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Effects of probiotics administration on lactose intolerance in adulthood: A meta-analysis.
Ahn, SI, Kim, MS, Park, DG, Han, BK, Kim, YJ
Journal of dairy science. 2023;106(7):4489-4501
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Plain language summary
Milk and dairy products are good sources of protein, calcium and other nutrients. However, many people experience lactose intolerance due to their digestive tract's inability to digest lactose, resulting in symptoms such as flatulence, abdominal pain and diarrhoea. Oral administration of certain friendly live microorganisms or probiotics can help digest lactose more efficiently as they have greater β-galactosidase (β-gal) activity. β-galactosidase is an enzyme responsible for the digestion of lactose in the dairy products. A total of twelve studies were included in this meta-analysis. The results of this meta-analysis showed an improvement in the symptoms of lactose intolerance in adult patients, following probiotic administration. Probiotic administration was also found to enhance the digestion of lactose and calcium absorption in adult patients. Healthcare professionals can use the results of this study to understand the potential benefits of oral supplementation of probiotics for adult lactose intolerance patients. However, further studies are needed to understand the relationship between calcium absorption and lactose digestion after probiotic administration.
Abstract
This meta-analysis aimed to investigate the effect of probiotic administration on adults with lactose intolerance. Twelve studies were identified from databases such as PubMed, Cochrane Library, and Web of Knowledge based on the inclusion and exclusion criteria. The effect size was estimated using the standardized mean difference (SMD), and Cochrane's Q test was used to evaluate the statistical heterogeneity of the effect size. Moderator analysis, including meta-ANOVA and meta-regression, were performed to determine the cause of heterogeneity in the effect size using a mixed-effect model. Egger's linear regression test was conducted to evaluate publication bias. The results showed that probiotic administration alleviated the symptoms of lactose intolerance, including abdominal pain, diarrhea, and flatulence. Among them, the area under the curve (AUC) showed the greatest decrease following probiotic administration (SMD, -4.96; 95% confidence interval, -6.92 to -3.00). In the meta-ANOVA test, abdominal pain and total symptoms decreased with monostrain probiotic administration. This combination was also effective for flatulence. The dosage of probiotics or lactose was significantly associated with a reduction in the total symptom score, and the linear regression models between the dosage and SMD were found to be Y = 2.3342 × dosage - 25.0400 (R2 = 79.68%) and Y = 0.2345 × dosage - 7.6618 (R2 = 34.03%), respectively. Publication bias was detected for most items. However, even after effect size correction, the probiotic administration effect for all items remained valid. The administration of probiotics was effective at improving adult lactose intolerance, and it is expected that the results of this study could help improve the nutritional status of adults by increasing their consumption of milk and dairy products in the future.