Lactose intolerance epidemiology and demographics: Difference between revisions

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==Overview==
==Overview==
The prevalence of lactose intolerance is approximately 75,000 per 100,000 individuals worldwide. The prevalence of lactose intolerance is low in children younger than six years. Europeans and European Americans individuals are less likely to develop lactose intolerance. Lactose intolerance affects men and women equally. The majority of lactose intolerance cases are reported in the Far East.


==Epidemiology and Demographics==
==Epidemiology and Demographics==
<ref name="pmid20144208">{{cite journal |vauthors=Itan Y, Jones BL, Ingram CJ, Swallow DM, Thomas MG |title=A worldwide correlation of lactase persistence phenotype and genotypes |journal=BMC Evol. Biol. |volume=10 |issue= |pages=36 |year=2010 |pmid=20144208 |pmc=2834688 |doi=10.1186/1471-2148-10-36 |url=}}</ref>
===Incidence===
Most humans normally cease to produce lactase after weaning and as a result become lactose intolerant. It is, therefore, not surprising that as adults, as much as 75% of the world’s human population is intolerant to ingested dietary lactose<ref name="pmid26404364">{{cite journal |vauthors=Silanikove N, Leitner G, Merin U |title=The Interrelationships between Lactose Intolerance and the Modern Dairy Industry: Global Perspectives in Evolutional and Historical Backgrounds |journal=Nutrients |volume=7 |issue=9 |pages=7312–31 |year=2015 |pmid=26404364 |pmc=4586535 |doi=10.3390/nu7095340 |url=}}</ref>
*The incidence/prevalence of [disease name] is approximately [number range] per 100,000 individuals worldwide.
*In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide.
===Prevalence===
===Prevalence===
*The incidence/prevalence of [disease name] is approximately [number range] per 100,000 individuals worldwide.
*The prevalence of lactose intolerance is up to 75000 per 100,000 individuals worldwide.<ref name="pmid26404364">{{cite journal |vauthors=Silanikove N, Leitner G, Merin U |title=The Interrelationships between Lactose Intolerance and the Modern Dairy Industry: Global Perspectives in Evolutional and Historical Backgrounds |journal=Nutrients |volume=7 |issue=9 |pages=7312–31 |year=2015 |pmid=26404364 |pmc=4586535 |doi=10.3390/nu7095340 |url=}}</ref><ref name="pmid3140651" />
*In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide.
*In North America, the prevalence of lactose intolerance:
*The prevalence of [disease/malignancy] is estimated to be [number] cases annually.
**Native America: 79000 per 100,000 individuals
 
**Black: 75000 per 100,000 individuals
===Case-fatality rate/Mortality rate===
**Hispanics: 51000  per 100,000 individuals
*In [year], the incidence of [disease name] is approximately [number range] per 100,000 individuals with a case-fatality rate/mortality rate of [number range]%.
**Caucasians: 21000 per 100,000 individuals
*The case-fatality rate/mortality rate of [disease name] is approximately [number range].
*The prevalence of lactose intolerance in Latin America, Africa, and Asia is 15000-100000 per 100,000 individuals.


