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Weight-Loss Drinks Increase
Gas in Milk-Intolerant

NEW YORK (Reuters Health) - As if losing weight wasn't difficult enough, researchers say that people who have difficulty digesting milk products may experience an increase in gas if they consume milk-based powder supplements designed as a meal replacement.

``I won't say that their health has been tremendously affected,'' said study lead author Dr. Michael Levitt of the Veterans Affairs Medical Center in Minneapolis, Minnesota. ''They can just say I'm going to have some gas and I don't care. But there's something about taking milk at breakfast and lunch without any other food that tends to make you very gassy.''

The study, which included 10 otherwise healthy women with lactose intolerance, was funded in part by Slim Fast Foods Company. About 25% of American adults have lactose intolerance, a condition in which an individual lacks a sufficient supply of an intestinal enzyme critical for the digestion of milk-based foods. Consuming large amounts of lactose--a sugar found in milk--can cause such individuals to experience bloating, diarrhea and flatulence.

While eating solid foods with milk can reduce such reactions, the researchers point out that between 11% and 21% of the 50 million Americans who diet each year rely to some degree on low-fat meal replacement supplements. Many such food substitutes contain milk-based powders that users mix with fat-free milk, before drinking as a replacement for a meal.

In the study, the women were randomly assigned to consume one of two commercially available, vanilla-flavored, milk-based nutritional powders: one with a high level of lactose mixed with fat-free milk; the other a soy powder mixed with lactose-free, low-fat milk.

The researchers found that those who consumed the high-lactose preparation experienced a large increase in intestinal gas. The women passed gas three times as frequently--from about 10 times a day to 30 times a day--compared with those who drank the low lactose mix.

The findings are published in the current issue of the Journal of the American Dietetic Association. Levitt and his colleagues note that none of the women experienced an increase in bloating, abdominal pain or diarrhea.

In addition, the researchers said that some of the women were asked to consume a third nutritional supplement mix, a ready-to-drink form of the product containing about a third less lactose than the high lactose preparation. These women did not experience a similar increase in gas. A mild rise in the frequency of gassiness was observed, although the subjects seemed unaware of the increase.

``I was a little surprised by this finding,'' Levitt told Reuters Health. ``I spent a lot of time knocking lactose intolerance as a problem, because for those who drank milk with their meals the message has always been that it is not much of a problem. But in this case there seems to be a threshold, when taking in lactose without additional food.''

Levitt explained that bacteria in the large intestine that typically break down lactose and the gas it produces appear to be overwhelmed when it is ingested too quickly in the absence of food. ``It turns into gas faster than you can consume the gas, and then it becomes a problem,'' he said.

But he added that those with lactose intolerance who wish to continue drinking such supplements can prevent the associated gas problems simply and quickly. ``They can buy the enzyme they're missing--called lactase--and add it directly into the supplement. We showed that that would solve the problem.''

Dr. Hank Frier, senior director of research for Slim Fast in New York, said there are several ways those with lactose intolerance can continue to use such products.

``We try and provide alternatives to individuals who might be lactose-intolerant,'' Frier told Reuters Health. ``They can either use lactase drops or they can use the fruit-based products as is, right off the shelf--and you can see they have almost no gas affect or symptomology.''

``So, yes, indeed lactose-intolerant individuals have to be concerned about using dairy products ...but there are ways they can use weight products like Slim Fast and not have the symptomology,'' he said.

SOURCE: Journal of the American Dietetic Association 2001;101:1447-1452.

Reference Source 89


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