Volume 81, Number 4 July/August 2010
A major concern is that individuals with lactose intolerance, either self-diagnosed or clinically diagnosed, may avoid dairy foods and consume insufficient amounts of dairy food nutrients such as calcium and vitamin D, among others, which may predispose them to increased risk of osteoporosis and other adverse outcomes (2,7). Dairy foods (milk, cheese, and yogurt) contribute many nutrients to the U.S. diet that are important for good health, including calcium, potassium, phosphorus, magnesium, zinc, protein, vitamin A, vitamin D, vitamin B12, and riboflavin (11-13). Consuming dairy foods can help meet recommendations for nutrients limiting in Americans’ diets such as calcium, potassium, and magnesium (14,15). The 2005 Dietary Guidelines for Americans recommends 3 cups per day of low-fat or fat-free milk or equivalent milk products for those aged nine years and older (15). For children two to eight years, 2 cups per day of low-fat or fat-free milk or equivalent milk products are recommended (15). Higher dairy food intake as part of a healthy diet leads to higher nutrient intake, better diet quality, and bone health, may help maintain a healthy weight, and has been associated with reduced risk of several diseases and conditions: osteoporosis, hypertension, colon cancer, metabolic syndrome, and diabetes (16-18).
Evidence is insufficient to accurately assess the prevalence of lactose intolerance in the U.S. population. However, findings from a recent study suggest that age-adjusted, self-reported lactose intolerance rates may be far lower than previously estimated.
According to the NIH expert panel, the health outcomes of dairy exclusion diets depend on whether nutrients such as calcium and vitamin D are provided in sufficient amounts by non-dairy foods (2). From childhood through adulthood, avoiding dairy foods may be a major factor limiting adequate calcium intake (2). Excluding dairy foods may exacerbate the risk of osteoporosis, especially for persons already at the highest risk, such as women and certain racial/ethnic groups (2).
African Americans have a low intake of dairy foods, which may be attributed in part to lactose intolerance (19-21). Although the majority of studies including African Americans indicate that osteoporosis is less prevalent in this group compared to white and Asian Americans, osteoporosis is still a concern for African Americans (6,19,20). African Americans’ low intake of dairy foods may place them at risk for inadequacies of other nutrients such as vitamin D that play a beneficial role in bone health (2,21,22). The NIH expert panel also reports that diets excluding dairy foods may adversely affect health outcomes other than osteoporosis (e.g., high blood pressure, development of adenomatous colon polyps) (2). African Americans’ low dairy consumption may lead to nutritional deficits that increase their potential risk of hypertension, obesity, certain cancers, and diabetes (19,20).
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