DOCSLIB.ORG

Diagnosing and Treating Intolerance to Carbohydrates in Children

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Diagnosing and Treating Intolerance to Carbohydrates in Children nutrients Review Diagnosing and Treating Intolerance to Carbohydrates in Children Roberto Berni Canani 1,2,3,*, Vincenza Pezzella 1, Antonio Amoroso 1, Tommaso Cozzolino 1, Carmen Di Scala 1 and Annalisa Passariello 1 1 Department of Translational Medical Science, University of Naples “Federico II”, 80131 Naples, Italy; [email protected] (V.P.); [email protected] (A.A.); [email protected] (T.C.); [email protected] (C.D.S.); [email protected] (A.P.) 2 European Laboratory for the Investigation of Food Induced Diseases, University of Naples “Federico II”, 80131 Naples, Italy 3 CEINGE Advanced Biotechnologies, University of Naples “Federico II”, 80131 Naples, Italy * Correspondence: [email protected]; Tel.: +39-081-746-2680 Received: 27 October 2015; Accepted: 25 February 2016; Published: 10 March 2016 Abstract: Intolerance to carbohydrates is relatively common in childhood, but still poorly recognized and managed. Over recent years it has come to the forefront because of progresses in our knowledge on the mechanisms and treatment of these conditions. Children with intolerance to carbohydrates often present with unexplained signs and symptoms. Here, we examine the most up-to-date research on these intolerances, discuss controversies relating to the diagnostic approach, including the role of molecular analysis, and provide new insights into modern management in the pediatric age, including the most recent evidence for correct dietary treatment. Keywords: lactose intolerance; fructose malabsorption; sucrase-isomaltase deficiency; glucose-galactose malabsorption; sorbitol intolerance; trehalose intolerance; FODMAPs intolerance; breath test; molecular analysis 1. Introduction Adverse food reactions (AFR) represent a relevant problem in daily clinical practice, but are poorly recognized and managed. They are common in industrialized countries, where, depending on data collection methods and definitions, they affect up to 20% of the general population [1]. The prevalence increases significantly in patients with irritable bowel syndrome (IBS). It has been described that up to 80% of IBS patients believe that their symptoms are diet-related, of which three quarters are possibly related to intolerance to carbohydrates [2,3]. According to the main pathophysiologic mechanism, AFRs are commonly classified into different groups (Figure1)[4–8]. Nutrients 2016, 8, 157; doi:10.3390/nu8030157 www.mdpi.com/journal/nutrients Nutrients 2016, 8, 157 2 of 16 Nutrients 20162016,, 88,, 157157 22 ofof 1616 Adverse Food Reactions ImmuneImmune mediated mediated Non‐‐ImmuneImmune mediated: mediated: Food Food Intolerances Intolerances Other EnzymaticEnzymatic TransporterTransporter Food Allergy Celiac Disease Pharmacological unknownunknown Food Allergy Celiac Disease defectsdefects defectsdefects Pharmacological triggerstriggers FigureFigure 1.1. ClassificationClassification of of adverseadverse foodfood reactions reactions (AFR). (AFR). IntoleranceIntolerance toto carbohydratescarbohydrates isis thethe most commoncommon typetype of non‐‐immuneimmune‐‐mediated AFR (Figure(Figure Intolerance to carbohydrates is the most common type of non-immune-mediated AFR (Figure2). 2). The prevalence of thisthis conditioncondition has seemedseemed toto increaseincrease during thethe lastlast fewfew decades as a The prevalence of this condition has seemed to increase during the last few decades as a consequence consequenceconsequence of thethe growing raterate of carbohydratecarbohydrate consumptionconsumption inin thethe diet. National surveysurvey data inin of the growing rate of carbohydrate consumption in the diet. National survey data in the United States thethe United States have indicatedindicated that,that, over thethe past fewfew decades, consumptionconsumption of selectedselected have indicated that, over the past few decades, consumption of selected carbohydrates, largely in the carbohydrates,carbohydrates, largelylargely inin thethe formform of added sugars,sugars, has increasedincreased by up toto 900% [9].