Notice: NIH Consensus Development Conference: Lactose Intolerance and 
Health; Notice

Federal Register: January 15, 2010 (Volume 75, Number 10)             
                  Page 2551-2552

Agency:  DEPARTMENT OF HEALTH AND HUMAN SERVICES
         National Institutes of Health


    Notice is hereby given by the National Institutes of Health (NIH) 
of the ``NIH Consensus Development Conference: Lactose Intolerance and 
Health'' to be held February 22-24, 2010, in the NIH Natcher Conference 
Center, 45 Center Drive, Bethesda, Maryland 20892. The conference will 
begin at 8:30 a.m. on February 22 and 23 and at 9 a.m. on February 24, 
and it will be open to the public.
    Lactose intolerance is the inability to digest significant amounts 
of lactose, a sugar found in milk and other dairy products. Lactose 
intolerance is caused by a shortage of the enzyme lactase, which is 
produced by expression of the lactase-phlorizin hydrolase gene by the 
cells that line the small intestine. Lactase breaks milk sugar down 
into two simpler forms of sugar called glucose and galactose, which are 
then absorbed into the bloodstream. Infants of every racial and ethnic 
group worldwide produce lactase and successfully digest lactose 
provided by human milk or by infant formulas. However, by the time many 
of the world's children reach the age of 3-4 years, expression of 
intestinal lactase ceases. Most affected individuals, referred to as 
lactase nonpersisters, in the United States belong to minority groups, 
especially Asians, African Americans, Hispanics, Native Americans, 
Alaskan Natives, and Pacific Islanders.
    Consumption of lactose-containing products by lactase nonpersisters 
may cause gas production, bloating, abdominal pain, and diarrhea. These 
symptoms of lactose intolerance are caused by intestinal bacteria's 
fermentation of undigested lactose and often cause individuals to avoid 
lactose-containing products. Lactose intolerance can be diagnosed by 
drinking one to two large glasses of milk after fasting and measuring 
breath hydrogen levels a few hours later. Other diagnostic tools 
include analyzing an intestinal biopsy sample or determining the 
genetic makeup of the chromosomal region coding for lactase. However, 
many individuals mistakenly ascribe symptoms of a variety of intestinal 
disorders to lactose intolerance without undergoing testing. This 
becomes intergenerational when self-diagnosed lactose-intolerant 
parents place their children on lactose-restricted diets in the belief 
that the condition is hereditary.
    Healthcare providers are concerned that many lactose-intolerant 
individuals are avoiding dairy products, which constitute a readily 
accessible source of calcium and are fortified with vitamin D and other 
nutrients. Therefore, these individuals may not be meeting recommended 
intakes of these essential nutrients. Insufficient intakes of calcium 
carry a risk of decreased bone mineral density. This may have effects 
on bone health and increase the risk of fracture throughout the 
lifecycle, especially in

[[Page 2552]]

postmenopausal women. Very low intake of vitamin D can lead to the 
development of rickets, especially in those of African descent and 
other highly pigmented individuals. Although milk alternative products 
are typically fortified with vitamin D and other nutrients, they are 
often more expensive and less widely available than conventional 
products.
    The public health burden from deficiencies attributable to lactose 
intolerance is difficult to quantify. Additionally, it is challenging 
to identify and manage lactase nonpersisters. Questions remain as to 
the amount, if any, of lactose that can be tolerated by lactose 
nonpersisters and how best to assist these individuals in meeting 
recommended intakes. To examine these important issues, the Eunice 
Kennedy Shriver National Institute of Child Health and Human 
Development and the Office of Medical Applications of Research of the 
National Institutes of Health will convene a Consensus Development 
Conference from February 22 to 24, 2010, to assess the available 
scientific evidence related to the following questions:
     What is the prevalence of lactose intolerance, and how 
does this prevalence differ by race, ethnicity, and age?
     What are the health outcomes of dairy exclusion diets?
     What amount of daily lactose intake is tolerable in 
subjects with diagnosed lactose intolerance?
     What strategies are effective in managing individuals with 
diagnosed lactose intolerance?
     What are the future research needs for understanding and 
managing lactose intolerance?
    An impartial, independent panel will be charged with reviewing the 
available published literature in advance of the conference, including 
a systematic literature review commissioned through the Agency for 
Healthcare Research and Quality. The first day and a half of the 
conference will consist of presentations by expert researchers and 
practitioners and open public discussions. On Wednesday, February 24, 
the panel will present a statement of its collective assessment of the 
evidence to answer each of the questions above. The panel will also 
hold a press telebriefing to address questions from the media. The 
draft statement will be published online later that day, and the final 
version will be released approximately six weeks later. The primary 
sponsors of this meeting are the NIH Eunice Kennedy Shriver National 
Institute of Child Health and Human Development and the NIH Office of 
Medical Applications of Research.
    Advance information about the conference and conference 
registration materials may be obtained from the NIH Consensus 
Development Program Information Center by calling 888-644-2667 or by 
sending e-mail to consensus@mail.nih.gov. The Information Center's 
mailing address is P.O. Box 2577, Kensington, Maryland 20891. 
Registration information is also available on the NIH Consensus 
Development Program Web site at http://consensus.nih.gov.

    Please Note: The NIH has instituted security measures to ensure 
the safety of NIH employees, guests, and property. All visitors must 
be prepared to show a photo ID upon request. Visitors may be 
required to pass through a metal detector and have bags, backpacks, 
or purses inspected or x-rayed as they enter NIH buildings. For more 
information about the security measures at NIH, please visit the Web 
site at http://www.nih.gov/about/visitorsecurity.htm.


    Dated: January 7, 2010.
Raynard S. Kington,
Deputy Director, National Institutes of Health.
[FR Doc. 2010-672 Filed 1-14-10; 8:45 am]
BILLING CODE 4140-01-P