Alergia à proteína do leite de vaca e intolerância à lactose: abordagem nutricional, pesquisa qualitativa e percepções dos profissionais da área de saúde

Abstract

Milk is rich in proteins of high nutritional value; lipids; lactose; vitamins, especially the ones of the B-complex such as riboflavin and cobalamin; minerals like calcium and phosphorus; and also, in whole milk, vitamins A and D. The diagnosis of allergy to cow milk protein (CMA) and lactose intolerance (LI) must be performed with caution and responsibility, once the treatment is based on the deletion of milk. The removal of milk from the diet without proper replacement and supplementation may impair normal growth and nutritional quality of the diet. Thus, the assessment of dietary intake and nutritional status of the individual during the deletion diet is important. This need is justified by the lower ingestion of energy, the main cause of weight and height deficit; proteins, minerals as calcium, phosphorus and zinc, vitamins B2, C, A, and folate deficit. Therefore, the present study aimed to understand the knowledge held by health professionals on CMA and LI, identifying possible biases regarding the consumption of milk, also pointing out the necessity of prescribing alternative dairy products and elucidating the nutritional impact of a cow-milk-free diet. For such, the methodological strategy in qualitative research used was the construction of the Collective Subject Discourse (CSD), as a technique of statements processing, which involves gathering statement contents with similar meanings. The proposal of the CSD for the rescue and description of collectivities opinions is, thus, quali-quantitative since it, in a same research process, qualifies and quantifies the opinions of collectivities. The subjects chosen to participate in the research work directly when facing the allergic or intolerant individual and represent Zona da Mata and Vertentes region. They were split as follows: seven dietitians, a pharmacist, a nutrition specialist, two pediatric allergists and nine general pediatricians. With the CSD, the prejudice against the use of milk and the belief that it adds no health benefit were identified. The terms "oral food challenge test", "oral tolerance" as well as similar ones were not mentioned by any of the respondents. The terms "replacement diet" and "supplementation" have only been cited by one of the subjects. The lack of knowledge among health professionals occurs in concept, diagnosis and treatment of CMA and LI.