[9]. form of added sugars, has increased by up to 900% [9]. FigureFigure 2.2.2.Classification Classification of carbohydrateof carbohydratecarbohydrate intolerances. intolerances.intolerances. CSID: CongenitalCSID: Congenital Sucrase-Isomaltase Sucrase‐‐Isomaltase Deficiency;Isomaltase Deficiency;GGM: Glucose-Galactose GGM: Glucose Malabsorption;‐‐Galactose Malabsorption; CLD: Congenital CLD: LactaseCongenital Deficiency. Lactase Deficiency. Symptoms of intoleranceintolerance toto carbohydratescarbohydrates are primarily due toto deficiency of enzymes or Symptoms of intolerance to carbohydrates are primarily due to deficiency of enzymes or transporterstransporters or overloading of a transporttransport systemsystem locatedlocated on thethe brush border of thethe epithelium transporters or overloading of a transport system located on the brush border of the epithelium lininglining thethe smallsmall intestineintestine (Figure(Figure 3). Non‐‐absorbed carbohydratescarbohydrates inin thethe intestinalintestinal tracttract drive fluidsfluids lining the small intestine (Figure3). Non-absorbed carbohydrates in the intestinal tract drive fluids into intointo thethe lumenlumen throughthrough an osmotic force,force, causingcausing osmotic diarrhea. Moreover, non‐‐absorbed the lumen through an osmotic force, causing osmotic diarrhea. Moreover, non-absorbed carbohydrates carbohydratescarbohydrates are fermentedfermented by gut microbiota toto gas. are fermented by gut microbiota to gas. Nutrients 2016, 8, 157 3 of 16 Nutrients 2016, 8, 157 3 of 16 FigureFigure 3. 3.Mechanisms Mechanisms involved involved in in main main carbohydratecarbohydrate intolerances. (A (A) )Lactose Lactose intolerance intolerance due due to to deficiencydeficiency of of lactase lactase enzyme; enzyme; ( B(B)) glucose-galactose glucose‐galactose malabsorption malabsorption due due to to a agenetic genetic defect defect in inSGLT1 SGLT1 expression; (C) fructose malabsorption due to dose‐dependent transporters overloading; (D) sucrase expression; (C) fructose malabsorption due to dose-dependent transporters overloading; (D) sucrase malabsorption due to a genetic defect in sucrase‐isomaltase activity. malabsorption due to a genetic defect in sucrase-isomaltase activity. All these events are responsible for the clinical symptoms, such as distension of the small bowel,All these non‐ eventsfocal abdominal are responsible pain associated for the clinical with symptoms,bloating and such flatulence, as distension nausea, of theincreased small bowel,gut non-focalmotility, abdominal and diarrhea pain [2,10–14]. associated Extraintestinal with bloating symptoms, and flatulence, such as nausea, headache, increased vertigo, gut memory motility, andimpairment, diarrhea [ 2and,10– 14lethargy]. Extraintestinal have been symptoms,described in such less as than headache, 20% of vertigo,subjects memorywith carbohydrate impairment, andintolerance lethargy have[15,16]. been These described systemic in symptoms less than 20%could of be subjects the result with of carbohydratetoxic metabolites, intolerance produced [15 by,16 ]. Thesesugar systemic fermentation symptoms of colonic could bacteria, be the resultthat can of alter toxic cell metabolites, signalling produced mechanisms by (Figure sugar fermentation 4). of colonic bacteria, that can alter cell signalling mechanisms (Figure4). These manifestations frequently lead to investigations to rule out other organic disorders at intestinal and extra-intestinal levels, including invasive procedures. Thus, there is a large unmet need for a clear diagnosis as well as consistent and effective advice on dietary treatments for these conditions. There have been significant advances in understanding the scientific basis of carbohydrate intolerances, and new forms (e.g., Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols intolerance, and non-celiac gluten sensitivity) have been identified [1,14]. Intolerance to carbohydrates often begins in childhood. Here, we examine the most up-to-date research on childhood intolerance to carbohydrates, discuss controversies relating to the diagnostic approach, including the role of molecular analysis, and provide new insights into the modern management of these conditions. Nutrients 2016, 8, 157 4 of 16 Nutrients 2016, 8, 157 4 of 16 Figure 4. Pathogenesis of gut and brain symptoms in patients with intolerance to carbohydrates. 2. GeneticThese manifestations Etiology with Early frequently Onset lead Carbohydrate to investigations Intolerances to rule out other organic disorders at intestinal and extra‐intestinal levels, including invasive procedures. Thus, there is a large unmet 2.1.need Congenital for a clear Sucrase-Isomaltase diagnosis as well Deficiency as consistent (CSID) and effective advice on dietary treatments for these conditions. There have been significant advances in understanding the scientific basis of Congenital sucrose-isomaltase deficiency (CSID, OMIM #222900) is a rare autosomal recessive carbohydrate intolerances, and new forms (e.g., Fermentable Oligosaccharides, Disaccharides, inherited disease of the small intestine resulting from genetic mutations in sucrase-isomaltase, an Monosaccharides, and Polyols intolerance, and non‐celiac gluten sensitivity) have been identified enzyme complex responsible for catalyzing the hydrolysis of dietary sucrose and starch [17]. Decreased [1,14]. Intolerance to carbohydrates often begins in childhood. Here, we examine the most up‐to‐
