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| Name | Class |
|---|---|
| Go Fruselva, S.L. | UNKNOWN |
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Lactose intolerance is a chronic disease caused by the total/partial lack of lactase production. When lactose is not properly digest, it is consumed by the microbiota. This situation presents different gastrointestinal symptoms such as meteorism, pain, bloating, diarrhoea and nausea. The dietetic treatment for this patients consists of avoiding lactose-rich foods, mainly milk and dairy products. However, nowadays exists a large diversity of lactose-free products specially focused on lactose intolerants. In this context, using B.coagulans as a probiotic in a food matrix could be an alternative for these patients, since its ability of spore forming and the production of beta-galactosidase.
Based on the foregoing, the group research has design a randomized, double-blind, placebo-controlled crossover nutritional clinical trial to evaluate the effect of a regular probiotic with high production of beta-galactosidase effect over gastrointestinal syntoms of patients with lactose intolerance.
Probiotics are defined by Food and Agriculture Organization of the United Nations and World Health Organization (FAO/WHO) as "living microorganisms that, properly administrated, confers a benefit on individual's health". Probiotics definition it's closely related to functional food concept, which encompasses either products or ingredients that are able to exert a positive impact on individual's health beyond their nutritional value. In fact, most of consumers in developed countries, strongly associate probiotics as functional foods. Lactic acid bacteria are the main microorganisms used as a probiotic, being Lactobacillus, Bifidobacterium, Propionibacterium and Streptococcus genus the most applied. Additionally, some Saccharomyces yeast may be used as probiotics.
However, a microorganism should present particular characteristic in human gastrointestinal's tract to be considered as a probiotic, following the Joint FAO/WHO Group directions: resistance to gastric and pancreatic secretions; adherence to intestinal epithelium and mucosa; antimicrobial activity against pathogenic bacteria; capability of reducing pathogen adhesion on intestinal epithelium; and present certain enzyme activity. The former bacteria genus fulfill most of the previous characteristics. However, these microorganism survival on gut is quite low (1-15%). For this reason, recent Works are searching for microorganism genus able to survive in a larger extend in gut.
Non-pathogenic bacteria of Bacillus genus have spore forming ability in the gastrointestinal tract. Specifically, Bacillus coagulans strain has been subject of new studies. B. coagulans has an optimal growth temperature of 35-50ºC, with pH conditions nearby 6. This microorganism consumes glucose, sucrose, maltose and mannitol while growing to produce lactic acid. In addition, B.coagulans is able to produce some enzymes (depending on the strain) such as alpha and beta-galactosidase, alpha-amylase, lipase and protease. However, the capability of growing in gut depends on time from its consumption (mostly oral) and the spore generation rate. The optimal dose is about 9,52x10e11 UFC, if an standard adult of 70 Kg is assumed. In addition, several studies have proved the B.coagulans ability of forming spores in presence of energy sources such as fructose and lactose.
Lactose intolerance is a chronic disease caused by the total/partial lack of lactase production. When lactose is not properly digest, it is consumed by the microbiota. This situation presents different gastrointestinal symptoms such as meteorism, pain, bloating, diarrhoea and nausea. The dietetic treatment for this patients consists of avoiding lactose-rich foods, mainly milk and dairy products. However, nowadays exists a large diversity of lactose-free products specially focused on lactose intolerants. In this context, using B.coagulans as a probiotic in a food matrix could be an alternative for these patients, since its ability of spore forming and the production of beta-galactosidase.
