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CDDW: Dairy-free Diets Appear to do More Harm Than Good in HIV Patients By Louise Gagnon Special to DG News MONTREAL, QC -- February 6, 2002 -- Patients with HIV probably do not benefit from staying away from lactose in their diet, according to an equivalency trial presented here yesterday during the Seventh Canadian Digestive Diseases Week, the annual meeting of the Canadian Association of Gastroenterology. "Diarrhoea remains a common problem in HIV patients, despite antiretroviral therapy," said Dr. Jill Tinmouth, the study’s principal researcher. "There was research on lactase deficiency before protease inhibitors were common therapy, but not in the protease era." Researchers surveyed physicians in Toronto, Ontario, Canada, to find out if they typically counsel their HIV patients to avoid dairy products in their diet, despite the fact there is no clinical evidence to support that recommendation. "There may actually be possible harms," said Dr. Tinmouth, clinical fellow at St. Michael’s Hospital, University of Toronto. "Those include decreased calcium intake, especially in the face of reports on osteopenia." The study of 20 patients was conducted in a randomised, double-blind, crossover fashion. The patient population consisted of HIV-positive patients, all of whom were male, who has at least three loose to watery bowel movements daily for four weeks or who required anti-diarrhoea medications. The median number of bowel movements per day was five. The median age of the patients was 41. Dairy product avoidance was reported by 25 percent of patients. The hydrogen breath test showed 30 percent were lactase deficient. The median CD4 count of patients was 345 cells/mm3 and median viral load was 462. Patients underwent lactose and placebo study periods in random order, ingesting either 240 mL of either low fat milk, containing 12 g of lactose, or lactose-free milk. An eight-hour stool collection was performed with concurrent hydrogen breath test. Stool weight was the primary outcome measurement after ingestion of the two liquids. Researchers also administered a symptom questionnaire that subjects completed. "The two periods showed no difference in statistical significance," said Dr. Tinmouth. "Based on our results, lactose avoidance is not of benefit to this population. You should not advocate diets that avoid lactose because there is no benefit, and there is theoretical risk of osteopenia and malnutrition." E-mail this page to a friend or colleague! To print, use this version