Load more

Recommended publications
  • Prevalence of Fructose Malabsorption in Patients with Irritable Bowel Syndrome After Excluding Small Intestinal Bacterial Overgrowth
    J Neurogastroenterol Motil, Vol. 24 No. 2 April, 2018 pISSN: 2093-0879 eISSN: 2093-0887 https://doi.org/10.5056/jnm17044 JNM Journal of Neurogastroenterology and Motility Original Article Prevalence of Fructose Malabsorption in Patients With Irritable Bowel Syndrome After Excluding Small Intestinal Bacterial Overgrowth Kee Wook Jung,1 Myeognsook Seo,1 Young Hwan Cho,1 Young-Ok Park,2 So-Yoon Yoon,2 Jungbok Lee,3 Dong-Hoon Yang,1 In Ja Yoon,1 So Young Seo,1 Hyo Jeong Lee,1 Sang Hyoung Park,1 Kyung Jo Kim,1 Byong Duk Ye,1 Jeong-Sik Byeon,1 Hwoon-Yong Jung,1 Suk-Kyun Yang,1 Jin-Ho Kim,1 and Seung-Jae Myung1* Departments of 1Gastroenterology, 2Clinical Nutrition, and 3Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Background/Aims Fructose malabsorption (FM) mimics symptoms of irritable bowel syndrome (IBS), and its prevalence has increased. Diagnosing FM in IBS is challenging because of its overlap with small intestinal bacterial overgrowth (SIBO). We assessed the prevalence of FM by comparing patients with IBS with asymptomatic control individuals after excluding SIBO using the glucose hydrogen breath test (HBT). Methods Patients diagnosed with IBS and asymptomatic control individuals were enrolled prospectively. Dietary habits were assessed with the Food Frequency Questionnaire. After excluding SIBO, participants underwent HBTs with both 15 g and 25 g of fructose. Results Thirty-five patients with IBS and 35 age- and sex-matched asymptomatic control individuals were enrolled. The 15-g fructose HBT yielded positive results in 7 of the 35 (20.0%) patients with IBS and in 2 of 35 (5.7%) controls (P = 0.070).
    [Show full text]
  • Limiting Fructose, Fructans Intake May Ease IBS
    36 Digestive Disorders FAMILY P RACTICE N EWS • July 1, 2008 Limiting Fructose, Fructans Intake May Ease IBS BY MARY ANN MOON “marked and sustained global improve- of irritable bowel syndrome (IBS) in patients prove symptoms. In the current study, the Contributing Writer ment in gastrointestinal symptoms,” re- who also have fructose malabsorption. researchers focused on osmotic load with- searchers noted. A subsequent study of The results also demonstrate that re- in the lumen and fermentative gas content. atients with irritable bowel syn- the patients revealed that symptom relief stricting intake of these substances may Poorly absorbed short-chain carbohy- drome and fructose malabsorption was not specific to restricted intake of lead to durable symptomatic improve- drates, including fructose and lactose, are Pappeared to benefit from a diet that fructose, but was achieved by limiting the ment, wrote Ms. Shepherd, a dietician at highly fermentable. They exert a strong restricted intake of fructose and fructans, intake of poorly absorbed short-chain Australia’s Monash University, Clayton, osmotic effect in people who have malab- Susan J. Shepherd and her colleagues re- carbohydrates. Victoria, and her colleagues. sorption of these two sugars—about 40% ported in an article appearing in the July These findings “represent the first high- They theorized that, because many ab- of the population in the case of fructose, 2008 issue of Clinical Gastroenterology level evidence” that poorly absorbed short- dominal symptoms may originate from and between 15% to 100% of the popula- and Hepatology. chain carbohydrates—fructose and fruc- bowel distension, addressing factors that tion for lactose. In the 25-patient study, the diet led to tans—are dietary triggers for the symptoms contribute to the distension would im- To minimize or eliminate intake of poor- ly absorbed short-chain carbohydrates, the investigators created a diet that omitted Brief Summary—see package insert for full prescribing information.
