Lactose Intolerance and Milk Protein Allergy

Abstract

Real or perceived lactose intolerance (LI) and true cow’s milk allergy (CMA) are common reasons for dairy avoidance but are underdiagnosed and under-treated. Dairy avoidance is associated with nutrient deficiencies and unintended health consequences that disproportionately affect minorities. Surveyed GI physicians report that at least 30% of their patients had LI and 16% had food allergies including CMA. In a 2019 survey, approximately 10.8% of adults have symptoms consistent with a food allergy and CMA was the second most common allergy reported. LI and CMA are more common in ethnic and racial minorities and occur more often in women. Treatment options are poorly implemented, in part, due to decreased awareness of the current guidelines. Dairy food consumption reduces risk for chronic disease states and remains first-line intervention for LI. Dairy avoidance and nutrient supplementation are effective in managing CMA. Methods to guide dairy food reintroduction, improve LI education, with ethnic and racial considerations and facilitate early identification of CMA are needed. The optimal nutrient supplementation strategy remains undefined.