Lactose maldigestion and milk intolerance: a study in rural and urban Mexico using physiological doses of milk

Lactose digestion capacity after ingestion of physiological doses of milk and its effect on milk intolerance and consumption were studied in rural and urban populations from three regions of Mexico with different milk intakes. All subjects (n = 926) received two treatments: whole milk (240 mL for children and 360 mL for adults) and the same amount of 90% lactose-hydrolyzed milk; 72% of the subjects also received as a third treatment a water solution containing lactulose (8 g for children and 10 g for adults). Lactose maldigestion determined by a hydrogen breath test was detected in 2 to 43% of subjects (depending on age group) and was higher in subjects from central and southern Mexico than in subjects from northern Mexico (P < 0.01). Only the experience of major symptoms of intolerance affected milk consumption, and these symptoms were present in 0 to 11% of children > 4 y old and in 7 to 17% of the 13- to 60-y-old subjects. No significant differences were found in lactose maldigestion or milk intolerance between rural and urban populations, but milk consumption was higher in urban areas (P < 0.01). Milk consumption in our study was affected primarily by factors not related to the capacity to digest or tolerate the lactose in milk.