Table of Contents
Peak bone mass and osteoporosis
From early childhood up to the age of thirty, the skeleton gradually strengthens until it reaches the maximum mineral density which is given the name of peak bone mass. Physical activity in the open air and a diet that ensures adequate calcium intake contribute to ensuring that theand our bones become dense and strong.
From the age of thirty onwards, a slow but inexorable decline begins. Women are generally more disadvantaged compared to men because they start from a lower mineral density and because they are affected by the effect of menopause. The drop in estrogen accelerates the demineralization process. However, there is also male osteoporosis.
There reduced bone mineral density leads first to osteopenia and then to osteoporosis. Osteoporosis can be defined as a bone disorder characterized by impairment of their robustness, which predisposes to an increased risk of fracture. For the WHO, the densitometric diagnosis of osteoporosis is based on the evaluation by MOC (Computerized Bone Mineralometry) of bone mineral density, compared to the average of healthy adult subjects of the same sex (who have reached the aforementioned peak bone mass). Overt osteoporosis is associated with the presence of one or more fragility fractures, most often affecting the vertebral bodies and the neck of the femur. This type of fracture occurs spontaneously or as a result of minor trauma.
Lactose intolerance
Lactose intolerance is due to lactase deficiency, the enzyme responsible for the digestion of lactose. This condition is clinically characterized by abdominal pain, bloating and diarrhea. At the base of the symptoms there is precisely the inability to digest lactose.
Lactase: what it is and what it is used for
The ability to digest lactose during the period of breastfeeding it is essential for the health of the baby so much so that lactase begins to be expressed already starting from the eighth week of gestation. Her activity increases until the thirty-fourth week and her expression is at its peak at the time of birth.
However, after the first three months of life, lactase activity decreases. In most cases the expression of lactase it is reduced following weaning until you reach levels that are no longer detectable. In general, the persistence of lactase is high in the inhabitants of Northern Europe (> 90% in Scandinavia and the Netherlands), decreases in continental Europe and the Middle East (~ 50% in Spain and Italy) and is low in Asia and largely part of Africa (~ 1% in China, ~ 5% -20% in Africa).
Lactose: what it is and treatment of intolerance
Lactose is one sugar formed by glucose and galactose which in order to be absorbed must first be split into its two constituent sugars.
For the purpose of diagnosis, several investigations are available which include genetic tests, breath tests and endoscopic examinations. Lactose intolerance depends not only on lactase expression, but also on other factors such as:
- dose of lactose to which one is exposed;
- composition of the intestinal bacterial flora;
- gastrointestinal motility;
- overgrowth of bacteria in the small intestine (a condition known as SIBO or Small Intestinal Bacterial Overgrowth);
- sensitivity of the gastrointestinal tract to the presence of gas and other products derived from the bacterial digestion of lactose.
The treatment of lactose intolerance it includes the consumption of pre-digested foods (delactosed milk) and the intake of the enzyme lactase just before drinking milk or eating cheese.
Specifically, the replacement of the lactase enzyme it is a viable approach for patients with lactose intolerance who wish to continue eating dairy products. Studies show that lactases obtained from some microorganisms (Kluyveromyces lactis or Aspergillus oryzae) represent a valid therapeutic strategy.
An alternative strategy is that based ontaking probiotics or on consumption of lacto-fermented foods (yogurt, kefir). Administration for a four-week period of a combination of probiotics (Lactobacillus casei Shirota and Bifidobacterium breve) has been shown to improve symptoms and reduce hydrogen production in lactose intolerant patients. These effects appear to persist for at least three months after stopping probiotics.
Diagnosis
The test most frequently used to diagnose lactose intolerance is the breath test or breath test, which measures the levels of hydrogen in exhaled air. How does it work?
The lactose left undigested due to the lack of action of the lactase enzyme, reaches the large intestine, where the resident bacteria ferment it. giving rise to a series of gases (hydrogen, methane and carbon dioxide). These same gases cause bloating, flatulence, nausea, and abdominal pain. A part of these gases is absorbed by the mucous membrane of the colon and transported through the bloodstream to the level of the pulmonary alveoli, where they are then eliminated through breathing.
Therefore, during the breath test, if the hydrogen levels differ significantly from the values considered normal, then a diagnosis of lactose intolerance will be made. Based on the magnitude of the hydrogen peak, lactose intolerance may be classified into mild, severe and moderate.
What to eat
All the milk-derived foods may contain traces of lactose. However, if the milk is fermented, most of the lactose will come converted to lactic acid. This is what happens in the case of yogurt or kefir. A regular consumption of these foods not only protects the consumer from the risk of excessive lactose intake, but ends up withenrich the intestine with lactobacilli, in turn lactase producers.
Basically the assumption of Lacto-fermented beverages and foods contributes to at least partially overcome lactose intolerance.
Foods to avoid
On a case-by-case basis, it will be possible to decide, in agreement with the doctor and on the basis of one’s degree of intolerance (mild, severe or moderate), whether to completely eliminate the following foods or limit their intake:
- milk;
- fresh cheeses;
- cream;
- ice cream and milkshakes;
- desserts prepared with butter and milk;
- milk bread;
- milk chocolate;
- butter and margarine.
Instead, the consumption of lacto-fermented foods should be increased and it is generally Parmigiano Reggiano is completely tolerated. This food should not be missing on the table of those who, suffering from osteoporosis, are also lactose intolerant.
Diet for lactose intolerance
The ideal diet for those who suffer from lactose intolerance and have at the same time a more fragile skeleton is that which guarantees a high calcium intake (up to 1500 mg / day) without requiring massive lactase intervention.
It is useful to point out that the delactosed milk guarantees the same calcium contribution as a non-delactosed milk. They are to be preferred anyway yogurt and kefir because in these foods, in which lactose has been almost entirely converted into lactic acid, lactobacilli, which in turn carry lactase, abound.
TO Breakfasttherefore, delactosed milk, yoghurt and kefir are fine. A possible solution for the snacks is to eat fresh fruit and parmesan (a small portion of 30 or 40 grams is sufficient).
The other food sources of calcium should not be neglected. THE fishes they contain about 40 mg of calcium per 100 grams of product. Anchovies, squid and crustaceans are particularly rich in this precious mineral reaching values of 148 mg / 100 g, 144 mg / 100 g and 100 mg / 100 g respectively.
In meat and in foods of plant origin the calcium content is more limited with the exception of nuts (walnuts, almonds, hazelnuts …), wheat bran and some leafy vegetables. Among these are the rocket, lettuce, agretti, broccoli, fennel, leeks.
It is of great helpuse of dried spices: oregano, thyme, sage, cumin in addition to enhancing the flavors of our dishes provide a fair amount of calcium even if consumed in small quantities.
With the ingredients listed here you can prepare a great variety of tasty meals that we will eat even more willingly knowing that in this way we enhance the health of our skeleton.
The walks in the fresh air are the ideal complement to a diet suitably rich in calcium, because muscle work stimulates an increase in bone density and because exposure to the sun makes it possible to synthesize vitamin D, whose role is precisely that of promote the absorption of calcium taken with food.
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