    [Show full text]
  • Pentose PO4 Pathway, Fructose, Galactose Metabolism.Pptx
    Pentose PO4 pathway, Fructose, galactose metabolism The Entner Doudoroff pathway begins with hexokinase producing Glucose 6 PO4 , but produce only one ATP. This pathway prevalent in anaerobes such as Pseudomonas, they doe not have a Phosphofructokinase. The pentose phosphate pathway (also called the phosphogluconate pathway and the hexose monophosphate shunt) is a biochemical pathway parallel to glycolysis that generates NADPH and pentoses. While it does involve oxidation of glucose, its primary role is anabolic rather than catabolic. There are two distinct phases in the pathway. The first is the oxidative phase, in which NADPH is generated, and the second is the non-oxidative synthesis of 5-carbon sugars. For most organisms, the pentose phosphate pathway takes place in the cytosol. For each mole of glucose 6 PO4 metabolized to ribulose 5 PO4, 2 moles of NADPH are produced. 6-Phosphogluconate dh is not only an oxidation step but it’s also a decarboxylation reaction. The primary results of the pathway are: The generation of reducing equivalents, in the form of NADPH, used in reductive biosynthesis reactions within cells (e.g. fatty acid synthesis). Production of ribose-5-phosphate (R5P), used in the synthesis of nucleotides and nucleic acids. Production of erythrose-4-phosphate (E4P), used in the synthesis of aromatic amino acids. Transketolase and transaldolase reactions are similar in that they transfer between carbon chains, transketolases 2 carbon units or transaldolases 3 carbon units. Regulation; Glucose-6-phosphate dehydrogenase is the rate- controlling enzyme of this pathway. It is allosterically stimulated by NADP+. The ratio of NADPH:NADP+ is normally about 100:1 in liver cytosol.
    [Show full text]
  • List of Approved Ndas for Biological Products That Were Deemed to Be Blas on March 23, 2020
    List of Approved NDAs for Biological Products That Were Deemed to be BLAs on March 23, 2020 On March 23, 2020, an approved application for a biological product under section 505 of the Federal Food, Drug, and Cosmetic Act (FD&C Act) was deemed to be a license for the biological product under section 351 of the Public Health Service Act (PHS Act) (see section 7002(e)(4)(A) of the Biologics Price Competition and Innovation Act of 2009). To enhance transparency and facilitate planning for the March 23, 2020, transition date, FDA compiled a preliminary list of approved applications for biological products under the FD&C Act that were listed in FDA’s Approved Drug Products with Therapeutic Equivalence Evaluations (the Orange Book) and that would be affected by this transition provision. FDA posted this list on the FDA website in December 2018, and periodically updated this list before the March 23, 2020, transition date. The September 2019 update to this preliminary list added certain administratively closed applications related to approved applications for biological products that were on the December 2018 version of this list. The January 2020 update to the preliminary list reflected a change to the definition of “biological product” made by the Further Consolidated Appropriations Act, 2020, which was enacted on December 20, 2019. Section 605 of this Act further amended the definition of a “biological product” in section 351(i) of the PHS Act to remove the parenthetical “(except any chemically synthesized polypeptide)” from the statutory category of “protein.” FDA has provided below a list of each approved application for a biological product under the FD&C Act that was deemed to be a license (i.e., an approved biologics license application (BLA)) for the biological product on March 23, 2020.
