Prevalence of lactose intolerance and nutrients intake in an older population regarded as lactase non-persistent

Energy and nutrient intakes of community-dwelling older adults in Indonesia are inadequate whereby milk consumption is among the lowest in the world. Lactose intolerance is probably one of the reasons for such low milk consumption, but information on the burden of this problem and its consequences for dietary intake is lacking. We obtained data on the prevalence of lactose intolerance and dietary intakes in Indonesian older outpatients, thereby comparing dairy users and non-dairy users.

A cross-sectional study was conducted in 2019 involving 103 community-dwelling older adults in the outpatient geriatric clinic, Dr. Cipto Mangunkusumo Hospital, Jakarta. A structured questionnaire was used to categorize participants as dairy- or non-dairy users. Food records were collected to assess nutrients intake from the diet. The prevalence of lactose intolerance (LI) was estimated based on the results of the hydrogen breath test (HBT) and on symptoms of lactose malabsorption. The difference in LI prevalence between dairy- and non-dairy user group was presented as a prevalence ratio (with 95% confidence interval). Chi-square tests, t-test, and Mann-Whitney tests were used to evaluate differences in demographic and clinical characteristics, as well as in nutrient intake profiles between dairy and non-dairy users.

The prevalence of lactose intolerance amounted to 66% (57-75%), 54% (37-70%), and 73% (61-84%) in the total population, dairy- and non-dairy users, respectively. Lactose intolerance tended to be higher among non-dairy users (PR 1.36 95% CI 0.99-1.89). On the other hand, we found no pronounced differences in symptoms of lactose intolerance between dairy and non-dairy users. The overall mean protein, calcium, vitamin D, and vitamin B12 intakes of the older adults were low. Intakes of protein, calcium, vitamin D and vitamin B12 were higher among dairy than among non-dairy users.

This study uncovered the large size of the lactose intolerance problem in Indonesian older adults. Especially in non-dairy users, the intakes of proteins and some micronutrients are a concern. Strategies to tackle lactose intolerance are most relevant as to open the door for more nutrient-dense foods in the diet of Indonesian older adults.