Lactose 1g/5ml oral solution

Preterm human milk (HM) is a major source of carbohydrates (CHOs), primarily lactose, which contribute to energy intake and support growth and neurodevelopment. This systematic review and meta-analyses quantified total CHO, lactose, and energy content in preterm HM. EBSCO (Health Source-Nursing/Academic Edition and MEDLINE with Full Text), PubMed, and Scopus were searched through July 2023 for studies reporting nutrient composition in preterm HM (2 and publication bias using Begg's rank correlation test. Repeated measures were aggregated. Of 884 identified articles, 53 studies reported total CHO, lactose, and energy. Mean (95% confidence interval) total CHO was 6.74 (6.41, 7.07) g/100 mL with the lowest concentration in colostrum [6.30 (6.13, 6.48) g/100 mL]. Total CHO was similar for transition [6.83 (6.60, 7.06) g/100 mL] and mature [6.80 (6.45, 7.14) g/100 mL] HM. Lactose followed a comparable pattern, with an overall mean of 6.33 (6.02, 6.64) g/100 mL. Mean energy content was 68.13 (65.92, 70.33) kcal/100 mL; colostrum had the lowest, whereas transition and mature were similar. Stratified analyses by analytical method and milk type were also conducted. This systematic review provides updated pooled estimates of total CHO and lactose concentrations and energy in preterm HM and highlights substantial variability related to study design, analytical methods, and data reporting. This trial was registered at the International Prospective Register of Systematic Reviews (https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=445191) as CRD42023445191.

Abstract licence: CC BY

ContextLactose intolerance (LI) is a common condition characterized by lactase deficiency and impaired digestion of lactose. Dairy avoidance among affected individuals can reduce intakes of calcium, vitamin D, and phosphorus, with potential implications for bone health. Therefore, this review aimed to assess the effects of LI on calcium, vitamin D and phosphorus status, as well as related bone health in adults.ObjectiveThis systematic review synthesizes evidence regarding implications for bone health reported in observational studies on calcium, vitamin D, and phosphorus status in adults with LI and dairy avoidance.Data sourcesPubMed, Web of Science, Scopus, and CINAHL were searched for studies from 1980 to 2024. The strategy followed the population-intervention-comparison-outcome framework and used MeSH terms with Boolean operators. Eligible designs were observational; most were cross-sectional studies and included adults (aged ≥18 years) with LI.Data extractionData were extracted on study characteristics, population demographics, diagnostic methods, assessment of micronutrient status, and bone outcomes. Risk of bias was assessed using the Newcastle-Ottawa Scale, adapted for cross-sectional designs.Data analysisA narrative synthesis following the Synthesis Without Meta-analysis (SWiM) guidelines was used to compare nutritional and bone outcomes between lactose-intolerant and lactose-tolerant groups. Thirteen studies were included. Overall, study quality was mostly good or satisfactory, with few studies rated as unsatisfactory or fair. For serum calcium and phosphorus, studies generally did not demonstrate differences by LI status. Evidence on vitamin D was limited to 3 studies with heterogenous results; therefore, we cannot conclude that vitamin D status is unaffected. Conversely, LI was generally associated with significantly reduced calcium intake. Bone outcomes were inconsistent.ConclusionsGiven inconsistent evidence across studies, chronically low calcium intake in LI may be associated with, but not definitively causal for, adverse bone outcomes. Our findings support ensuring sufficient calcium intake and highlighting the need for prospective studies.Systematic review registrationPROSPERO registration No. [CRD42024607063].

Abstract licence: CC BY