Lactose intolerance is a condition in which the body is unable to digest lactose, a sugar highly present in dairy products. This happens because of a reduced production by the body of lactase, the enzyme needed to break down this sugar and, therefore, digest it without discomfort. So much so that, in many products labeled “lactose-free,” this enzyme is specifically added. When we are born, except for the rare cases of Congenital Lactase Deficiency (CLD), we all have this enzyme to digest breast milk, and it is equally physiological for it to decrease starting from weaning, progressively reducing to a greater or lesser extent during adulthood. For this reason too, we are talking about a rather widespread condition in the world, with significant differences between geographic areas. Unlike other intolerances, this one is officially recognized by the World Health Organization (WHO) and has a more precise diagnosis.
Globally, it is estimated that about 65-70% of the world population is affected by this intolerance, with significant variations among different areas. In Asia, particularly in China and Japan, prevalence can reach 80-100%, while in Africa there are populations in which practically all individuals are intolerant. In Europe, the situation is more heterogeneous: in the Nordic countries, such as Sweden and Finland, the percentage of people who can digest lactose in adulthood is very high, reaching 74% and 82% respectively, while in Greece only 20% of the population retains this ability. In Italy, this condition affects between 30% and 50% of the population, with rather marked regional differences: in the North prevalence is around 52%, in the Center it drops to 19%, while in the South it stands at around 41%. All these differences are mainly due to genetic and cultural factors, because the ability to digest lactose in adulthood depends, as mentioned, on the persistence of the lactase enzyme, which in some populations has been favored by evolution following the regular consumption of milk and dairy products over the centuries.
Not all people with reduced lactase activity show clinical symptoms, and the severity of the disorder varies according to the amount of lactose ingested and the individual ability to adapt, which can change over time. Among the most common reactions are abdominal bloating, cramps, diarrhea, and nausea, which generally appear within a few hours after consuming dairy products. In addition to gastrointestinal symptoms, headache, fatigue, and, in some cases, skin rashes may also occur. Less common, but still possible: irritability or depression, due to general malaise. If ignored, these signs can further complicate daily life, turning a temporary discomfort into chronic discomfort.
To diagnose lactose intolerance, it is essential to consult an experienced doctor. The professional uses two specific complementary tests to determine sensitivity to this sugar. The first is the breath test, considered the number one reference standard. This test assesses the presence of hydrogen in exhaled breath before and after administering 25 grams of lactose dissolved in water. The second test, used mainly in Italy, is the genetic test through a buccal swab, for collecting a DNA sample from the oral mucosa. As explained by the Italian Lactose Intolerant Association (AILI), these are complementary tests and not alternatives to one another. Self-diagnosis also plays a fundamental role in recognizing lactose intolerance.
There are dietary adjustments and specific treatments that can greatly improve the quality of life of those who are lactose intolerant. The first step is obviously to change the diet, eliminating or reducing dairy products and opting for lactose-free alternatives, such as plant-based milk and aged cheeses. There are also therapeutic options, such as taking supplements containing the lactase enzyme, which help break down lactose and prevent unpleasant symptoms. A fortunate solution for those who do not want to give up entirely on a beloved dish or food containing lactose. Finally, note that symptoms associated with this condition, such as inflammation of the gastrointestinal mucosa, can take several months to disappear completely once the right precautions have been adopted.
Lactose is naturally found in milk and its derivatives, but it can also be present in unsuspected foods, because it is often used as an additive to improve texture, flavor, or preservation. Some examples include:
1. Baked goods and cereals
2. Cured meats and sliced meats
3. Sauces and condiments
4. Ready meals and frozen foods
6. Alcoholic drinks and beverages
Those who are intolerant should therefore carefully check labels, including the “may contain” section, to avoid accidental intake. As always, an excellent alternative is to cook nice homemade dishes, thus keeping control over the ingredients. On Tuduu you’ll find lots of recipes that can inspire you!A0😉
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