Nutritional Supplements Used in Weight-Reduction Programs Increase Intestinal Gas in Persons who Malabsorb Lactose.

Suarez FL, Zumarraga LM, Furne JK, Levitt MD. J Am Diet Assoc. 2001;101(12):1447-1452.

Objective

To evaluate the degree to which a milk-based dietary supplement (Slim•Fast), affects gaseous symptoms in subjects who malabsorb lactose.

Methods

In this double-blind, crossover trial, 10 female subjects (4 Asian, 3 White, 3 Hispanic) who malabsorb lactose were randomized to receive one of two different lactose-based preparations (high and low). The high-lactose preparation consisted of a milk-based Slim•Fast powder dissolved in one cup of fat-free milk. The low-lactose preparation consisted of a soy powder dissolved in lactose-free low-fat milk. In a second phase of this study, subjects ingested two servings of one of four preparations: a ready-to-drink, chocolate-flavored, milk-based Slim•Fast (9.2 g lactose); a ready-to-drink, chocolate-flavored, milk-based Slim•Fast plus 0.15 g Lactaid®; a fruit-based preparation (0.75 g lactose); and a fruit-based preparation supplemented with 14 g lactose. In all studies on the day before the test, subjects were provided a meal that has been shown to result in very low baseline H2 excretion on the test day. Alveolar breath samples were obtained first thing in the morning for H2 measurements, and hourly for 8 hours after consuming the a.m. supplement. The severity of symptoms was self-rated by subjects for 2 periods: breakfast to lunchtime, and lunchtime to dinnertime. Frequency and consistency of bowel movements were recorded as were self perceptions of gas passage.

Results

The high-lactose content (27g) of 2 servings of the powder-based Slim•Fast supplement, when ingested without other food, resulted in a marked increase in daily flatus passages from baseline level, and a significant increase in the subject's perception of gas. The lower-lactose content (18.4 g) of 2 servings of the ready-to-drink Slim•Fast shake resulted in less flatus frequency and no significant increase in the perception of increased gas. Neither supplement resulted in a significant increase in bloating, abdominal pain, or diarrhea. The lactose content of the liquid supplement was reduced by 80% following incubation with a lactase preparation.

Conclusion

People who malabsorb lactose experience minimal gaseous effects after consuming 2 servings of a milk-based Slim•Fast ready-to-drink shake as compared with increases in rectal gas after consuming a milk-based powder reconstituted in milk

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