloan M, Blue CL, Boushey CJ. Perceived milk intolerance is related to bone mineral content in 10- to 13-year-old female adolescents. Pediatrics. 2007; 120(3): e669-e77. doi: 10.1542/peds.2006-1240.
Carroccio A, Montalto G, Cavera G, Notarbatolo AA. Lactose intolerance and self-reported Milk intolerance: relationship with lactose maldigestion and nutrient intake. J Am Coll Nutr. 1998; 17(6): 631-6.
Aloha H. Diagnosis of hypolactasia and lactose malabsorpition. Scand J Gastroenterol Suppl. 1994; 202:26-35.
Di Stefano M, Veneto G, Malservisi S, Cecchett L, Minguzzi L, Strocchi A, et al. Lactose malabsorption and intolerance and peak bone mass. Gastroenterology. 2002; 122(7):1793-9. doi: 10.1053/gast.2002.33600.
Ulrich CM, Georgiou CC, Snow-Harter CM, Gillis DE. Bone mineral density in mother-daughter pairs: relations to lifetime exercise, lifetime milk consumption, and calcium supplements. Am J Clin Nutr. 1996; 63(1):72-9.
Nieves JW, Komar L, Cosman F, Lindsay R. Calcium potentiates the effect of estrogen and calcitonin on bone mass: review and analysis. Am J Clin Nutr. 1998; 67(1):18-24.
Séva-Pereira A. Malabsorção de lactose do adulto em uma população brasileira [doutorado]. Campinas: Universidade Estadual de Campinas; 1981.
Isokoski M, Jussila J, Sarna S. A simple screening method for lactose malabsorption. Gastroenterology. 1972; 62(1):28-32.
World Health Organization. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser. 1994; 843:1-129.
Fornetti WC, Pivarnik JM, Foley JM, Fiechtner JJ. Reliability and validity of body composition measures in female athletes. J Appl Physiol. 1999; 87(3):1114-22.
Crawford PB, Wang MC, Sabry ZI, Hudes M, VanLoan M, Davis D, et al. Adolescent diet is predictive of peak bone mass. Am J Clin Nutr. 2002; 75:356S.
Ennatah N, Pekkarien T, Välimäki MJ, Löyttyniemi E, Järvela I. Genetically defined adult-type hypolactasia and self-report lactose intolerance as risk factors of osteoporosis in finish postmenopausal women. Eur J Clin Nutr. 2005; 59(10): 1105-11. doi:10.1038/sj.ejcn.1602219.
Enattah NS, Kuokkanen M, Forsblom C, Natah S, Oksanen A, Jarvela I, et al. Correlation of intestinal disaccharidase activities with the C/T-13910 variant and age. World J Gastroenterol. 2007; 13(25):3508-12.
Institute of Medicine. Dietary reference intakes: the essential guide to nutrient requirements. Washington (DC): National Academy Press; 2006.
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2023 Najoua Adriana SALOMÃO, Thays de Ataide e SILVA, Amandio Aristides Rihan GERALDES, Adriano Eduardo LIMA-SILVA
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
