Lactose Intolerance

乳糖不耐受
  • 文章类型: Journal Article
    有牛奶过敏或乳糖不耐受风险的人可能需要避免食用牛奶和奶制品。这是众所周知的丰富的钙(Ca)来源。钙摄入的这种限制可能会影响骨骼健康。目前,关于避免食用牛奶和奶制品对有牛奶过敏风险的人的每日钙摄入量和骨矿物质密度(BMD)的影响的知识有限。这项研究旨在调查有牛奶过敏风险的人和没有牛奶过敏风险的人之间的钙摄入量和BMD值之间的差异。
    共招募了80名参与者,并进一步分为两组,高危牛奶过敏(AR)组(n=40)和正常(NOR)组,使用牛奶过敏和乳糖不耐受筛查问卷。人体测量评估,身体成分分析,3天饮食记录,使用双X线吸收法(DEXA)技术收集所有参与者的骨密度(腕骨和踝骨)测量值,以比较两组之间变量的差异.
    AR组的参与者的钙摄入量(317mg/天)明显低于NOR组(623mg/天)(p<0.05)。骨密度(BMD)参数表明,与AR组相比,NOR组的腕骨(T评分=-0.27,BMD=0.57g/cm2)和踝骨(T评分=-0.01,BMD=0.59g/cm2)的T评分和BMD值明显更高(腕骨的T评分=-1.96,BMD=0.48g/cm2),踝骨的T评分=-1.18,BMD=0.47g/cm2(p<0.05)。此外,结果表明,所有参与者的钙摄入量与腕骨和踝骨的T评分和BMD值之间存在显着正相关(p<0.05)。
    在此响应样本中,有牛奶过敏风险的参与者对Ca摄入量和BMD值产生显著负面影响.营养和营养学专业人员应提供营养教育和策略,以提高该人群的钙摄入量,以帮助他们满足每日钙摄入量的建议。最终导致更好的骨骼健康。
    UNASSIGNED: People who are at risk of either cow milk allergies or lactose intolerance may need to avoid consuming milk and milk products, which are well-known abundant sources of calcium (Ca). This limitation in calcium intake could affect bone health. Currently, there is limited knowledge on the impact of avoiding the consumption of milk and milk products on the daily Ca intake and bone mineral density (BMD) of people at risk of cow milk allergies. This study aimed to investigate the differences between the amount of Ca intake and BMD values between people who are at risk of cow milk allergies and those who are not.
    UNASSIGNED: A total of 80 participants were recruited, and further divided into two groups, the at-risk cow milk allergies (AR) group (n = 40) and the normal (NOR) group, using the cow milk allergies and lactose intolerance screening questionnaire. The anthropometric assessment, body composition analyses, 3-day dietary record, and bone mass density (wrist and ankle bones) measurement of all participants were collected using the dual x-ray absorptiometry (DEXA) technique to compare the differences of variables between the two groups.
    UNASSIGNED: The participants in the AR group presented a significantly lower amount of Ca intake (317 mg/day) than those in the NOR group (623 mg/day) (p < 0.05). The bone mineral density (BMD) parameters indicated that the NOR group presented significantly higher T-scores and BMD values of the wrist (T-score = -0.27 and BMD = 0.57 g/cm2) and ankle (T-score = -0.01 and BMD = 0.59 g/cm2) bones when compared with the AR group (T-score = -1.96 and BMD = 0.48 g/cm2 for the wrist bone, and T-score = -1.18 and BMD = 0.47 g/cm2 for the ankle bone) (p < 0.05). In addition, the results indicated significantly positive correlations between the amount of Ca intake and the T-scores and BMD values of both the wrist and ankle bones among all participants (p < 0.05).
    UNASSIGNED: In this responding sample, participants at risk of cow milk allergies experienced a significantly negative impact on the amount of Ca intake and BMD values. Professionals in nutrition and dietetics should provide nutrition education and strategies that can enhance the Ca intake among this population to help them meet the daily Ca intake recommendation, ultimately leading to better bone health.
