Lactose Maldigestion Revisited: Diagnosis,Prevalence in Ethnic Minorities,and Dietary Recommendations to Overcome It

Abstract

Currently, an estimated 25% of Americans and 75% of individuals worldwide seem to suffer from lactose maldigestion. The authors' objective was to evaluate current prevalence of lactose maldigestion/intolerance in populations of various ethnic groups, examine the severity of symptoms, and recommend ways in alleviating them. In the United States, 25% of people who are lactose maldigesters are ethnic minorities. Earlier estimates report that ∽50% of Hispanic, almost 100% of Asian, and ∽80% of African Americans suffer from lactose maldigestion. There is evidence linking lactose maldigestion as a factor contributing to low calcium intake, leading to subsequent osteoporotic fractures. Although bone mineral density is higher in African and Hispanic American men and women compared to white and Asian Americans, osteoporosis is still a concern in those populations. Recent studies suggest that current estimates of lactose maldigestion may be grossly overestimated. Clinical trials show that even those individuals who do maldigest lactose could overcome adverse symptoms by a few simple dietary strategies. In addition, new research points to possible manipulation of colonic microflora toward alleviating symptoms.