The Myth of Increased Lactose Intolerance in African-Americans

Abstract

In the United States, approximately three fourths of African-Americans have the potential for symptoms of lactose intolerance because lactose digestion depends on the presence of the enzyme lactase-phlorizin hydrolase which is reduced by up to 90–95% in individuals with lactase nonpersistence. The ‘African-American diet’ is more likely to be low in a variety of vitamins and minerals, including calcium. African-Americans consume low amounts of dairy foods and do not meet recommended intakes of a variety of vitamins and minerals, including calcium. Low intake of calcium and other nutrients put African-Americans at an increased risk for chronic diseases. The 2005 Dietary Guidelines recommend consuming three servings of dairy foods per day to ensure adequate calcium intake, among other nutrients, and the National Medical Association has recently published a similar recommendation of three to four servings of dairy per day for the African-American population. Research has shown that lactose maldigesters, including African-American maldigesters, can consume at least one cup (8 oz) of milk without experiencing symptoms, and that tolerance can be improved by consuming the milk with a meal, choosing yogurt or hard cheeses, or using products that aid in the digestion of lactose such as lactase supplements or lactose-reduced milks.

• lactose intolerance
• lactose maldigestion
• African-Americans
• calcium

Key teaching points:

• African-Americans are at high risk for a number of chronic diseases that may be ameliorated by adequate calcium intake.

• Lactose maldigesters, including African-American maldigesters, can consume one cup (8 oz) of milk in one meal setting without experiencing symptoms.

• Lactose intolerance can be limited by drinking milk with meals.

• Yogurts and hard cheeses are well tolerated.

• African-Americans, like other Americans, should not avoid consumption of dairy products due to concerns about lactose intolerance.

Key teaching points:

• African-Americans are at high risk for a number of chronic diseases that may be ameliorated by adequate calcium intake.

• Lactose maldigesters, including African-American maldigesters, can consume one cup (8 oz) of milk in one meal setting without experiencing symptoms.

• Lactose intolerance can be limited by drinking milk with meals.

• Yogurts and hard cheeses are well tolerated.

• African-Americans, like other Americans, should not avoid consumption of dairy products due to concerns about lactose intolerance.