    [Show full text]
  • Disaccharidase Deficiencies
    J Clin Pathol: first published as 10.1136/jcp.s3-5.1.22 on 1 January 1971. Downloaded from J. clin. Path., 24, Suppl. (Roy. Coll. Path.), 5, 22-28 Disaccharidase deficiencies G. NEALE From the Department ofMedicine, Royal Postgraduate Medical School, Du Cane Road, London Up to 12 years ago the absorption of disaccharides capable of hydrolysing maltose, which may explain was a problem in physiology which attracted little why maltase deficiency is not found as an isolated attention and which appeared to be unrelated to the defect of the enterocyte. Isomaltase and sucrase problems of clinical medicine. Indeed, most text- appear to be distinct but linked entities, and hence books stated incorrectly that the disaccharides were they are absent together in the hereditary condition hydrolysed to monosaccharides in the lumen of the of sucrase-isomaltase deficiency (Dahlquist and small intestine despite the evidence of half a century Telenius, 1969). Lactase activity consists of at least before, which had suggested that they were digested two separate enzymes, one of which is not in the by the mucosal surface (Reid, 1901). The renewal of brush border but within the cell (Zoppi, Hadom, interest in the subject of disaccharide absorption Gitzelmann, Kistler, and Prader, 1966). The signifi- occurred after the description of congenital lactase cance of intracellular lactase activity is uncertain. It deficiency by Holzel, Schwarz, and Sutcliffe (1959) cannot play any part in the normal digestion of and of sucrase-isomaltase deficiency by Weijers, lactose which is a function of the brush border of the van de Kamer, Mossel, and Dicke (1960).
    [Show full text]
  • Biochemistry Entry of Fructose and Galactose
    Paper : 04 Metabolism of carbohydrates Module : 06 Entry of Fructose and Galactose Dr. Vijaya Khader Dr. MC Varadaraj Principal Investigator Dr.S.K.Khare,Professor IIT Delhi. Paper Coordinator Dr. Ramesh Kothari,Professor UGC-CAS Department of Biosciences Saurashtra University, Rajkot-5, Gujarat-INDIA Dr. S. P. Singh, Professor Content Reviewer UGC-CAS Department of Biosciences Saurashtra University, Rajkot-5, Gujarat-INDIA Dr. Charmy Kothari, Assistant Professor Content Writer Department of Biotechnology Christ College, Affiliated to Saurashtra University, Rajkot-5, Gujarat-INDIA 1 Metabolism of Carbohydrates Biochemistry Entry of Fructose and Galactose Description of Module Subject Name Biochemistry Paper Name 04 Metabolism of Carbohydrates Module Name/Title 06 Entry of Fructose and Galactose 2 Metabolism of Carbohydrates Biochemistry Entry of Fructose and Galactose METABOLISM OF FRUCTOSE Objectives 1. To study the major pathway of fructose metabolism 2. To study specialized pathways of fructose metabolism 3. To study metabolism of galactose 4. To study disorders of galactose metabolism 3 Metabolism of Carbohydrates Biochemistry Entry of Fructose and Galactose Introduction Sucrose disaccharide contains glucose and fructose as monomers. Sucrose can be utilized as a major source of energy. Sucrose includes sugar beets, sugar cane, sorghum, maple sugar pineapple, ripe fruits and honey Corn syrup is recognized as high fructose corn syrup which gives the impression that it is very rich in fructose content but the difference between the fructose content in sucrose and high fructose corn syrup is only 5-10%. HFCS is rich in fructose because the sucrose extracted from the corn syrup is treated with the enzyme that converts some glucose in fructose which makes it more sweet.
    [Show full text]
  • Properties of Maltodextrins and Glucose Syrups in Experiments in Vitro and in the Diets of Laboratory Animals, Relating to Dental Health
    Downloaded from British Journal of Nutrition (2000), 84, 565±574 565 https://www.cambridge.org/core Properties of maltodextrins and glucose syrups in experiments in vitro and in the diets of laboratory animals, relating to dental health T. H. Grenby* and M. Mistry . IP address: Department of Oral Medicine and Pathology, GKT Dental Institute, Guy's Hospital, London SE1 9RT, UK (Received 5 July 1999 ± Revised 13 December 1999 ± Accepted 26 January 2000) 170.106.33.42 The objective of the study was to examine the cariogenic potentials of maltodextrins and glucose , on syrups (two glucose polymers derived from starch) using a range of techniques in vitro and in 01 Oct 2021 at 02:19:26 laboratory animals. The experimental methods used were: (1) measurement of acid production from glucose syrups and maltodextrins by human dental plaque micro-organisms; (2) evaluation of the role salivary a-amylase in degrading oligosaccharides (degree of polymerisation .3) in the glucose polymers, estimating the products by HPLC; (3) assessment of the fermentability of trioses relative to maltose; (4) measurement of dental caries levels in three large-scale studies in laboratory rats fed on diets containing the glucose polymers. It was found that acid production from the glucose polymers increased as their higher saccharide content fell. Salivary a-amylase , subject to the Cambridge Core terms of use, available at rapidly degraded the oligosaccharides (degree of polymerisation .3), mainly to maltose and maltotriose. In the presence of oral micro-organisms, maltotriose took longer to ferment than maltose, but by the end of a 2 h period the total amount of acid produced was the same from both.
