Prevalence of Lactose Intolerance on the Fort Peck Indian Reservation
Multi-PI: Holly Hunts, Montana State University | Steven Coon, Fort Peck Community College
United States (U.S.) food policies over the past 150 years have pressured American Indians (AI) living on reservations to transition away from their traditional diets of wild game, berries, and other wild plants to a diet high in processed foods with insufficient nutrient content and deleterious nutrient imbalances that are too high in dairy, starches, and sugars. The debilitating combination of living in food deserts with poor access to affordable and quality food, food insecurity and poverty have led to a widespread and multi-generational health crisis in Native communities. The AI life expectancies are considerably lower than those for whites, largely because of a higher incidence of diabetes, liver and kidney diseases. Current efforts to treat these chronic diseases through dietary changes and medications have limited success. We hypothesize that Lactose Intolerance (LI) and sugar malabsorption problems, which cause diarrhea, are underlying factors in inhibiting absorption of nutrients from foods--as well as preventing medications prescribed to address these diseases from being absorbed and therefore from being fully effective. Native Americans have come to depend on non-traditional foods, which are high in sugars, starches and dairy, which tend to cause malabsorption problems. MSU staff propose to train FPCC students and FPCC staff how to carry out highly non-invasive breath screening for LI. Control tests will also be carried out for sugar malabsorption to identify false positive results for LI. The FPCC students will be encouraged and supported to develop their own research projects using this equipment and assays, which will give them practice and enhance their skills in biomedical analysis. The FPCC students and staff, with MSU faculty support, will offer the LI tests and the sugar malabsorption control tests to interested members of the Native community, free of charge, at a number of locations to increase the convenience of reaching the test sites. A Community Advisory Board will advise on the conduct of the project and will assist in recruiting subjects for testing. Some of the groups will be participants in the Food Distribution Program on Indian Reservations (FDIPR), SNAP, other interested community members and groups who participate in programs where milk is served as a requirement of program funding. If this program is informative, we expect that we will be able to obtain funding for bringing these tests to other Native and rural communities in Montana and to engage Tribal College students from other colleges. We propose testing across age groups and noting deidentified racial differences so that we can add information to the literature about LI and sugar malabsorption in American Indians and to ultimately encourage return to more traditional and healthier foods.
- Determine the prevalence of Lactose Intolerance on the Fort Peck Reservation in cooperation with a Community Advisory Board (CAB). USDA funded school breakfast and lunch programs expect children to take containers of milk, which they may tend to drink if they are hungry. CDC assumes that 80-100% of Native Americans are Lactose Intolerant, but there appears to be little reliable data in the literature. The test for Lactose Intolerance is a very non-invasive breath test, given before and after drinking a measured amount of lactose in water. Subjects will also be given an initial control test with glucose to familiarize them with the test and to determine if there is a general intolerance of sugars, which is common in individuals whose diets are high in sugars and carbohydrates. If individuals are intolerant of sugars in general that could lead to a misdiagnosis of Lactose Intolerance. If individuals are Lactose Intolerant, then milk or milk products in their diets will tend to upset their digestive tract, interfere with nutrient absorption, and make them less able to do well in school or in other aspects of their lives.
- Build scientific research capacity at Fort Peck Community College through students learning quantitative chemical analysis methods to monitor Lactose Intolerance and/or general intolerance of sugars. The methods are relatively straightforward but require attention to detail, quantitative analysis techniques, and good record keeping. A small group of FPCC students will learn the methods in the summer, with guidance of staff from MSU. The FPCC students will run the tests on each other and on faculty or staff that are available to gain experience with the testing. They will test each other and some of the individuals repeatedly (with a week in between tests) to assess reproducibility of the tests. They will do other experiments to compare milk to lactose, the effectiveness of Lactaid or lactose free milk, and will assess if there are individual variations in severity. During the school year, a larger group of students will be trained in the methods, will carry out similar reproducibility and experimental tests, and will assist in the testing of a larger group of community members. The CAB will assist in the recruitment of community members to take the tests. Lactose Intolerant people will feel much better if they avoid dairy. The most engaged students will assist in preparing statistical summaries and written reports on the prevalence of Lactose Intolerance and sugar sensitivity on the Fort Peck Reservation and present this information to the community.
- Explore possible interventions to counteract the negative effects of Lactose Intolerance, if present. A key factor in cases of Lactose Intolerance is to provide other sources of calcium and vitamin D since milk is the primary source of these key nutrients in food sources in Native diets. A possible intervention would be to develop an energy drink that would provide calcium and vitamin D, as well as other important nutrients for improved health. One idea would be a drink possibly called “Red Buffalo Bull” (a takeoff on the popular Red Bull drink). Berries, high in nutrients, traditionally used as Native food sources, could be used for flavor and for their high nutrient content. Dried grass-fed buffalo meat and bone broth made from grass-fed buffalo could be a high nutrient base. Other nutrients, such as tryptophan, zinc, DHA, MCT, and glycine, could be included, which are important for brain performance, feelings of well-being and improved health. Individuals in the community who may be interested could possibly develop a company and work to popularize the use of this product on the reservation, in Montana and around the country.