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sufferers will often avoid products such as rye-based alcohol, wheat starch and malted products made from barley. Proof of the role of these grain-based ingredients in the causation of celiac disease is lacking.

Food Intolerances

Several types of food intolerances exist. The major categories include anaphylactoid reactions, metabolic food disorders and idiosyncratic reactions (2). The anaphylactoid reactions are not discussed further here because there is no conclusive proof that such reactions occur related to foods. Metabolic food disorders occur in individuals who are unable to normally metabolize a food component. Lactose intolerance is the best example, and is an example that has relevance to chocolate manufacturing (see below). Idiosyncratic reactions are those illnesses that occur through unknown mechanisms. By definition, relatively little is known about idiosyncratic reactions. In many cases, the cause-and-effect relationship with specific foods or food components has not been well established. The role of sugar in hyperkinetic and other abnormal behaviors in children is discussed briefly below as an example of an idiosyncratic reaction. Individuals with these various forms of intolerances can often tolerate some of the offending food or ingredient in their diets.

Lactose Intolerance

Lactose intolerance is a metabolic disorder caused by a deficiency of the enzyme b-galactosidase (lactase) in the intestine (34). As a result, lactose-intolerant individuals cannot properly metabolize lactose (milk sugar). Lactase hydrolyzes lactose into its constituent monosaccharides galactose and glucose, which can then be absorbed for energy. Without the action of lactase, the lactose cannot be digested and absorbed from the small intestine. The lactose passes into the colon where large numbers of bacteria exist and metabolize the lactose to carbon dioxide, hydrogen and water. The resulting symptoms are bloating, flatulence, abdominal cramping and frothy diarrhea (2, 34). While lactose intolerance is treated with a dairy product-avoidance diet, many individuals with lactose intolerance can tolerate several grams or more of lactose in their diets.

Few chocolate confectionery products would contain sufficient lactose to cause symptoms in lactose-intolerant individuals. Lactose can be a significant component of several ingredients used in chocolate manufacturing, including milk and whey. Little concern exists about the minuscule levels of lactose present in other dairy-based ingredients such as caseinates or butter. Since lactose-intolerant consumers can tolerate some lactose in their diets (often as much as 10 g or more), the amount of lactose in most confectionery products would be insufficient to cause reactions in most lactose-intolerant consumers. Few problems

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