Lactose malabsorption and intolerance: a review

Area of Science:

• Food science and nutrition
• Human genetics
• Gastroenterology

Background:

• Lactose intolerance, affecting approximately 70% of the global adult population, stems from reduced levels of the enzyme lactase-phlorizin hydrolase (LPH).
• This condition is often linked to the natural decline of intestinal lactase activity after infancy, a trait influenced by autosomal recessive inheritance patterns that vary significantly across different racial groups.
• The prevalence of lactase persistence is theorized to have emerged in Northern European populations around 10,000 years ago, coinciding with the post-weaning consumption of mammalian milk.

Purpose of the Study:

• To provide a comprehensive review of the current scientific understanding of lactose and lactose intolerance.
• To examine the diagnostic methods and clinical management strategies for lactose intolerance.
• To survey the range of food products available for individuals with lactose intolerance and discuss regulatory aspects.

Main Methods:

• Literature review of recent scientific advancements in lactose intolerance.
• Analysis of diagnostic approaches and clinical management guidelines.
• Survey of the current market for lactose-free and low-lactose food alternatives.

Main Results:

• Scientific knowledge regarding lactose intolerance has significantly advanced, impacting diagnosis and management.
• A variety of food products are marketed as lactose-free alternatives, though regulatory harmonization is lacking in the EU.
• Many individuals with lactose intolerance can tolerate certain levels of dietary lactose, and probiotics show potential for symptom management.

Conclusions:

• A comprehensive understanding of lactose intolerance is crucial for effective dietary management and product development.
• Further research and regulatory clarity are needed to support individuals with lactose intolerance.
• The review highlights the importance of personalized approaches to managing lactose intolerance, considering individual tolerance levels and available alternatives.