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  • 文章类型: Journal Article
    食物不耐受和乳糜泻的增加,加上先进的诊断技术,促使卫生专业人员寻求有效和经济的测试方法。这项研究评估了将遗传测试与常规碳水化合物吸收呼气测试相结合,以将患有慢性胃肠道疾病的患者分为治疗组。加强饮食管理,改善肠道健康和生活质量。49名疑似碳水化合物不耐受的患者接受了乳糖酶不持久性基因检测,遗传性果糖不耐受,和乳糜泻的风险。同时,呼气试验评估乳糖和果糖的吸收。36.7%的病例出现乳糖酶非持久性基因型,一个遗传性果糖不耐受病例处于杂合状态。在49.0%的人群中发现了乳糜泻风险标志物(HLA-DQ2/8单倍型)。67.3%的患者存在继发性乳糖和/或果糖吸收不良,66.1%的乳糖酶非持久性个体表现出继发性乳糖吸收不良。在有乳糜泻风险的患者中,有45.8%的人普遍存在果糖吸收不良。根据遗传结果定义了两个主要的治疗组,表明原发性和不可逆的胃肠道疾病的原因,然后使用呼气测试结果进行分类。基因检测是设计饮食管理计划的有价值的工具,避免不必要的饮食限制,减少恢复时间。
    The rise in food intolerances and celiac disease, along with advanced diagnostic techniques, has prompted health professionals to seek effective and economical testing methods. This study evaluates combining genetic tests with routine carbohydrate-absorption breath tests to classify patients with chronic gastrointestinal disorders into therapeutic groups, enhancing dietary management and improving gut health and quality of life. Forty-nine patients with suspected carbohydrate intolerance underwent genetic testing for lactase non-persistence, hereditary fructose intolerance, and celiac disease risk. Simultaneously, breath tests assessed lactose and fructose absorption. The lactase non-persistence genotype appeared in 36.7% of cases, with one hereditary fructose-intolerance case in a heterozygous condition. Celiac disease risk markers (HLA-DQ2/8 haplotypes) were found in 49.0% of the population. Secondary lactose and/or fructose malabsorption was present in 67.3% of patients, with 66.1% of lactase non-persistence individuals showing secondary lactose malabsorption. Fructose malabsorption was prevalent in 45.8% of patients at risk for celiac disease. Two main treatment groups were defined based on genetic results, indicating primary and irreversible gastrointestinal disorder causes, followed by a sub-classification using breath test results. Genetic testing is a valuable tool for designing dietary management plans, avoiding unnecessary diet restrictions, and reducing recovery times.
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  • 文章类型: Case Reports
    该病例报告研究了一次功能神经病学对诊断为乳糖不耐受的35岁女性患者的影响。患者出现严重的胃肠道症状,包括频繁的腹泻,腹胀,在食用乳制品时呕吐。干预措施旨在重置可能导致她病情的功能失调的神经系统计划。该研究利用标准化的乳糖不耐受呼气测试来测量治疗前后不同间隔的氢气和甲烷水平。治疗后结果显示症状缓解,患者报告排便正常,没有先前的症状。尽管有这些改进,生化标志物在较高的时间点(150和175分钟)治疗后保持与治疗前的值相似,表明持续的乳糖吸收不良,并突出氢测量的可变性。该病例报告表明,一次功能神经病学可以显着缓解乳糖不耐受的症状。然而,这些结果的初步性质强调了需要进一步研究,包括更大的样本量和长期随访,以充分了解治疗的疗效和潜在机制。
    This case report examines the impact of a single session of functional neurology on a 35-year-old female patient diagnosed with lactose intolerance. The patient presented with severe gastrointestinal symptoms, including frequent diarrhea, bloating, and vomiting upon dairy consumption. The intervention aimed to reset dysfunctional neurological programs believed to contribute to her condition. The study utilized a standardized lactose intolerance breath test to measure the hydrogen and methane levels at various intervals before and after treatment. Post-treatment results showed symptomatic relief with the patient reporting normalized bowel movements and the absence of previous symptoms. Despite these improvements, the biochemical markers at higher time points (150 and 175 min) post-treatment remained similar to the pre-treatment values, indicating persistent lactose malabsorption and highlighting the variability of hydrogen measurements. This case report suggests that a single session of functional neurology can significantly alleviate the symptoms of lactose intolerance. However, the preliminary nature of these results underscores the need for further research involving larger sample sizes and long-term follow-up to fully understand the treatment\'s efficacy and underlying mechanisms.
