Cow's Milk: A Benefit for Human Health? Omics Tools and Precision Nutrition for Lactose Intolerance Management

Abstract

Cow's milk (CM) is a healthy food consumed worldwide by individuals of all ages. Unfortunately, "lactase-deficient" individuals cannot digest milk's main carbohydrate, lactose, depriving themselves of highly beneficial milk proteins like casein, lactoalbumin, and lactoglobulin due to lactose intolerance (LI), while other individuals develop allergies specifically against these proteins (CMPA). The management of these conditions differs, and an inappropriate diagnosis or treatment may have significant implications for the patients, especially if they are infants or very young children, resulting in unnecessary dietary restrictions or avoidable adverse reactions. Omics technologies play a pivotal role in elucidating the intricate interactions between nutrients and the human body, spanning from genetic factors to the microbiota profile and metabolites. This comprehensive approach enables the precise delineation and identification of distinct cohorts of individuals with specific dietary requirements, so that tailored nutrition strategies can be developed. This is what is called personalized nutrition or precision nutrition (PN), the area of nutrition that focuses on the effects of nutrients on the genome, proteome, and metabolome, promoting well-being and health, preventing diseases, reducing chronic disease incidence, and increasing life expectancy. Here, we report the opinion of the scientific community proposing to replace the "one size fits all" approach with tailor-made nutrition programs, designed by integrating nutrigenomic data together with clinical parameters and microbiota profiles, taking into account the individual lactose tolerance threshold and needs in terms of specific nutrients intake. This customized approach could help LI patients to improve their quality of life, overcoming depression or anxiety often resulting from the individual perception of this condition as different from a normal state.

Keywords: cow’s milk; food allergy; inflammation; lactose intolerance; microbiota; omics..

Figure 1

Schematic representation showing the components of cow milk. Parts of the figure were drawn using pictures from Server Medical Art. Servier Medical Art by Servier is licensed under a Creative Commons Attribution 3.0 Unported License.

Figure 2

Adverse effects that may occur following milk intake in some predisposed individuals. Parts of the figure were drawn by using BioRender.com.

Figure 3

Model for the onset of IgE- and non-IgE-mediated cow’s milk protein allergy. Parts of the figure were drawn using pictures from Server Medical Art. Servier Medical Art by Servier is licensed under a Creative Commons Attribution 3.0 Unported License.

Figure 4

Intestinal digestion and absorption of lactose. The β-galactosidase lactase phlorizin hydrolase (LPH) breaks down lactose into glucose and galactose (white and blue diamonds) in the brush border microvilli (BBM) on the apical surface of the small intestine enterocytes (A). Here, after hydrolysis by LPH (yellow oval), monosaccharides are actively transported into enterocytes by the Na⁺/glucose co-transporter (blue oval) together with H₂O molecules, rapidly absorbed into the surrounding capillaries by facilitated diffusion and transported in the bloodstream (B). LPH is synthesized as monomeric pro-LPH, which consists of four domains (I–IV), proteolytically activated first in the endoplasmic reticulum and in the Golgi apparatus of the enterocytes for cleavage of domains I and then sorted to BBM, where also domains II are cleaved to final mature LPH form (C).