===Age===
===Age===
* The prevalence of lactose intoleance are low in children younger than six years <ref name="pmid8026265">{{cite journal |vauthors=Rao DR, Bello H, Warren AP, Brown GE |title=Prevalence of lactose maldigestion. Influence and interaction of age, race, and sex |journal=Dig. Dis. Sci. |volume=39 |issue=7 |pages=1519–24 |year=1994 |pmid=8026265 |doi= |url=}}</ref><ref name="pmid11761016">{{cite journal |vauthors=Di Stefano M, Veneto G, Malservisi S, Strocchi A, Corazza GR |title=Lactose malabsorption and intolerance in the elderly |journal=Scand. J. Gastroenterol. |volume=36 |issue=12 |pages=1274–8 |year=2001 |pmid=11761016 |doi= |url=}}</ref>
* The prevalence of lactose intoleance is low in children younger than six years. <ref name="pmid8026265">{{cite journal |vauthors=Rao DR, Bello H, Warren AP, Brown GE |title=Prevalence of lactose maldigestion. Influence and interaction of age, race, and sex |journal=Dig. Dis. Sci. |volume=39 |issue=7 |pages=1519–24 |year=1994 |pmid=8026265 |doi= |url=}}</ref><ref name="pmid11761016">{{cite journal |vauthors=Di Stefano M, Veneto G, Malservisi S, Strocchi A, Corazza GR |title=Lactose malabsorption and intolerance in the elderly |journal=Scand. J. Gastroenterol. |volume=36 |issue=12 |pages=1274–8 |year=2001 |pmid=11761016 |doi= |url=}}</ref>
* The prevalence of lactose intoleance inceresed with age
* The prevalence of lactose intoleance incereses with age.
 
*Patients of all age groups may develop [disease name].
*The incidence of [disease name] increases with age; the median age at diagnosis is [#] years.
*[Disease name] commonly affects individuals younger than/older than [number of years] years of age.
*[Chronic disease name] is usually first diagnosed among [age group].
*[Acute disease name] commonly affects [age group].


===Race===
===Race===
In North American adults lactose maldigestion is found in approximately 79% of Native Americans, 75% of blacks, 51% of Hispanics, and 21% of Caucasians. In Africa, Asia, and Latin America prevalence rates range from 15-100% depending on the population studied. <ref name="pmid3140651">{{cite journal |vauthors=Scrimshaw NS, Murray EB |title=The acceptability of milk and milk products in populations with a high prevalence of lactose intolerance |journal=Am. J. Clin. Nutr. |volume=48 |issue=4 Suppl |pages=1079–159 |year=1988 |pmid=3140651 |doi= |url=}}</ref>
* Lactose intolerance usually affects the following populations:<ref name="pmid3140651">{{cite journal |vauthors=Scrimshaw NS, Murray EB |title=The acceptability of milk and milk products in populations with a high prevalence of lactose intolerance |journal=Am. J. Clin. Nutr. |volume=48 |issue=4 Suppl |pages=1079–159 |year=1988 |pmid=3140651 |doi= |url=}}</ref><ref name="pmid201442082">{{cite journal |vauthors=Itan Y, Jones BL, Ingram CJ, Swallow DM, Thomas MG |title=A worldwide correlation of lactase persistence phenotype and genotypes |journal=BMC Evol. Biol. |volume=10 |issue= |pages=36 |year=2010 |pmid=20144208 |pmc=2834688 |doi=10.1186/1471-2148-10-36 |url=}}</ref>
*There is no racial predilection to [disease name].
** African Americans
*Lactose intolerance usually affects individuals of the:
** Hispanics
**African Americans
**Hispanics  
**Asians
**Asians
**Asian Americans
**Asian Americans
**Native Americans
**Native Americans
*Europeans and European Americans individuals are less likely to develop lactose intolerance.


* Countries with high rates of lactase intolerance in Africa include:
*Europeans and European Americans are less likely to develop lactose intolerance.
** South Nigerian
** Hausa, Bantu
* Countries with low rates of lactase intolerance in Africa include:
** Hima
** Tutsi
** Nomadic Fulani
*
 