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  • 文章类型: Journal Article
    目的:在这项回顾性研究中,我们根据性别评估了乳糖不耐受婴儿口服乳糖酶的疗效,出生体重,和其他药物的干扰。
    方法:该研究是针对在DokuzEylul大学社会儿科入院时被诊断为乳糖不耐受的0-6个月的患者进行的。人口统计数据,症状的出现,记录使用的药物。
    结果:我们发现86.7%的婴儿对乳糖酶有反应,没有明显的性别差异,出生体重,或出现症状时的年龄。我们观察到,然而,随着时间的推移,治疗的效果确实有所改善,从而从肠道发育和适应中获益。有趣的是,对乳糖酶的反应在接受伴随西甲硅油绞痛症状的婴儿中降低,暗示潜在的药物相互作用,而益生菌对治疗结果无影响.
    结论:我们建议不要使用口服乳糖酶的其他药物,指出与西甲硅油的相互作用可能会降低治疗的有效性。
    OBJECTIVE: In this retrospective study, we assessed the efficacy of oral lactase in infants with lactose intolerance in terms of sex, birth weight, and interference by other medications.
    METHODS: The study was conducted on patients aged 0-6 months who had been diagnosed with lactose intolerance on admission to the Department of Social Pediatrics at Dokuz Eylul University. Demographic data, the onset of symptoms, and medications used were recorded.
    RESULTS: We found that 86.7% of the infants responded to lactase, with no significant differences based on sex, birth weight, or age at symptom presentation. We observed, however, that the efficacy of treatment did improve over time, thereby deriving benefits from intestinal development and adaptation. Interestingly, the response to lactase was reduced in infants receiving concomitant simethicone for colic symptoms, suggesting a potential drug interaction, while probiotics had no impact on treatment outcomes.
    CONCLUSIONS: We advise against using additional medications with oral lactase, pointing out a possible interaction with simethicone that might decrease the effectiveness of treatment.
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  • 文章类型: Journal Article
    乳糖不耐受和乳糜泻是临床常见的营养吸收障碍,发病机制不清楚,治疗选择有限。人们普遍认为,肠道菌群在许多消化系统疾病中起着重要作用。但其在乳糖不耐受和乳糜泻中的作用尚不清楚。本研究旨在探讨肠道菌群与乳糖不耐受与乳糜泻的相关性。
    本研究利用全基因组关联研究数据库,利用孟德尔随机化(MR)研究肠道微生物群与乳糖不耐受和乳糜泻之间的关联。我们的研究结果的稳健性得到了后续分析的证实,包括Cochrane的Q统计量,MR-Egger截距回归,MR-PRESSO全局测试和留一法。
    通过使用逆方差加权方法,我们确定了维洛诺拉科,草酸杆菌属和塞内加尔对乳糖不耐受具有保护作用,而厌氧菌属,发现Eubacteriumrectale组和Ruminococus2是乳糖不耐受的危险因素。关于乳糜泻,类芽孢杆菌和γ变形杆菌,家族FamilyXIII和Veillonellaceae,艾森伯氏菌属,衣原体,RuminoccaceUCG014和Ruminococus2被确定为保护因子,而Betaproteobacteria类,木杆菌属和布劳特氏菌属是危险因素。此外,逆转MR分析未发现任何乳糖不耐受或乳糜泻与我们研究中确定的细菌之间存在因果关系的证据.
    这项研究为探索肠道微生物群在乳糖不耐受和乳糜泻中的作用提供了新的见解;然而,需要进一步的实验研究来阐明具体的潜在机制。
    UNASSIGNED: Lactose intolerance and coeliac disease are common clinical nutrient malabsorption disorders, with an unclear pathogenesis and limited therapeutic options. It is widely believed that the gut microbiota plays an important role in many digestive disorders, but its role in lactose intolerance and coeliac disease is not yet clear. This study aimed to investigate the correlation between gut microbiota and lactose intolerance and coeliac disease.
    UNASSIGNED: This study utilized the genome-wide association study database to investigate the association between gut microbiota and lactose intolerance and coeliac disease using Mendelian randomization (MR). The robustness of our findings was confirmed through subsequent analyses including Cochrane\'s Q statistic, MR-Egger Intercept Regression, MR-PRESSO Global Test and Leave-one-out methods.
