Dairy Intake and Lactose Intolerance in Recurrent Aphthous Stomatitis

Recurrent aphthous stomatitis (RAS) is a common inflammatory condition of unknown etiology characterized by painful recurrent oral ulcerations. We have previously shown that calcium levels are higher when aphthae are present.

Objective: Since dairy intake (DI) and lactose intolerance (LI) may affect calcium levels, we determined their association with idiopathic RAS.

Methods: Participants from an unmatched case-control design (UF, June 2006-August 2007) completed a standardized questionnaire. We compared LI and childhood DI in cases vs. controls and DI in the past 30 days in inactive (RAS ≥6 months earlier up to never in life) vs. active status (RAS ≤1 month earlier) using the Mantel-Haenszel test with rank scores, two-sided alpha=0.05 and SAS v9.1.

Results: Overall, 234 participants were screened with 12 excluded, 25 withdrawn, and 197 completing the study (123 cases, 74 controls). Participants were 17 and older (mean age for both cases/controls=25 years), 56% females, 14% Hispanics/mixed, 63% Whites, 17% Asians, 11% Blacks, and 9% other/mixed race. Cases with RAS 1-6 months ago (n=35) and current smokers (n=26) were also excluded from the analysis of DI in the past 30 days (final n=136, 43 active and 93 inactive). Childhood DI was similar in cases vs. controls [63% vs. 73%, respectively, reported drinking milk often (once a day or more) vs. rarely/sometimes; overall p=0.16]. The two groups reported a similar positive history of LI (11% cases vs. 15% controls; p=0.49). There was no difference in DI in the past 30 days between active and inactive status (both had high to medium intake; p=0.99).

Conclusion: There was no association between DI/LI and RAS. Although we only accounted for major sources of dietary calcium, these results raise the interesting possibility that higher calcium levels are of osseous origin. Further research is needed to explore this association.

NIH Support: R03DE016356, 5U24DE016509, and M01RR00082.