Prebiotics May Play a Role in Lactose Intolerance

According to data from the 2012 National Health Interview Survey, probiotic and prebiotic use continues to grow in the United States. Between 2007 and 2012, probiotic and prebiotic use quadrupled. In fact, 4 million US adults reported they had used probiotics or prebiotics in the 30 days before the survey.1 Yet, prebiotics are often confused with probiotics.

In an effort to clear up the confusion, the International Scientific Association for Probiotics and Prebiotics (ISAPP) issued consensus statements in 2014 and 2017 defining probiotics and prebiotics respectively. Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit to the host.2 Unlike probiotics, prebiotics aren’t bacteria; they are a substrate that is selectively utilized by host microorganisms conferring a health benefit.3 Inulin is an example of a prebiotic that is commonly used. Inulin is a dietary fiber from chicory root and can be found in many different foods, including some bars and yogurts.

The Food and Drug Administration (FDA) defines yogurt as a fermented dairy product derived from the fermentation of milk by two species of bacterial cultures: Streptococcus thermophilus and Lactobacillus bulgaricus4 – these two cultures aide in lactose digestion, which may help people with lactose intolerance. These two bacteria (Streptococcus thermophilus and Lactobacillus bulgaricus) are considered live and active cultures. Live and active cultures are living organisms which convert pasteurized milk to yogurt during fermentation.5 Probiotics, are live and active cultures that have been studied to provide a specific health benefit, such as supporting digestive or immune health. The benefits of probiotics are strain specific and not all probiotics offer the same benefit. Probiotics are available in a variety of different products, including dietary supplements, juices, bars, dried fruits and fermented foods such as kefir and probiotic yogurts.1

Prebiotics may also have a role to play in lactose intolerance. In a recent study, researchers from the University of North Carolina found that lactose intolerant individuals given the prebiotic galactooligosaccharide (GOS) showed a significant increase in lactosefermenting bacteria and increased tolerance to dairy.6

Synbiotics are the combination of probiotics and prebiotics. Synbiotics are thought to be the best way to ensure maximum benefit from probiotics.7 Combining probiotic yogurt with bananas is an example of a synbiotic food combination.

Current management of lactose intolerance depends on the degree of lactase deficiency and may include avoiding or limiting amounts of lactose, consuming lactose in small amounts as part of a meal, choosing foods with lower lactose content, lactase enzyme supplementation, or the use of probiotics such as those found in specific probiotic yogurts or available as dietary supplements. However, as the science on prebiotics and lactose digestion continue, prebiotics along with probiotics may play a greater role in increasing food choices for lactose intolerant individuals.


Constance Brown-Riggs


Dannon Nutrition Advisor

1 The basics of probiotics. NIH Medline Plus Magazine. https://medlineplus.gov /magazine/issues/winter16/articles/winter16pg22.html. Published 2016. Accessed August 11, 2017.

2 The International Scientific Association for Probiotics and Prebiotics. Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Available at. https://isappscience.org/science-of-microbiomes/. Accessed August 11, 2017.

3 The International Scientific Association for Probiotics and Prebiotics. Prebiotics. Available at. https://isappscience.org/prebiotics. Accessed August 11, 2017

4 US Department of Health and Human Services. CFR – Code of Federal Regulations Title 21. https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr /CFRSearch.cfm?fr=131. 200. Accessed August 10, 2017.

5 The National Yogurt Association. Live and active culture yogurt. Available at. http://www.aboutyogurt.com/live-culture Accessed August 15, 2017.

6 Azcarate-Peril MA, Ritter AJ, Savaiano D, Monteagudo-Mera A, Anderson C, Magness ST. Impact of short-chain galactooligosaccharides on the gut microbiome of lactose-intolerant individuals. Proc Natl Acad Sci U S A. 2017;114(3):E367-E375.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648921/. Accessed August 11, 2017

Looking for More Information on Probiotics and Prebiotics?

The International Scientific Association for Probiotics and Prebiotics provides information on probiotics and prebiotics. For a more in-depth look at prebiotics’ role in treating lactose intolerance click here to read Constance’s recent article in Today’s Dietitian Magazine.

Support Children’s Nutrition During Kids Eat Right Month

August is Kids Eat Right Month, when the Academy of Nutrition and Dietetics and the Academy Foundation highlight the fight for children’s healthy futures. Kids Eat Right Month showcases the Foundation’s Kids Eat Right campaign, which supports public education projects and programs that address childhood obesity in the U.S. Kids Eat Right Month focuses on smart shopping, healthy eating and active lifestyles for every age group, from infants to teens. Visit the Academy of Nutrition and Dietetics for resources for community leaders, schools, parents, kids and registered dietitian nutritionists.

Deadline to Implement CACFP’s New Meal Patterns is October 1

The United States Department of Agriculture (USDA) recently revised the Child and Adult Care Food Program (CACFP) meal patterns. Based on the Dietary Guidelines for Americans, scientific recommendations from the National Academy of Medicine and stakeholder input, the changes to the meal patterns include a greater variety of vegetables and fruit, more whole grains and also include yogurt as an option for children six months of age and older. USDA has a worksheet that helps CACFP centers and day care homes choose yogurts with less added sugar.