Lactose intolerance is a condition in which the body cannot digest lactose, a sugar found abundantly in dairy products. This happens because the body produces too little lactase, the enzyme needed to break down and digest this sugar without discomfort. This is why many products described as “lactose-free” have this enzyme specifically added. At birth, except in rare cases of Congenital Lactase Deficiency (CLD), we all have this enzyme to digest breast milk, and it is equally physiological for it to begin decreasing from weaning, progressively declining to a greater or lesser extent during adulthood. This is also why we speak of a fairly widespread condition worldwide, with significant differences between geographical areas. Unlike other intolerances, this one is officially recognised by the World Health Organization (WHO) and has a more precise diagnosis.
Globally, it is estimated that around 65–70% of the world’s population is affected by this intolerance, with significant variations between regions. In Asia, particularly China and Japan, prevalence can reach 80–100%, while in Africa there are populations in which virtually everyone is intolerant. In Europe, the situation is more varied: in Nordic countries, such as Sweden and Finland, the percentage of people able to digest lactose in adulthood is very high, reaching 74% and 82% respectively, whereas in Greece only 20% of the population retains this ability. In Italy, this condition affects between 30% and 50% of the population, with marked regional differences: prevalence is around 52% in the North, falls to 19% in the Centre and stands at around 41% in the South. These differences are mainly due to genetic and cultural factors, since the ability to digest lactose in adulthood depends on the persistence of the lactase enzyme, which evolution favoured in some populations following regular consumption of milk and dairy products over the centuries.
Not everyone with reduced lactase activity develops clinical symptoms, and the severity of the problems varies according to the amount of lactose consumed and the individual’s ability to adapt, which can change over time. The most common reactions include abdominal bloating, cramps, diarrhoea and nausea, generally appearing within a few hours of consuming dairy products. In addition to gastrointestinal symptoms, headaches, fatigue and, in some cases, skin rashes may occur. Less common but still possible are irritability or depression, caused by general discomfort. If overlooked, these signs can further complicate daily life, turning temporary discomfort into chronic discomfort.
To diagnose lactose intolerance, it is essential to consult an experienced doctor. The professional mainly uses two specific complementary tests to determine sensitivity to this sugar. The first is the breath test, considered the leading reference standard. It measures hydrogen in exhaled air before and after administering 25 grams of lactose dissolved in water. The second, used mainly in Italy, is the genetic test performed with a buccal swab to collect a DNA sample from the oral mucosa. As explained by the Italian Lactose Intolerance Association (AILI), these are complementary rather than alternative tests. Self-diagnosis also plays an important role in recognising lactose intolerance.
There are dietary adjustments and specific treatments that can considerably improve the quality of life of people with lactose intolerance. The first step is obviously to modify the diet by eliminating or reducing dairy products and choosing 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. This is a fortunate solution for those who do not want to completely give up a beloved dish or food containing lactose. Finally, symptoms associated with this condition, such as inflammation of the gastrointestinal mucosa, may take several months to disappear completely once the correct precautions have been adopted.
Lactose occurs naturally in milk and its derivatives, but it may also be present in unsuspected foods, as it is often used as an additive to improve consistency, flavour or preservation. Examples include:
1. Baked goods and cereals
2. Cured meats and cold cuts
3. Sauces and dressings
4. Ready-made and frozen dishes
6. Alcoholic drinks and beverages
People with intolerance must therefore check labels carefully, including the “may contain traces of” section, to avoid accidental consumption. As always, cooking good homemade dishes is an excellent alternative, allowing you to control the ingredients. On Tuduu you will find many recipes for inspiration! 😉
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