    UNASSIGNED: By employing the inverse variance weighted method, we identified that family Veillonellaceae, genus Oxalobacter and Senegalimassilia were protective against lactose intolerance, whereas genus Anaerotruncus, Eubacterium rectale group and Ruminococcus2 were found to be risk factors for lactose intolerance. Regarding coeliac disease, class Bacilli and Gammaproteobacteria, family FamilyXIII and Veillonellaceae, genus Eisenbergiella, Lachnoclostridium, RuminococcaceaeUCG014 and Ruminococcus2 were identified as protective factors, while class Betaproteobacteria, genus Eubacterium xylanophilum group and Blautia were risk factors. Furthermore, reverse the MR analysis did not reveal any evidence of a causal relationship between lactose intolerance or coeliac disease and the bacteria identified in our study.
    UNASSIGNED: This study provides novel insights into exploring the role of gut microbiota in lactose intolerance and coeliac disease; however, further experiments investigations are required to elucidate the specific underlying mechanisms.
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  • 文章类型: Journal Article
    背景:这项研究的目的是评估配方奶粉治疗儿童乳糖不耐受的疗效和安全性,并通过Meta分析为各种原因引起的乳糖不耐受患儿的合理用药提供循证医学依据。
    方法:使用计算机搜索主要数据库,包括WebofScience,PubMed,CNKI,万方数据知识服务平台,和其他数据库,检索时间是从数据库建立到2023年4月。对收集的文献进行筛选,数据提取和处理,然后通过Review-Manager5.4统计软件进行荟萃分析。
    结果:共纳入10项随机对照试验,1112名患者,其中治疗组562例,对照组550例。对照组采用常规治疗,治疗组在常规治疗基础上加用无乳糖/低乳糖奶粉。Meta分析结果显示,治疗组临床疗效明显优于对照组[比值比=6.01,95%置信区间(CI):3.94~9.18,P<0.00001],治疗组病程短于对照组(均差=-1.45,95%CI:-1.76~-1.13,P<0.0001)。治疗组的止泻时间明显短于对照组,两组之间的差异有统计学意义(平均差异=-1.41,95%CI:-1.67至-1.15,P<0.0001)。
    结论:低/无乳糖奶粉可提高乳糖不耐受婴幼儿的临床疗效,缩短疗程。这可以通过进一步的大规模临床研究来证明。
    BACKGROUND: The aim of this study was to evaluate the efficacy and safety of formula milk powder in the treatment of lactose intolerance in children, and to provide an evidence-based medicine basis for the rational use of drugs in children with lactose intolerance caused by various reasons by meta-analysis.
    METHODS: Use computers to search major databases, including Web of Science, PubMed, CNKI, Wanfang Data Knowledge Service Platform, and other databases, the retrieval time is from the establishment of the database to April 2023. The collected literatures were screened, data extracted and processed, and then meta-analysis was performed by Review-Manager 5.4 statistical software.
    RESULTS: A total of 10 randomized controlled trials were included, with 1112 patients, including 562 patients in the treatment group and 550 patients in the control group. The control group was treated with conventional therapy, and the treatment group was treated with lactose-free/low-lactose milk powder on the basis of conventional therapy. The results of the meta-analysis showed that the clinical efficacy of the treatment group was significantly better than that of the control group [odds ratio=6.01, 95% confidence interval (CI): 3.94-9.18, P<0.00001], the course of disease in the treatment group was shorter than that in the control group (mean difference=-1.45, 95% CI: -1.76 to -1.13, P<0.0001). The antidiarrhea time of the treatment group was shorter than that of the control group, and the difference between the 2 groups was statistically significant (mean difference=-1.41, 95% CI: -1.67 to -1.15, P<0.0001).
    CONCLUSIONS: Low/lactose-free milk powder can improve clinical efficacy and shorten the course of treatment in infants with lactose intolerance, which can be demonstrated by further large-scale clinical studies.