*
===Gender===
===Gender===
*[Disease name] affects men and women equally.
*Lactose intolerance affects men and women equally.
*[Gender 1] are more commonly affected by [disease name] than [gender 2]. The [gender 1] to [gender 2] ratio is approximately [number > 1] to 1.
===Region===
===Region===
*The majority of [disease name] cases are reported in [geographical region].
*The majority of lactose intolerance cases are reported in the Far East.<ref name="pmid8042019">{{cite journal |vauthors=Sahi T |title=Genetics and epidemiology of adult-type hypolactasia |journal=Scand. J. Gastroenterol. Suppl. |volume=202 |issue= |pages=7–20 |year=1994 |pmid=8042019 |doi= |url=}}</ref>
*Northwestern Europe has the lowest prevalence of lactose intolerance.
*The following countries have the highest rates of lactose intolerance in Africa:<ref name="pmid22826639">{{cite journal |vauthors=Mattar R, de Campos Mazo DF, Carrilho FJ |title=Lactose intolerance: diagnosis, genetic, and clinical factors |journal=Clin Exp Gastroenterol |volume=5 |issue= |pages=113–21 |year=2012 |pmid=22826639 |pmc=3401057 |doi=10.2147/CEG.S32368 |url=}}</ref>
**Nigeria
**Malawi
**Sudan
**Ethiopia
**Uganda


*[Disease name] is a common/rare disease that tends to affect [patient population 1] and [patient population 2].
* The following countries have the lowest rates of lactose intolerance in Africa:
*e lowest prevalence in Europeans and European Americans and higher prevalence in African Americans, Hispanics, Asians, Asian Americans, and Native Americans. In Africa, some ethnic groups have high rates of lactase intolerance (South Nigerian, Hausa, Bantu), while others have low rates (Hima, Tutsi, nomadic Fulani). The prevalence of lactose malabsorption and intolerance are low in children younger than six years and increases with age [2,3].
** Cameroon 
** Mali 
** South Africa
** Morocco


===Developed Countries===
*Congenital lactase deficiency is a rare disease that tends to affect Finnish population.<ref name="pmid9758622">{{cite journal |vauthors=Järvelä I, Enattah NS, Kokkonen J, Varilo T, Savilahti E, Peltonen L |title=Assignment of the locus for congenital lactase deficiency to 2q21, in the vicinity of but separate from the lactase-phlorizin hydrolase gene |journal=Am. J. Hum. Genet. |volume=63 |issue=4 |pages=1078–85 |year=1998 |pmid=9758622 |pmc=1377496 |doi= |url=}}</ref>


===Developing Countries===
===Developing Countries===
* Secondary lactase deficiency is more common in children, particularly in the the developing countries due to high prevalence of infections. <ref name="pmid17599979">{{cite journal |vauthors=Bhatnagar S, Aggarwal R |title=Lactose intolerance |journal=BMJ |volume=334 |issue=7608 |pages=1331–2 |year=2007 |pmid=17599979 |pmc=1906652 |doi=10.1136/bmj.39252.524375.80 |url=}}</ref>


==References==
==References==
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[[Category: (name of the system)]]
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{{Lactose intolerance}}
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==Overview==
An estimated 70%<ref name="Kretchmer1">Kretchmer N. ''Lactose and lactase: a historical perspective''. Gastroenterology, 1971;61, 805–813</ref> of adult humans are considered lactose intolerant, it is uncommon in healthy northern westerners and a few others groups. Between 30 and 50 million Americans are [[lactose]] intolerant and certain ethnic and [[race|racial]] populations are more affected than others. Up to 80 percent of African Americans, 80 to 100 percent of American Indians, and 90 to 100 percent of Asian Americans are lactose intolerant. The condition is least common among people of northern European descent.
 