Based on the foregoing, the group research has designed a randomized, double-blind, placebo-controlled crossover nutritional clinical trial to evaluate the effect of a regular probiotic with high production of beta-galactosidase effect over gastrointestinal syntoms of patients with lactose intolerance.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Lactase | Active Comparator | Volunteers will consume once a day for 1 month a tropical juice (orange, mango, pineapple and turmeric) and a lactase tablet |
|
| Probiotic | Experimental | Volunteers will consume once a day for 1 month the probiotic added to a liquid matrix (tropical juice) and and a placebo tablet (cornstarch) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Tropical juice with probiotics (B.coagulans) | Dietary Supplement | Once a day during all the intervention phase, volunteers with lactose intolerance should allow the spore-forming ability of B. coagulans in order to digest lactase from dairy products through regular consumption of Tropical juice with probiotics (B.coagulans) |
| Measure | Description | Time Frame |
|---|---|---|
| Gastrointestinal symptoms | The questionnaire developed by Casellas et al. 2009 on the specific symptoms of lactose intolerance. The patient will indicate on a scale of 1 to 10 the intensity of the following gastrointestinal symptoms: abdominal pain, bloating, flatulence, diarrhea and cramps. The scale indicates the total absence of symptoms (0) or their severe presence (10). | 3 months |
| Measure | Description | Time Frame |
|---|---|---|
| Sensory perception | It is evaluated using a visual analog scale (VAS) on different sensory aspects of the product: the desire to take it, taste, smell, consistency and effectiveness of its consumption. The scale analyzes values between 0% (most negative values) or 100% (extremely positive values). | 3 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Institute for Health Research IdiPAZ | Madrid | 28046 | Spain |
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| a Tropical juice with no probiotics | Other | Once a day during all the intervention phase, volunteers with lactose intolerance should consume a Tropical juice with no probiotics |
|
| lactase tablet | Other | lactase tablet |
|
| placebo tablet (cornstarch) | Other | placebo tablet (cornstarch) |
|
| Physical activity |
Use of International Physical Activity Questionnaire (IPAQ) to determine changes on physical activity during the clinical trial |
| 3 months |
| Waist circumference | Data referring to the waist circumference of the Spanish population allow to estimate cardiovascular risk parameters from 95 cm in men and 82 cm in women, and very high risk from 102 cm in men and 90 cm in women. The measurement is taken at the narrowest point between the last rib and the iliac crest, with the tape against the skin but not compressed. The person should be kept in an upright position, distributing the weight equally on both legs and their arms relaxed at the sides of the body. | 3 months |
| Body weight | Body weight is measured using a digital scale for clinical use (capacity 0 - 150 kg), with the person positioned with their back to the viewer, without shoes, with a minimum of warm clothing (pants and t-shirt), heels together, looking towards straight forehead and body posture. | 3 months |
| Digestive Symptoms Questionnaire (GSRS) | Assessment of digestive symptoms throughout the study. The questionnaire includes 15 items grouped into 5 blocks based on different gastrointestinal symptoms. The 5 groups of symptoms are: reflux, abdominal pain, indigestion, diarrhea and constipation. Subject is asked about pain or discomfort in the upper abdomen or pit of the stomach, heartburn, acid reflux, hunger, nausea, "gut rumbling," bloating, belching, farting, constipation , diarrhoea, loose or hard stools, an urgent need to have a bowel movement and a feeling of not having finished having a bowel movement. It is scored based on a 7-point Likert-type scale, where 1 represents the most positive option and 7 the most negative. The equivalence in this questionnaire would be: 1 asymptomatic; 2 slight discomfort; 3 mild symptoms; 4 moderate symptoms; 5 moderately severe symptoms; 6 severe symptoms; 7 very serious symptoms | 3 months |
| Changes in stool quality | Bristol scale to find out changes in stool form and stool frequency. The Bristol scale has 7 groups: types 1 and 2 are indicative of constipation, types 3 and 4 are desirable stools, especially 4, since they are the easiest to defecate, finally types 5, 6 and 7 are indicative diarrhea or cholera | 3 months |
| ID | Term |
|---|---|
| D007787 | Lactose Intolerance |
| ID | Term |
|---|---|
| D008286 | Malabsorption Syndromes |
| D007410 | Intestinal Diseases |
| D005767 | Gastrointestinal Diseases |
| D004066 | Digestive System Diseases |
| D002239 | Carbohydrate Metabolism, Inborn Errors |
| D008661 | Metabolism, Inborn Errors |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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| ID | Term |
|---|---|
| D019936 | Probiotics |
| D043322 | Lactase |
| D013213 | Starch |
| ID | Term |
|---|---|
| D019587 | Dietary Supplements |
| D005502 | Food |
| D000066888 | Diet, Food, and Nutrition |
| D010829 | Physiological Phenomena |
| D019602 | Food and Beverages |
| D001616 | beta-Galactosidase |
| D005696 | Galactosidases |
| D006026 | Glycoside Hydrolases |
| D006867 | Hydrolases |
| D004798 | Enzymes |
| D045762 | Enzymes and Coenzymes |
| D005936 | Glucans |
| D001704 | Biopolymers |
| D011108 | Polymers |
| D046911 | Macromolecular Substances |
| D004040 | Dietary Carbohydrates |
| D002241 | Carbohydrates |
| D011134 | Polysaccharides |
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