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Biological Factors of Lactose Intolerance

Evidence Set 1

STOP & THINK: What causes the breakdown of the foods we consume? What causes the
breakdown of macromolecules in the body? How does maintain homeostasis in the body?
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1.1 Mechanical and Chemical Digestion:

Digestion of food is a form of catabolism, in which the
food is broken down into small molecules that the
body can absorb and use for energy, growth, and
repair. Digestion occurs when food is moved through
the digestive system. It begins in the mouth and ends
in the small intestine. The final products of digestion
are absorbed from the digestive tract, primarily in the
small intestine. There are two different types of
digestion that occur in the digestive system:
mechanical digestion and chemical digestion. The
following diagram summarizes the roles played by
different digestive organs in mechanical and chemical digestion, both of which are described in
detail below.

Mechanical digestion is a physical process in which food is broken into smaller pieces without
becoming changed chemically. It begins with your first bite of food and continues as you chew
food with your teeth into smaller pieces. The process of mechanical digestion continues in the
stomach. This muscular organ churns and mixes the food it contains, an action that breaks any
solid food into still smaller pieces.
Although some mechanical digestion also occurs in the intestines, it is mostly completed by the
time food leaves the stomach. At that stage, food in the GI tract has been changed to the thick
semi-fluid called chyme. Mechanical digestion is necessary so that chemical digestion can be
effective. Mechanical digestion tremendously increases the surface area of food particles so they
can be acted upon more effectively by digestive enzymes.
 Chemical digestion is the biochemical process in which macromolecules in food are changed
into smaller molecules that can be absorbed into body fluids and transported to cells throughout
the body. Substances in food that must be chemically digested include carbohydrates, proteins,
lipids, and nucleic acids. Carbohydrates must be broken down into simple sugars, proteins into
amino acids, lipids into fatty acids and glycerol, and nucleic acids into nitrogen bases and sugars.
Some chemical digestion takes place in the mouth and stomach, but most of it occurs in the first
part of the small intestine (duodenum).

Chemical digestion could not occur without the help of many different digestive enzymes.
Enzymes are proteins that catalyze, or speed up, biochemical reactions. Digestive enzymes are
secreted by exocrine glands or by the mucosal layer of the epithelium lining the gastrointestinal
tract. In the mouth, digestive enzymes are secreted by salivary glands. The lining of the stomach
secretes enzymes, as does the lining of the small intestine. Many more digestive enzymes are
secreted by exocrine cells in the pancreas and carried by ducts to the small intestine. The
following table lists several important digestive enzymes, the organs and/or glands that secrete
them, and the compounds they digest.

Digestive Enzyme Organ, Glands That Secretes It Compound It Digests

Amylase Salivary Glands, Pancreas Amylose (Polysaccharide)
Sucrase Small Intestine Sucrose (Disaccharide)
Lactase Small Intestine Lactose (Disaccharide)
Lipase Salivary Glands, Pancreas Lipid
Pepsin Stomach Protein
Trypsin Pancreas Protein
Chymotrypsin Pancreas Protein
Deoxyribonuclease Pancreas DNA
Ribonuclease Pancreas RNA
Nuclease Small Intestine Small Nucleic Acids

Evidence #1: Mechanical and Chemical Digestion:

Read the evidence and answer the following questions

1. According to the reading, what is the biochemical process in which macromolecules are
broken down into smaller molecules? What helps this to happen?
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2. With your group, take a look at the chart above. Make a prediction on which of the
following digestive enzymes would make the most sense with the phenomenon at hand.
Be sure to look at the driving question board and your own models when making your
decision. Discuss how this would change your model.
1.2 Enzymes Help Us Digest Food:
After Maria drinks a tall glass of milk, her abdomen feels
uncomfortable and she has diarrhea and flatulence. Maria has noticed
three things about her problem.
1. She has the same symptoms after she drinks milk that has
had the fat removed.
2. She does not have these symptoms if she drinks milk that
has had the sugar lactose removed.
3. She also does not have these symptoms if she takes a pill
that contains the enzyme lactase when she drinks a glass of
whole milk.