==Epidemiology and Demographics==
===Incidence and Prevalence===
{| class="wikitable"
| '''Human groups'''
| '''Individuals Examined'''
| '''Percent Intolerant'''
| '''[[Allele frequency]]'''
|-
|Dutch || N/A || 1%<ref name="AdvHG">''Genetics of lactose digestion in humans.'', Flatz, G. , Advances in Human Genetics, 1987</ref> || N/A
|-
|Swedes || N/A || 2%<ref name="SA">''Lactose and Lactase'', Norman Kretchmer, Scientific American, October, 1972</ref> || 0.14
|-
||Europeans in Australia ||160 || 4%<ref name="SA" /> || 0.20
|-
|White people of Northern European and Scandinavian descent||N/A||5%<ref name="variant" /><ref name="UCD" />||N/A
|-
|Danes || N/A || 5%<ref>[[Anne Charlotte Jäger]], [http://www.dskb.dk/index.jsp?id=7353&gr=7446 "Laktose-intolerans: Gentest for laktose-intolerans - hurtig og billig diagnostik"], [[DSKB-NYT]], no. 1, February 2006.</ref> || N/A
|-
| Demographics of the United Kingdom |British||5–15%<ref name="probiotic">[[Michael de Vrese]], Anna Stegelmann, Bernd Richter, Susanne Fenselau, Christiane Laue and Jürgen Schrezenmeir,[http://www.ajcn.org/cgi/content/full/73/2/421S "Probiotics—compensation for lactase insufficiency"], ''[[American Journal of Clinical Nutrition]]'', Vol. 73, No. 2, 421S-429s, February 2001.</ref> ||N/A
|-
|Swiss || N/A || 10%<ref name="SA" /> || 0.316
|-
|White Americans || 245 || 12%<ref name="SA" /> || 0.346
|-
|Tuareg || N/A || 13%<ref name="probiotic" /> || N/A
|-
| Germans || N/A || 15%<ref name="probiotic" />  || N/A
|-
| Austrians || N/A || 15–20%<ref name="probiotic" />  || N/A
|-
|Eastern Slavs (Russians, Belarusians, Ukrainians) || N/A || 15%<ref>[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15991859&dopt=Abstract Prevalence of the lactase deficiency among the population of the northwestern region of Russia]</ref> || N/A
|-
|Northern French||N/A||17%<ref name="probiotic" /> ||N/A
|-
|Finns || 134 || 18%<ref name="SA" /> || 0.424
|-
|Central Italians||  65  || 19%<ref name="Italian" /> ||N/A
|-
|Indian Children||N/A||20%<ref name="variant">[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11788828&query_hl=14&itool=pubmed_docsum ''Identification of a variant associated with adult-type hypolactasia'', Enattah NS, Sahi T, Savilahti E, Terwilliger JD, Peltonen L, Jarvela I, Nat Genet. 2002 Feb;30(2):233–7]</ref><ref name="UCD">[http://nutrigenomics.ucdavis.edu/nutrigenomics/index.cfm?objectid=968814F6-65B3-C1E7-0C7007B71CC9959A ''Lactose Intolerance: The Molecular Explanation'', UC Davis Nutritional Genomics website]</ref>
||N/A
|-
|African Tutsi || N/A || 20%<ref name="SA" /> || 0.447
|-
|African Fulani || N/A || 23%<ref name="SA" /> || 0.48
|-
|Bedouins || N/A||25%<ref name="probiotic" /> ||N/A
|-
|Northern Indians ||N/A||27%<ref name="Indian">''Lactose intolerance in North and South Indians'', Tandon RK, Joshi YK, Singh DS, Narendranathan M, Balakrishnan V, Lal K., Am J Clin Nutr 1981;35:943–6, 1981.</ref>||N/A
|-
|African American Children||N/A||45%<ref name="variant" />||N/A
|-
|Indian Adults||150||50%<ref name="variant" /><ref name="UCD" /><ref>[http://www.indianjgastro.com/article.asp?issn=0254-8860;year=2004;volume=23;issue=2;spage=78;epage=78;aulast=Rana ''Lactose malabsorption in apparently healthy adults in northern India, assessed using lactose hydrogen breath test'', Rana SV, Bhasin DK, Naik N, Indian Journal of Gastroenterology, Volume 23, Issue 2, p. 78, 2004]</ref>||N/A
|-
|Southern Italians|| 51  || 41%<ref name="Italian" /> || N/A
|-
