Cow's milk contains two types of β-casein: A1 and A2. It is evident from human clinical trials that milk with A1 protein produces more hydrogen and symptoms of lactose intolerance. A pro-inflammatory μ-opioid peptide BCM-7 is released from A1 but not from A2. Milk containing A1 β-casein produced more inflammatory markers than A2 β-casein. This is a double-blinded, randomized, controlled trial conducted to determine if there are changes in inflammatory markers following two weeks of milk feeding, due to milk containing A1 and A2 beta-casein as compared to milk containing only A2 beta-casein.
Recruitment: Flyers, emails, and advertisements in local and university newspapers will be used for recruitment of study participants. Phone screening: Interested individuals will be contacted via phone by study staff to assess eligibility by asking questions listed in the inclusion and exclusion criteria. Informed consent: If the individual is eligible through phone screening, the study staff will read and explain the informed consent to the individual. Informed consent will contain all the information regarding study procedure, compensation, risks and benefits. If Informed Consent is granted, the participant will be contacted through their preferred method of contact (email or phone) to schedule a hydrogen breath test (HBT). Screening lactose maldigesters via HBT: Maldigestion will be classified by a rise of breath hydrogen concentration of greater than 20ppm after a challenge dose of 2% commercial milk containing 0.5g lactose per kg body weight. Participants will consume a low-fiber meal and then fast 12 hours prior to HBT. A breath sample will be obtained from participants just before drinking the milk dose. Participants will then consume milk containing 0.5 grams lactose per kilogram body weight. Breath samples will be obtained according to the following schedule: 0 hour (pre dose), 30 minutes, 1 hour, 90 minutes, 2 hours, 3 hours, 4 hours, 5 hours and 6 hours. Participants who exhibit a rise of breath hydrogen concentration of greater than 20ppm between any two timepoints of the 6-hour test will be classified as lactose maldigesters, and will be qualified to enter the intervention portion of the study. Intervention: There will be two phases in intervention. Each phase is 15 days long. Phase 1: Blood will be drawn from the participants before consumption of milk on day 1 of the phase. Participants will then consume the 500 ml of first randomized milk every day from day 1 to day 14 (14 days in total). Dietary intake, stool type and symptoms (abdominal pain, bloating, flatulence, fecal urgency, and diarrhea) severity will be recorded on each day from day 1 to day 14 after milk consumption. Participants will consume a low-fiber dinner and fast for 12 hours prior to HBT on day 15. Participants will provide their first breath sample before consumption of milk. Participants will then consume a challenge dose of first randomized milk containing 0.5g lactose per kg body weight. Breath samples will be collected at 0 hour (pre dose), 30 minutes, 1 hour, 90 minutes, 2 hours, 3 hours, 4 hours, 5 hours and 6 hours. Participants will be asked to report and rate any symptoms including abdominal pain, bloating, flatulence, fecal urgency, and diarrhea they might experience during the 6 hour test. Blood will be drawn from participants at 0 hour (pre-dose), 1 hour, 2 hours and 3 hours time-point via catheter and serum will be isolated from whole blood for analyses of markers including hs-CRP, IgG, IgG1, Il-4, GSH and BCM-7. Phase 2: There will be at least a 6-day interval between Phase 1 and Phase 2. The same procedure from phase 1 will be followed in phase 2. Participants will consume the second randomized milk for 14 days and undergo HBT on day 15.
Milk dose for 2 weeks
Milk dose for 2 weeks
Purdue University
West Lafayette, Indiana, United States
RECRUITINGDifference in inflammation between commercial and A2 milk
The concentration of inflammatory markers hs-CRP, IL-4, IgG, IgG1, BCM-7, GSH in serum will be measured using ELISA kits, Cobas 400 plus analyzer and a Cobas e411 analyzer in nanometers.
Time frame: Baseline blood draw on day 1 and within the 3 hours following milk dose on day 15
Difference in hydrogen between commercial and A2 milk
Hydrogen concentration (ppm) will be measured in breath sample using a hydrogen breath analyzer.
Time frame: Within the 6 hours following milk dose on day 15
Difference in symptoms between commercial and A2 milk
Participants will record and rate abdominal pain, bloating, flatulence, diarrhea and fecal urgency using a 6-point Likert Scale during the 6-hour test. The scale ranges from a score of 0 to 5 (0 = none, 1 =slight, 2 = mild, 3 = moderate, 4 = moderately severe, 5 = severe).
Time frame: From day 1 to day 14 after 500 ml milk consumption and within the 6 hours following milk dose on day 15
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Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
TRIPLE
Enrollment
35