    [Show full text]
  • Enhanced Trehalose Production Improves Growth of Escherichia Coli Under Osmotic Stress† J
    APPLIED AND ENVIRONMENTAL MICROBIOLOGY, July 2005, p. 3761–3769 Vol. 71, No. 7 0099-2240/05/$08.00ϩ0 doi:10.1128/AEM.71.7.3761–3769.2005 Copyright © 2005, American Society for Microbiology. All Rights Reserved. Enhanced Trehalose Production Improves Growth of Escherichia coli under Osmotic Stress† J. E. Purvis, L. P. Yomano, and L. O. Ingram* Department of Microbiology and Cell Science, Box 110700, University of Florida, Gainesville, Florida 32611 Downloaded from Received 7 July 2004/Accepted 9 January 2005 The biosynthesis of trehalose has been previously shown to serve as an important osmoprotectant and stress protectant in Escherichia coli. Our results indicate that overproduction of trehalose (integrated lacI-Ptac-otsBA) above the level produced by the native regulatory system can be used to increase the growth of E. coli in M9-2% glucose medium at 37°C to 41°C and to increase growth at 37°C in the presence of a variety of osmotic-stress agents (hexose sugars, inorganic salts, and pyruvate). Smaller improvements were noted with xylose and some fermentation products (ethanol and pyruvate). Based on these results, overproduction of trehalose may be a useful trait to include in biocatalysts engineered for commodity chemicals. http://aem.asm.org/ Bacteria have a remarkable capacity for adaptation to envi- and lignocellulose (6, 7, 10, 28, 30, 31, 32, 45). Biobased pro- ronmental stress (39). A part of this defense system involves duction of these renewable chemicals would be facilitated by the intracellular accumulation of protective compounds that improved growth under thermal stress and by increased toler- shield macromolecules and membranes from damage (9, 24).
    [Show full text]
  • Celiac Disease and Lactose Intolerance
    Celiac Disease and Lactose Intolerance HALINA WOJCIK, MPH, RDN, CDN AHRC, NY Celiac – Definition Celiac, also known as coeliac disease, celiac sprue, gluten-sensitive enteropathy, and non-tropical sprue is a genetic, hereditary autoimmune disorder. attributed to the specific genetic markers known as HLA-DQ2 and HLA-DQ8 that are present in affected individuals. Characteristics Sensitivity to amino acids found in the prolamin fraction of wheat (gliadin), barley (hordein), and rye (secalin), commonly known as glutens. When these grains are consumed by persons with celiac disease, they trigger an immune response that results in damage to the person’s mucosa of the small intestine. This damage causes the malabsorption of macronutrients and micronutrients. Source: Nutrition Care Manual. Academy of Nutrition and Dietetics. 2019: Gastrointestinal Disease: Celiac. Available from [https://www.nutritioncaremanual.org ] Comparison of lining of the small intestine in healthy individual and person with Celiac disease Prevalence of Celiac in the United States 1% of population ~ 3 million Americans It’s about the same number of people living in the state of Nevada. In the general US population: 1 in 133 people In people with first - degree relatives (parent, child, sibling) who has celiac: 1 in 22 In people with second degree relatives (aunt, uncle, cousin) who has celiac: 1 in 39 Source: Nutrition Care Manual. Academy of Nutrition and Dietetics. 2019: Gastrointestinal Disease: Celiac. Available from [https://www.nutritioncaremanual.org ] Prevalence of Celiac Disease (CD) in Down Syndrome (DS) Ample of studies suggest that CD is higher in individuals with Down Syndrome. 1 The meta-analysis study ( 31 studies included 4383 individuals) showed that individuals with DS are at very high risk of CD.