|Saami (in Russia and Finland) || N/A || 25–60%<ref>A. Kozlov, D. Lisitsyn, "Hypolactasia in Saami subpopulations of Russia and Finland", ''[[Anthropologischer Anzeiger]]'', 55(3-4):281–287, 1997.</ref> || N/A
|-
|Northern Italians|| 89  || 52%<ref name="Italian">[http://www.ajcn.org/cgi/content/abstract/45/4/748 ''Primary adult lactose malabsorption in Italy: regional differences in prevalence and relationship to lactose intolerance and milk consumption'', LT Cavalli-Sforza, A Strata, A Barone and L Cucurachi, American Journal of Clinical Nutrition, Vol 45, 748–754, 1987]</ref>  || N/A
|-
|North American Hispanics ||N/A||53%<ref name="probiotic" />  ||N/A
|-
|Balkans|| N/A||55%<ref name="probiotic" /> ||N/A
|-
|Mexican American Males||N/A||55%<ref name="variant" /><ref name="UCD" />||N/A
|-
|Cretans||N/A||56%<ref name="variant" />||N/A
|-
|African Maasai || 21 || 62%<ref>[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=581925&dopt=Abstract ''Lactose malabsorption among Masai children of East Africa'', RT Jackson, MC Latham, Am J Clin Nutr. 1979 Apr;32(4):779–82.]</ref>
|| N/A
|-
| Southern French||N/A||65%<ref name="probiotic" /> ||N/A
|-
|Greek Cypriots||N/A||66%<ref name="variant" /><ref name="UCD" />||N/A
|-
|North American Jews||N/A||68.8%<ref name="variant" /><ref name="UCD" />||N/A
|-
|Southern Indians ||N/A||70%<ref name="Indian" />||N/A
|-
|Sicilians ||100||71%<ref name="Burgio">[http://www.ajcn.org/cgi/reprint/39/1/100.pdf ''Prevalence of primary adult lactose malabsorption and awareness of milk intolerance in Italy'', G Roberto Burgio, Gebhard Flatz, Cristiana Barbera, Rosario Patan, Attilio Boner, Cinzia Cajozzo, and Sibylle D Flaiz, The American Journal of Clinical Nutrition 39: pp 100–104, January 1984.]</ref><ref>[http://www.jacn.org/cgi/content/full/19/suppl_2/165S ''Lactose Intolerance'', Tuula H. Vesa, Philippe Marteau, and Riitta Korpela, Journal of the American College of Nutrition, Vol. 19, No. 90002, 165S-175S (2000)]</ref>||N/A
|-
|South Americans||N/A||65–75%<ref name="probiotic" /> ||N/A
|-
|Rural Mexicans||N/A||73.8%<ref name="variant" /><ref name="UCD" />||N/A
|-
|African Americans || 20 || 75%<ref name="SA" /> || 0.87
|-
|Kazakhs from northwest Xinjiang || 195 || 76.4% <ref name="China" />||
|-
|Lebanese||75||78%<ref>[http://www.ajcn.org/cgi/reprint/32/10/1994.pdf ''Lactose intolerance in the Lebanese population and in “Mediterranean lymphoma”'', Salah M. Nasrallah, The American Journal of Clinical Nutrition 32 , pp. 1994–1996, October, 1979.]</ref>||N/A
|-
|Central Asians||N/A||80%<ref name="probiotic" />  ||N/A
|-
|Alaskan Eskimo||N/A||80%<ref name="variant" /><ref name="UCD" />||N/A
|-
|Australian Aborigines || 44 || 85%<ref name="SA" /> || 0.922
|-
|Inner Mongolians||198||87.9%<ref name="China">[http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=6235167&dopt=Abstract ''Prevalence of primary adult lactose malabsorption in three populations of northern China''], Wang YG, Yan YS, Xu JJ, Du RF, Flatz SD, Kühnau W, Flatz G., Hum Genet. 1984;67(1):103-6.</ref>||
|-
|African Bantu || 59 || 89%<ref name="SA" /> || 0.943
|-
|Asian Americans||N/A||90%<ref name="variant" /><ref name="UCD" />||N/A
|-
|Northeastern Han Chinese || 248 || 92.3%<ref name="China" />||
|-
|Chinese || 71 || 93%<ref name="SA" /> || 0.964
|-
|Southeast Asians||N/A||98%<ref name="variant" /><ref name="UCD" />||N/A
|-
|Thais || 134 || 98%<ref name="SA" /> || 0.99
|-
|Native Americans || 24 || 100%<ref name="SA" /> || 1.00
|}
 
