Adults

The progressive increase in prevalence of lactose maldigestion increases with age, reaching reported adult levels of approximately 70% of the world's adult population. The exceptions are populations of Northern and Central Europeans and some Middle Eastern populations as well as groups of primarily European descent in Australia, New Zealand, and North America. Thus, minority populations in North America and Europe, as well as adult populations in most developing countries, are lactose mal-digesters (Table 2).

Reported milk drinking patterns of individuals classified as maldigesters vary considerably in adults. Data range from 50% reporting symptoms with one 8-oz. glass of milk to 75% reporting symptoms with two 8-oz. glasses of milk and 30% reporting not drinking any milk. Nevertheless, caution

Table 2 Prevalence of lactose maldigestion in selected populations

Population

Country

% Lactose

Population

Country

% Lactose

maldigestion

maldigestion

African American, 18-54years

US

75

General, 21-65years

Finland

15

Asian, 23-39years

US

100

General, 20.3years

Germany

70

Native American, 18-54years

US

81

General, 16-54 years

Chile

80

African American, 13-19years

US

69

Non-Caucasian

Peru

94

Mexican, 18-94 years

US

53

General, 38-49 years

Brazil

80

Vietnamese, 22-63 years

US

100

Arab adult

Israel

81

Sicilian, 25years average

Italy

71

General, male 14-34years

Egypt

73

Northern, 28.7years average

Italy

52

General, 15-78 years

Greece

45

Central, 36years average

Italy

18

Bantu, 13-43 years

Uganda

100

Romai

Hungary

56

Yoruba, 13-70years

Nigeria

83

Austrian, 22years average

Austria

20

General, adult

India

61

General, 20.3years average

Finland

17

General, 17-83 years

Korea

75

Aboriginal

Australia

84

General, 15-64 years

Japan

100

must be exercised in interpreting reported symptoms and making the diagnosis of lactose intolerance. There can be considerable crossover between individuals who self-identify as intolerant to lactose and are not diagnosed as lactose intolerant versus those in whom the diagnosis was carefully established. More attention to identifying and categorizing symptoms better may help. A Finnish study noted flatulence as the most severe symptom in maldige-sters, whereas abdominal bloating was most frequently reported by individuals self-identifying as lactose digesters. Moreover, microbiota may play a role in the presence and intensity of lactose-related symptoms. Data suggest that increased levels of colonic bacteria, as well as their diversity, may play a role as a result of increased fermentative capacity in reducing the symptoms associated with lactose intolerance.

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