Lactose and Milk Intolerance: Clinical Implications

Theodore M. Bayless, Benjamin Rothfeld, Carol Massa, Ladymarie Wise, David Paige, Marshall S. Bedine

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114 Scopus citations


We studied 166 hospitalized male patients to determine the clinical importance of tolerance-test-determined “lactose intolerance,” assumed to affect most of the world's adults. Abnormal lactose tolerance tests were found in 81% of 98 blacks, 12% of 59 whites of Scandinavian or Northwestern European extraction, and three of nine non-European whites. Seventy-two per cent of the “lactose-intolerant” subjects had previously realized that milk drinking could induce abdominal and bowel symptoms. Two hundred and forty milliliters of low-fat milk produced gaseousness or cramps in 59% of 44 “lactose-intolerant” men, and 68% were symptomatic with the equivalent amount of lactose. None of 18 “lactose-tolerant” men noted symptoms with milk or lactose. Refusal to drink 240 ml of low-fat milk served with meals correlated significantly with “lactose-intolerance”: 31.4% versus 12.9% among “lactose-tolerant” patients. “Lactose intolerance” is common in adults and is a clinically relevant problem. (N Engl J Med 292:1156–1159, 1975), LACTOSE intolerance,” as determined by conventional lactose-tolerance testing, is a genetic trait and is very common in otherwise healthy teen-agers and adults of many population groups. For example, over two thirds of randomly selected American blacks, Mexican-Americans, American Indians, Ashkenazic Jews and Orientals are “lactose intolerant.” Even in the lower prevalence groups, such as white Americans of Scandinavian or Northwestern European extraction, 5 to 15% are “lactose intolerant.”.

Original languageEnglish (US)
Pages (from-to)1156-1159
Number of pages4
JournalNew England Journal of Medicine
Issue number22
StatePublished - May 29 1975

ASJC Scopus subject areas

  • Medicine(all)


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