The [[statistical significance]] varies greatly depending on number of people sampled.
 
[[Image:LacIntol-World2.png|center|thumb|300px|Lactose Intolerance by Region (African countries are only a rough guess)]]
 
===Age===
Lactose intolerance levels also increase with age. At ages 2 - 3 yrs., 6 yrs., and 9 - 10 yrs., the amount of lactose intolerance is, respectively:
 
* 6% to 15% in white Americans and northern Europeans
* 18%, 30%, and 47% in Mexican Americans
* 25%, 45%, and 60% in black South Africans
* Approximately 30%, 80%, and 85% in Chinese and Japanese
* 30–55%, 90%, and >90% in Mestizos of Peru<ref name="Sahi">''Genetics and epidemiology of adult-type hypolactasia'', Sahi T., Scand J Gastroenterol Suppl ;29:202:7–20, 1994</ref><ref>[http://www.ajcn.org/cgi/content/abstract/29/1/19?ijkey=10c44e0ee3932cb3ee9d514dd65488c8284bc803&keytype2=tf_ipsecsha ''Lactose malabsorption in Mexican-American children'', Woteki CE, Weser E, Young EA, Am J Clin Nutr;29:19–24, 1976]</ref>
 
Chinese and Japanese populations typically lose between 80 and 90 percent of their ability to digest lactose within three to four years of weaning.
 
===Race===
Ashkenazi Jews can keep 20 - 30 percent of their ability to digest lactose for many years.<ref name="Sahi" /><ref>''Genetics of lactose digestion in humans'', Flatz G., Adv Hum Genet ;16:1 - 77, 1987</ref><ref>''Genetics of lactase persistence and lactose intolerance'', Swallow DM., Annu Rev Genet ;37:197 - 219, 2003.</ref> Of the 10% of the Northern European population that develops lactose intolerance, the development of lactose intolerance is a gradual process spread out over as many as 20 years.<ref>[http://pmj.bmj.com/cgi/content/full/81/953/167 ''Systemic lactose intolerance: a new perspective on an old problem'', S B Matthews, J P Waud, A G Roberts and A K Campbell, Postgraduate Medical Journal;81:167 - 173, 2005.]</ref>Most Japanese can consume 200 ml (8 fl oz) of milk without severe symptoms.<ref name="Yoshida">[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1234085&dopt=Abstract ''Studies on the etiology of milk intolerance in Japanese adults'', Yoshida Y, Sasaki G, Goto S, Yanagiya S, Takashina K, Gastroenterol Jpn.;10(1):29–34, 1975]</ref>
 
==References==
{{Reflist|2}}
{{WS}}
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[[Category:Gastroenterology]]
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahda Alihashemi M.D. [2]

Overview

The prevalence of lactose intolerance is approximately 75,000 per 100,000 individuals worldwide. The prevalence of lactose intolerance is low in children younger than six years. Europeans and European Americans individuals are less likely to develop lactose intolerance. Lactose intolerance affects men and women equally. The majority of lactose intolerance cases are reported in the Far East.

Epidemiology and Demographics

Prevalence

  • The prevalence of lactose intolerance is up to 75000 per 100,000 individuals worldwide.[1][2]
  • In North America, the prevalence of lactose intolerance:
    • Native America: 79000 per 100,000 individuals
    • Black: 75000 per 100,000 individuals
    • Hispanics: 51000 per 100,000 individuals
    • Caucasians: 21000 per 100,000 individuals
  • The prevalence of lactose intolerance in Latin America, Africa, and Asia is 15000-100000 per 100,000 individuals.