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  • 文章类型: Journal Article
    乳糖和牛乳蛋白(CMP)作为药物中的潜在过敏原的用途及其引起过敏反应的能力仍然是医学中的重要问题。乳糖,一种常见的药物赋形剂,由于其惰性,便宜,和稳定的性能,在许多处方药和非处方药中都有发现。然而,尽管它们被广泛使用,患有乳糖不耐受(LI)或牛奶蛋白过敏(CMPA)的个体可能会出现这些赋形剂的不良反应.这项研究调查了在葡萄牙销售的药品中乳糖和其他乳制品衍生成分的患病率。使用INFOMED数据库中的产品特性摘要(SmPC),各种药物,包括镇痛药,退烧药,非甾体抗炎药(NSAIDs),和抗哮喘药,进行了分析。结果显示,乳制品衍生赋形剂的患病率很高,特别是在平喘药物(62.6%)和NSAIDs(39%)中。虽然在SmPC中没有明确提到CMP,乳糖作为成分的存在会带来交叉污染的风险。研究结果强调,医疗保健专业人员需要意识到药物中潜在的过敏原,以及开发无乳糖替代品以确保LI和CMPA患者安全的重要性。需要进一步的研究来评估这些人群药物中乳糖的安全性和影响。
    The use of lactose and cow milk protein (CMP) as potential allergens in pharmaceuticals and their ability to cause allergic reactions remains a significant concern in medicine. Lactose, a common pharmaceutical excipient due to its inert, inexpensive, and stable properties, is found in many prescription-only and over-the-counter medications. However, despite their widespread use, individuals with lactose intolerance (LI) or cow milk protein allergy (CMPA) may experience adverse reactions to these excipients. This study investigated the prevalence of lactose and other dairy-derived ingredients in pharmaceuticals marketed in Portugal. Using the Summary of Product Characteristics (SmPC) from the INFOMED database, various medications, including analgesics, antipyretics, non-steroidal anti-inflammatory drugs (NSAIDs), and antiasthmatics, were analyzed. Results showed a high prevalence of dairy-derived excipients, particularly in antiasthmatic drugs (62.6%) and NSAIDs (39%). Although CMP are not explicitly mentioned in SmPCs, the presence of lactose as an ingredient poses a risk of cross-contamination. The findings emphasize the need for healthcare professionals to be aware of potential allergens in medications and the importance of developing lactose-free alternatives to ensure the safety of patients with LI and CMPA. Further research is required to assess the safety and implications of lactose in medicines for these populations.
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  • 文章类型: Journal Article
    大约30%的乳蛋白是β-酪蛋白。我们旨在确定长期食用两杯A1/A2牛奶(含有75%A1β-酪蛋白和25%A2β-酪蛋白)的乳糖消化液是否会适应减少不耐受症状,较低的血清炎症标志物,和/或与消耗A2牛奶(含有100%A2β-酪蛋白)的谷胱甘肽水平相似。双盲,随机化,进行交叉试验。16个确认的乳糖消化液每天两次食用250mL的A1/A2牛奶和A2牛奶,连续两周。在第15天的适应期结束时,在用用于适应的相同牛奶(每千克体重0.5g乳糖)激发后,用氢呼气试验测量乳糖消化不良。与A2牛奶相比,在两周内食用A1/A2牛奶的粪便紧迫性更高(p=0.04,n=16)。与A2牛奶挑战相比,A1/A2牛奶在第15天的腹胀(p=0.03,n=16)和肠胃胀气(p=0.02,n=16)也更高。然而,日常症状,氢气,血清炎症标志物,A1/A2和A2牛奶消费适应期后,抗氧化剂浓度没有差异。两周内的适应并不能改善A1/A2牛奶的乳糖消化或耐受性,以匹配A2牛奶。
    Approximately 30% of milk protein is β-casein. We aimed to determine whether lactose maldigesters who chronically consumed two cups of A1/A2 milk (containing 75% A1 β-casein and 25% A2 β-casein) would adapt to have fewer intolerance symptoms, lower serum inflammatory markers, and/or altered glutathione levels similar to those consuming A2 milk (containing 100% A2 β-casein). A double-blinded, randomized, crossover trial was conducted. Sixteen confirmed lactose maldigesters consumed 250 mL of A1/A2 milk and A2 milk twice daily with meals for two weeks. At the end of the adaptation period on day 15, lactose maldigestion was measured after a challenge with the same milk used for adaptation (0.5 g of lactose per kg of body weight) with a hydrogen breath test. Fecal urgency was higher during the two-week consumption of A1/A2 milk compared to A2 milk (p = 0.04, n = 16). Bloating (p = 0.03, n = 16) and flatulence (p = 0.02, n = 16) were also higher on the 15th day with A1/A2 milk compared to A2 milk challenge. However, day-to-day symptoms, hydrogen, serum inflammatory markers, and antioxidant concentrations were not different after A1/A2 and A2 milk consumption adaptation periods. Adaptation over two weeks did not improve lactose digestion or tolerance of A1/A2 milk to match that of A2 milk.
