Lactose intolerance: Too Little Is Known
Panel Says More Research Needed, Not Less Dairy
Feb. 24, 2010 -- People who are lactose intolerant often avoid dairy
products, thereby depriving themselves of calcium, vitamin
D, and other essential nutrients, according to a draft statement released
today by a National Institutes of Health-sponsored panel on lactose intolerance and
The panel, composed of experts from across the medical spectrum, was tasked
with evaluating what we know about lactose intolerance. Very little, as it
"There are huge gaps in knowledge," says panel chairman Frederick J. Suchy,
MD, professor and chief of pediatric hepatology at Mount Sinai School of
Lactose Intolerance Information Lacking
The panel reviewed nearly 60 relevant studies, a quarter of which were
conducted in the United States. "None of the studies," the draft states,
"evaluated a representative U.S. sample ... [and] they cannot be used to
estimate the prevalence of lactose intolerance."
The numbers may be elusive, but outcomes of a dairy-poor diet are easy to predict.
"It has implications for bone health, cardiovascular health, and maybe colon cancer," Suchy says. But
for those who experience symptoms of lactose intolerance -- bloating, gas, diarrhea -- after a glass of
milk, "the reflex response is to stop drinking milk and eating dairy
What Is Lactose?
Lactose is a sugar found in milk. In order to digest it, the body needs a
special enzyme, called lactase. Everyone is born with lactase; otherwise,
babies and breast milk wouldn’t mix very well. But most of the world’s
population -- people of northern European descent are an exception -- is
genetically programmed to decrease the production of lactase around age 3 or
In the U.S., Asians, African-Americans, Hispanics, and other minority groups
are particularly likely to be deficient of lactase.
However, not everyone who is deficient of lactase will suffer from drinking
a glass of milk.
"Whether or not it becomes clinically important is very variable," says John
Snyder, MD, chief of gastroenterology, hepatology, and nutrition at Children’s
National Medical Center in Washington, D.C. It is quite possible, he says, that
someone with a low level of lactase will tolerate dairy products as well as
someone whose level is a lot higher.
Get Tested for Lactose Intolerance
For Snyder, who was not a member of the panel, the important thing is to get
evaluated. Taking a lactase enzyme pill may alleviate symptoms. If it does,
says Snyder, that would suggest you are lactose intolerant. A breath test can
offer more conclusive results. Your doctor will also want to rule out other
conditions, such as irritable bowel syndrome or celiac disease.
A diagnosis of lactose intolerance does not have to mean a dairy-free diet,
Suchy emphasizes. Yogurt and hard cheeses, he says, shouldn’t cause any
trouble. And small amounts of milk throughout the day, rather than a large
glass all at once, might be easier on your gut.
"The reality is that alternate strategies may be effective," says Suchy.