Ingestão de cálcio e densidade mineral óssea em mulheres adultas intolerantes a lactose

Abstract

The malabsorption of lactose is the most common type of carbohydrate intolerance and is caused by the low lactase activity (phlorizin hydrolase) in intestinal cells. The activity of this enzyme is higher at birth and declines after weaning, a situation of hypolactasia in adulthood. When malabsorption of lactose leads to symptoms such as pain, bloating, flatulence and diarrhea after ingesting lactose that is called lactose intolerance. This condition causes the individual to reduce the consumption of dairy products, which are considered important sources of calcium, thus, low calcium intake can dramatically reduce the bone mineral density (BMD), making bones more fragile and subject to fractures. Moreover, the condition of lactose intolerance by interfering in food intake, can also modify the intake of macronutrients (carbohydrate, protein and fat). This dissertation is composed of two articles: a review of the main aspects of the pathophysiology and symptoms of lactose intolerance, the principal methods of diagnosing lactase deficiency, the epidemiology of the disease, the absorption and metabolism of calcium, bone tissue physiology , Treatment of lactose intolerance and peak bone mass, bone mineral density and its relationship with lactose intolerance, the relationship between calcium intake, dairy intake and BMD, discussing the findings of the literature - and a descriptive-observational , in order to compare the intake of calcium, vitamin D, bone mass (BO), BMD and intake of macronutrients (carbohydrate, protein and lipid) among adult women with LI and their peers without the disease. In the latter, the sample was composed of 60 young female adults (20 to 40 years), separated into two groups: 30 diagnosed with lactose intolerance (LIG) and 30 healthy as control group (CG). Calcium intake and macronutrients were assessed using a food record and BMD of the lumbar spine areas of (L1 - L4), femoral neck (NF) and total femur (TF) was evaluated using the Dual Energy Absorptiometry Radiological (DXA ). Observed at all sites, BMD was significantly lower for GIL (p <0.01) when compared with GC. A low intake of animal protein, carbohydrates, lipids and total consumption of the diet were found to LIG when compared with CG. In addition, LIG lean mass was significantly lower than CG. The results of this study show that calcium intake and BMD were directly affected by lactose malabsorption in young women, suggesting that the appearance of symptoms of intolerance may influence BMD by reducing the intake of calcium.