Age

  • The prevalence of lactose intoleance is low in children younger than six years. [3][4]
  • The prevalence of lactose intoleance incereses with age.

Race

  • Lactose intolerance usually affects the following populations:[2][5]
    • African Americans
    • Hispanics
    • Asians
    • Asian Americans
    • Native Americans
  • Europeans and European Americans are less likely to develop lactose intolerance.

Gender

  • Lactose intolerance affects men and women equally.

Region

  • The majority of lactose intolerance cases are reported in the Far East.[6]
  • Northwestern Europe has the lowest prevalence of lactose intolerance.
  • The following countries have the highest rates of lactose intolerance in Africa:[7]
    • Nigeria
    • Malawi
    • Sudan
    • Ethiopia
    • Uganda
  • The following countries have the lowest rates of lactose intolerance in Africa:
    • Cameroon 
    • Mali 
    • South Africa
    • Morocco
  • Congenital lactase deficiency is a rare disease that tends to affect Finnish population.[8]

Developing Countries

  • Secondary lactase deficiency is more common in children, particularly in the the developing countries due to high prevalence of infections. [9]

References

  1. ↑ Silanikove N, Leitner G, Merin U (2015). "The Interrelationships between Lactose Intolerance and the Modern Dairy Industry: Global Perspectives in Evolutional and Historical Backgrounds". Nutrients. 7 (9): 7312–31. doi:10.3390/nu7095340. PMC 4586535. PMID 26404364.
  2. ↑ 2.0 2.1 Scrimshaw NS, Murray EB (1988). "The acceptability of milk and milk products in populations with a high prevalence of lactose intolerance". Am. J. Clin. Nutr. 48 (4 Suppl): 1079–159. PMID 3140651.
  3. ↑ Rao DR, Bello H, Warren AP, Brown GE (1994). "Prevalence of lactose maldigestion. Influence and interaction of age, race, and sex". Dig. Dis. Sci. 39 (7): 1519–24. PMID 8026265.
  4. ↑ Di Stefano M, Veneto G, Malservisi S, Strocchi A, Corazza GR (2001). "Lactose malabsorption and intolerance in the elderly". Scand. J. Gastroenterol. 36 (12): 1274–8. PMID 11761016.
  5. ↑ Itan Y, Jones BL, Ingram CJ, Swallow DM, Thomas MG (2010). "A worldwide correlation of lactase persistence phenotype and genotypes". BMC Evol. Biol. 10: 36. doi:10.1186/1471-2148-10-36. PMC 2834688. PMID 20144208.
  6. ↑ Sahi T (1994). "Genetics and epidemiology of adult-type hypolactasia". Scand. J. Gastroenterol. Suppl. 202: 7–20. PMID 8042019.
  7. ↑ Mattar R, de Campos Mazo DF, Carrilho FJ (2012). "Lactose intolerance: diagnosis, genetic, and clinical factors". Clin Exp Gastroenterol. 5: 113–21. doi:10.2147/CEG.S32368. PMC 3401057. PMID 22826639.
  8. ↑ Järvelä I, Enattah NS, Kokkonen J, Varilo T, Savilahti E, Peltonen L (1998). "Assignment of the locus for congenital lactase deficiency to 2q21, in the vicinity of but separate from the lactase-phlorizin hydrolase gene". Am. J. Hum. Genet. 63 (4): 1078–85. PMC 1377496. PMID 9758622.
  9. ↑ Bhatnagar S, Aggarwal R (2007). "Lactose intolerance". BMJ. 334 (7608): 1331–2. doi:10.1136/bmj.39252.524375.80. PMC 1906652. PMID 17599979.

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