期刊
NUTRITION JOURNAL
卷 15, 期 -, 页码 -出版社
BMC
DOI: 10.1186/s12937-016-0147-z
关键词
beta-casein; Cows' milk; Lactose intolerance; Gastrointestinal function; Cognitive processing
资金
- The a2 Milk Company Limited
Background: Cows' milk generally contains two types of beta-casein, A1 and A2 types. Digestion of A1 type can yield the peptide beta-casomorphin-7, which is implicated in adverse gastrointestinal effects of milk consumption, some of which resemble those in lactose intolerance. This study aimed to compare the effects of milk containing A1 beta-casein with those of milk containing only A2 beta-casein on inflammation, symptoms of post-dairy digestive discomfort (PD3), and cognitive processing in subjects with self-reported lactose intolerance. Methods: Forty-five Han Chinese subjects participated in this double-blind, randomized, 2 x 2 crossover trial and consumed milk containing both beta-casein types or milk containing only A2 beta-casein. Each treatment period was 14 days with a 14-day washout period at baseline and between treatment periods. Outcomes included PD3, gastrointestinal function (measured by smart pill), Subtle Cognitive Impairment Test (SCIT), serum/fecal laboratory biomarkers, and adverse events. Results: Compared with milk containing only A2 beta-casein, the consumption of milk containing both beta-casein types was associated with significantly greater PD3 symptoms; higher concentrations of inflammation-related biomarkers and beta-casomorphin-7; longer gastrointestinal transit times and lower levels of short-chain fatty acids; and increased response time and error rate on the SCIT. Consumption of milk containing both beta-casein types was associated with worsening of PD3 symptoms relative to baseline in lactose tolerant and lactose intolerant subjects. Consumption of milk containing only A2 beta-casein did not aggravate PD3 symptoms relative to baseline (i.e., after washout of dairy products) in lactose tolerant and intolerant subjects. Conclusions: Consumption of milk containing A1 beta-casein was associated with increased gastrointestinal inflammation, worsening of PD3 symptoms, delayed transit, and decreased cognitive processing speed and accuracy. Because elimination of A1 beta-casein attenuated these effects, some symptoms of lactose intolerance may stem from inflammation it triggers, and can be avoided by consuming milk containing only the A2 type of beta casein.
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