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Abstract. Lactase-phlorizin hydrolase (LCT), more commonly known as lactase, is an enzyme responsible for cleaving lactose into absorbable monosaccharides, glucose and galactose. LCT deficiency (hypolactasia - HL) is caused by a decreased activity of LCT in the small intestinal villi and potentially results in lactose malabsorption what may lead to the development of clinical symptoms (diarrhea, bloating, flatulence and cramps) and avoiding milk products in the diet. HL is the world's most common enzyme deficiency in humans. HL exists in three distinct forms - congenital, primary and secondary. Adult type hypolactasia (ATH) is the most common phenotype found in human. It is a genetically predetermined physiological condition inherited through an autosomal recessive mode which results in a decline of lactase activity after weaning. ATH is associated with the LCT -13910 C>T polymorphism worldwide, except in Africa. Lactase non-persistence has been observed in individuals with the C/C-13910 genotype, whereas lactase persistence in subjects with remaining allelic variants. Small intestine biopsy is the only diagnostic procedure allowing for the direct measurement of LCT activity, however due to its invasive nature it is hardly accepted by patients. Therefore, LCT status is often inferred simply by assessing the patient's lactose digestion. A lactose tolerance test can be performed after lactose load and then measuring blood glucose concentration or breath hydrogen (preferably hydrogen and methane) expiration. A genetic test of the C/T-13910 polymorphism is also available at present. It is a reliable method in excluding/confirming ATH predisposition. However, it definitely does not assess lactose tolerance or malabsorption.
Background. There are no long-term prospective studies assessing the impact of the vegan diet on vitamin B-12 (B-12) status. Many vegans take B-12 supplements irregularly or refuse to adopt them at all, considering them to be “unnatural” products. The use of B-12 fortified food may be an altemative. Therefore, we aimed to estimate the long-term effect of a vegan diet on serum B-12 concentrations in healthy omnivore adults, comparing the influence of natural products consumption and B-12 fortified food. Material and methods. A five year prospective study was carried out comprising 20 omnivore healthy adult subjects, who moved to strict vegan diet for 5 years. Ten volunteers followed vegan diet based entirely on natural products, while the remaining ten subjects consumed food fortified in B-12. In all subjects serum vitamin B-12 concentration was determined before and 6, 12, 24 and 60 months after the implementation of the diet. Results. A significant decrease (p < 0.0002) of serum B-12 concentrations in the whole studied group was noted after 60 months of vegan diet. However, observed changes were in fact limited to the subgroup consuming exclusively natural products (p < 0.0001). Conclusions. Transition from omnivore to vegan diet is associated with the risk of vitamin B-12 deficiency. B-12 fortified products might constitute a valuable altemative in vegans refiising to take vitamin supplements.
Background. Avoiding of meat is the basic principle of vegetarian diet with several variants existing. In the present study we have focused on lacto-ovo-vegetarian (LOV) diet which includes dairy products and eggs. We have aimed to assess its long-term effect on vitamin B12 status and intended to verify the influence of natural and vitamin B12- -fortified food. Material and methods. The prospective study was carried out comprising 16 healthy omnivores (12 females, 4 males) who intentionally declared to follow strict LOV diet for at least 5 years. The studied group was divided into 2 subgroups. First subgroup followed LOV diet based entirely on natural products while the second consumed food fortified with B12 vitamin. Evaluation of vitamin B12 concentration was performed before and after 6, 12, 24 and 60 months from LOV diet implementation. Results. Five-years of LOV diet resulted in significant decrease of serum vitamin B12 concentrations in the whole studied group (p < 0.05). However, the significant drop of vitamin B 12 level was in fact limited to the subgroup consuming exclusively natural products (p < 0.05). In none of the subjects abnormal serum vitamin B12 levels were observed. Conclusions. Five-year lacto-ovo-vegetarian diet did not result in a risk of vitamin B12 deficiency in healthy subjects. However, the levels of serum vitamin B12 concentrations in a subgroup consuming natural diet tend to be significantly lower as compared with the group consuming fortified food. It confirms the need of follow-up (and potentially vitamin B12 fortification of food and/or its supplementation) in long-term lacto-ovo- -vegetarians
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