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  • 文章类型: Journal Article
    目的:乳糖吸收不良和不耐受是非常常见的病症。然而,他们的最佳方法,包括诊断评估,仍然是一个争论的问题,尤其是在高龄。在这个简短的审查,我们专注于当前的知识,关注,以及老年人乳糖吸收不良和不耐受对临床实践的影响。
    结果:老年人营养不良的风险很高,由于认知障碍的频繁发生,食欲不振,吞咽困难,口腔健康状况不佳。乳制品消费量的大幅减少可能导致优质蛋白质和矿物质摄入不足,从而影响肌肉和骨骼健康。测试乳糖吸收不良在老年人中可能具有挑战性,如果不是无用的。相反,应始终进行详细的临床评估,以确定乳糖不耐受和模拟相同临床表现的所有混杂因素.
    结论:老年人乳糖吸收不良和不耐受的管理值得采取个性化的方法。由于在这个年龄段保持足够的营养状况的重要性,应努力避免过度限制饮食。
    OBJECTIVE: Lactose malabsorption and intolerance are very common conditions. However, their optimal approach, including the diagnostic assessment, remains a matter of debate, especially in advanced age. In this brief review, we focused on current knowledge, concerns, and impact in clinical practice of lactose malabsorption and intolerance in elderly.
    RESULTS: Older adults are at high risk of malnutrition, owing to frequent occurrence of cognitive impairment, loss of appetite, dysphagia, and poor oral health. A significant decrease in the consumption of dairy products may lead to inadequate intake of high-quality protein and minerals, with a consequent impact on muscle and bone health. Testing for lactose malabsorption may be challenging in older adults, if not useless. Instead, a detailed clinical evaluation should always be pursued to identify both lactose intolerance and all confounding factors mimicking the same clinical picture.
    CONCLUSIONS: The management of lactose malabsorption and intolerance in older adults deserves a personalized approach. Because of the importance of maintaining an adequate nutritional status in this age group, efforts should be put forth to avoid excessively restrictive diets.
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  • 文章类型: Journal Article
    目的:开发并表征添加姜和蜂蜜的功能性无乳糖冰淇淋,评估干酪乳杆菌CSL3在冷冻储存和模拟胃肠道(GIT)下的存活率,以及抗氧化活性和产品可接受性。
    结果:评估干酪乳杆菌CSL3的存活180天,在冷冻储存下,和GIT在60天。在储存15天的时候,近端成分,抗氧化活性,颜色,pH值,酸度,聚变,密度,溢出,并进行了感官分析。冰淇淋是维持CSL3活力的有效食物基质,在储存和GIT期间浓度>7logCFUg-1。此外,分析显示,通过高抗氧化活性和酚类化合物的值,溢出和益生元的特征,良好的可接受性,和购买意向。
    结论:该产品具有令人满意的市场潜力(接受率为95.19%,购买意向率>96%),它可能成为在食物中插入益生菌的另一种手段。
    OBJECTIVE: To develop and characterize a functional lactose-free ice cream with added ginger and honey, evaluate the survival of Lacticaseibacillus casei CSL3 under frozen storage and the simulated gastrointestinal tract (GIT), as well as antioxidant activity and product acceptability.
    RESULTS: The survival of Lacticaseibacillus casei CSL3 was evaluated for 180 days, under frozen storage, and GIT at 60 days. At 15 days of storage, proximal composition, antioxidant activity, color, pH, acidity, fusion, density, overrun, and sensory analysis were performed. Ice cream was an effective food matrix for maintaining the viability of CSL3, with concentrations > 7 log CFU g- 1 during storage and GIT. In addition, the analysis showed overrun and prebiotic characteristics through high values of antioxidant activity and phenolic compounds, good acceptability, and purchase intention.
    CONCLUSIONS: The product has satisfactory market potential (acceptance rate of 95.19% and purchase intention rate > 96%), and it could become another means of inserting probiotics in food.
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