Nutritional support of malnourished lactose intolerant African patients.

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Abstract
The effectiveness of 2 commonly available liquid diets was assessed in 40 severely malnourished black African patients. All patients had normal xylose absorption. The diets were given according to the manufacturer''s recommendations. One diet was lactose containing (LC diet) (150 g/d [day]) and high protein (112 g/d), the other normal protein and lactose free (LF diet) (protein 67 g/d), total energy being similar. Patients were randomly divided into 2 equal groups and allocated (blind) to one of the diets. Tolerance and N balance were assessed over two 3-day periods on half and then full strength formulations. Severe intolerant symptoms were observed in 50% of patients on half strength and 94% of patients on full strength lactose containing diet with evidence of malabsorption of fluid, N, and fat. Despite high stool N losses (3.75 .+-. 1.04 g/dl), however, positive N balance was achieved in most patients receiving the full strength LC formulation. The full strength LF diet was generally well tolerated and was associated with significantly lower fecal losses and positive N balance. High density lactose containing liquid formulae are poorly tolerated by severely malnourished black African patients, whole lactose free formulae containing .apprx. 10 g N/d are well tolerated and result in positive N balance.