What do you think is the cause of Maria’s symptoms?

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How do you think the enzyme lactase prevents Maria’s symptoms?

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Peter does not experience symptoms after he drinks a tall glass of milk. What molecule do you
think is more abundant in Peter’s digestive system and deficient in Maria’s digestive system?
Explain your reasoning.

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1.3 A Tale Of Famine And Deadly Diarrhea
Thomas thinks a combination of two reasons may explain the persistence of the lactase mutation
in Northern Europe.

First, the farmers that settled there came from the Fertile Crescent, and they brought crops native
to that region, like wheat and barley. But with Northern Europe's shorter growing season, these
crops were more likely to fail, causing famine.

Additionally, the colder Northern European climate lent itself to natural refrigeration. "If you're a
farmer in Southern Europe, and you milk a cow in the morning and you leave the milk out, it will
be yogurt by noon. But if you do the same thing in Germany, it'll still be milk," says Thomas. A
healthy lactose-intolerant person who drank that still-fresh milk would get a bad case of diarrhea.
"But if you're malnourished, then you'll die," Thomas says.

In times of famine, milk drinking probably increased. And the very people who shouldn't have
been consuming high-lactose dairy products — the hungry and malnourished — would be the
ones more likely to drink fresh milk. So, with milk's deadly effects for the lactose intolerant,
individuals with the lactase mutation would have been more likely to survive and pass on that
gene.

The combination of famine and longer processing time for milk is "kind of like a double
whammy," says Thomas, who has yet to publish his theory. Under his scenario, the lactose
tolerant wouldn't always have had an evolutionary advantage, but for short periods of time,
having that genetic mutation would have helped. "Over a long run, it's modest; but over short
periods of time, it's extremely high selection" for the lactose tolerant, says Thomas.

Scientists may never discover the reason why adult lactose tolerance evolved so quickly. Other
researchers have suggested that fresh milk provided a purer fluid alternative to contaminated
water sources in arid environments; that milk fat gave people a fertility advantage; or that milk
drinking might have been associated with social prestige. Cordain argues that milk gave humans
an advantage against malaria in Africa and Southern Europe, and rickets in Northern Europe.

"Whatever constellation of factors was involved, they're going to be different in different

regions," says Thomas. "But the selection pressure might have been equally strong in East Africa
and Northern Europe, for example."

It's hard to tell how prevalent lactose tolerance has been over time. But so far scientists have
found evidence of adult lactase persistence in ancient skeletons in Northern Europe, Scandinavia,
southern France and elsewhere. Thomas and his colleague Oddný Sverrisdóttir of Uppsala
University in Sweden recently discovered lactase persistence in Spanish remains from about
5,000 years ago and hope to publish their research next year.

Thomas thinks that as genetic and archaeological technology continues to develop, modern
science may someday reveal the culprit. But it might take a while because the research — like
our genes — is still evolving.
1.4 Lactose Tolerance Tests In Adults With Normal Lactase
Activity:
Lactose intolerance has been well
documented by several groups in recent
years. Pediatricians have long suspected
this condition, and current interest has
been stimulated by several technical and
conceptual advances. Dahlqvist has
developed a simple method for the
quantitative study of these enzymes in
homogenates of the mucosa of the small
bowel. He and others have been able to
separate several enzymes which split
disaccharides with varying specificities
for different substrates.
Our purpose is to report the findings in 18
normal subjects who were given an oral
lactose load of 100 g and to correlate the
peak rise in blood sugar with the
concentrations of lactase in the jejunum at
the ligament of Treitz. Lactose tolerance
tests were repeated in the same persons
after a 50-g dose, and the patterns of
response were compared.
Rubric for Biological Factors Group Models:

1 2 3

Use of evidence in Evidence is not used Only one evidence is All evidence that was
models used relevant was used

Model Revisions Model does not have Model had one or Model revision had
any/many changes; more changes all relevant changed
still looks like initial made
model