    [Show full text]
  • LACTOSE & D-GALACTOSE (Rapid)
    www.megazyme.com LACTOSE & D-GALACTOSE (Rapid) ASSAY PROCEDURE K-LACGAR 02/21 Incorporating A Procedure For The Analysis Of “Low- Lactose” Or “Lactose-Free” Samples Containing High Levels Of Monosaccharides (Improved Rapid Format) (*115 Assays per Kit) * The number of tests per kit can be doubled if all volumes are halved The reagents provided in this kit are also suitable for use with AOAC method 2006.06 – Lactose in milk. Patented: US 7,785,771 B2 and EP1 828 407 (GB, FR, IE, DE) © Megazyme 2021 INTRODUCTION: Lactose, or milk sugar, is a white crystalline disaccharide. It is formed in the mammary glands of all lactating animals and is present in their milk. Lactose yields D-galactose and D-glucose on hydrolysis by lactase (β-galactosidase), an enzyme found in gastric juice. People who lack this enzyme after childhood cannot digest milk and are said to be lactose intolerant. Common symptoms of lactose intolerance include nausea, cramps, gas and diarrhoea, which begin about 30 minutes to 2 hours after eating or drinking foods containing lactose. Between 30 and 50 million Americans are lactose intolerant, with certain ethnic and racial populations being more widely affected than others; as many as 75 percent of all African-Americans and Native Americans and 90 percent of Asian-Americans are lactose intolerant. The condition is least common among persons of northern European descent. Enzymic methods for the measurement of lactose are well known and are generally based on the hydrolysis of lactose to D-galactose and D-glucose with β-galactosidase, followed by determination of either D-galactose or D-glucose.
    [Show full text]
  • Is There Hidden Sugar in Your Drink?
    Is There Hidden Sugar in Your Drink? Anjali Shankar 9th Grade Moravian Academy Upper School June 5th, 2020 Motivation - I have a big passion for the medical field, showed by last year’s project. - Food labels and nutrition have caught my eye and are important when eating. How do glucose levels Research in different drinks change after adding Question an invertase enzyme? Given that the invertase enzyme breaks down sucrose, glucose levels will rise after adding the enzyme because the sucrose will convert to Hypothesis glucose and fructose. Coca Cola will have the most glucose because it has the most calories of each drink. Glucose - Chemical compound in the body - C6H12O6 - Comes from food and drink - Generally rich in sugars/carbohydrates - Used for many purposes: - Used to make energy (ATP) in cellular respiration - Stores energy - Used to build carbohydrates Chemical Reaction - A chemical reaction transfers a set of compounds into another - Reactants: Enter into a chemical reaction - Products: Compounds produced by the reaction - Catalyst: Speeds up the rate of a chemical reaction - Enzyme: Biological catalysts; usually proteins The formula for this experiment is: Invertase Sucrose + Water Glucose + Fructose Invertase C12H22O11 + H20 C6H12O6 + C6H12O6 In the Body - The most common sugar is eaten as sucrose. - Also known as table sugar - It is broken down in the body into glucose and fructose through a chemical reaction during digestion. - Fructose: Contains the same elements as glucose, but has a different chemical construction - Often used to make more glucose - The reaction is catalyzed by an enzyme named sucrase. - Modeled by invertase in experiment - The pancreas monitors blood sugar, or amount of glucose in the body.
    [Show full text]
  • Food Intolerance
    Food intolerance A food intolerance is when the body reacts to a food but the reaction doesn’t involve the immune system. Symptoms Diagnoses Symptoms of intolerance can include The 'elimination diet' is the only way to bloating and wind, diarrhoea, nausea, diagnose a food intolerance. All suspected indigestion, eczema and asthma. foods are completely removed from the diet for one to three weeks. Unlike food allergies most food intolerances are dose-dependent, A small amount is then reintroduced and meaning that a person can usually if symptoms reoccur, the intolerance is consume a certain amount before confirmed. symptoms appear. It is important that this test is taken under the supervision of a doctor, allergy specialist or Registered Dietitian to make sure that proper nutrition is maintained. Source: Allergy New Zealand, a national not-for-profit society whose primary role is to provide information, education, and support to the many thousands of New Zealanders living with allergies, including those at risk of anaphylaxis. For more information phone 09 623 3912 or email [email protected]. Food intolerance Almost any food can cause an intolerance, but there are some types of intolerances that occur more than others. Lactose intolerance This condition is called coeliac disease. It involves the immune system and is not an A condition in which a person cannot digest intolerance. the sugar found in dairy products, is one of the most common food intolerances. It is estimated that 1 in Sensitivity to naturally occurring food chemicals can cause symptoms of 100 New Zealanders are intolerance as well.
    [Show full text]