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Lactose intolerance
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=== History of research === It was not until relatively recently that [[medicine]] recognised the worldwide prevalence of lactose intolerance and its genetic causes. Its symptoms were described as early as [[Hippocrates]] (460β370 BC),<ref>{{cite journal |author=Wilson J |title=Milk Intolerance: Lactose Intolerance and Cow's Milk Protein Allergy |journal=Newborn and Infant Nursing Reviews |date=December 2005 |volume=5 |issue=4 |pages=203β7 |doi=10.1053/j.nainr.2005.08.004}}</ref> but until the 1960s, the prevailing assumption was that tolerance was the norm. Intolerance was explained as the result of a milk allergy, intestinal pathogens, or as being [[psychosomatic]] β it being recognised that some cultures did not practice dairying, and people from those cultures often reacted badly to consuming milk.<ref name="pmid14044269">{{cite journal | vauthors = Auricchio S, Rubino A, Landolt M, Semenza G, Prader A | journal = Lancet | volume = 2 | issue = 7303 | pages = 324β6 | date = August 1963 | pmid = 14044269 | doi = 10.1016/s0140-6736(63)92991-x | title = Isolated Intestinal Lactase Deficiency in the Adult }}</ref><ref name="Simoons_1969">{{cite journal | vauthors = Simoons FJ | title = Primary adult lactose intolerance and the milking habit: a problem in biological and cultural interrelations. I. Review of the medical research | journal = The American Journal of Digestive Diseases | volume = 14 | issue = 12 | pages = 819β36 | date = December 1969 | pmid = 4902756 | doi = 10.1007/bf02233204 | s2cid = 22597839 }}</ref> Two reasons have been given for this misconception. One was that early research was conducted solely on European-descended populations, which have an unusually low incidence of lactose intolerance<ref name="Itan et al. 2010">{{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 Evolutionary Biology | volume = 10 | pages = 36 | date = February 2010 | issue = 1 | pmid = 20144208 | pmc = 2834688 | doi = 10.1186/1471-2148-10-36 | doi-access = free | bibcode = 2010BMCEE..10...36I }}</ref> and an extensive cultural history of dairying. As a result, researchers wrongly concluded that tolerance was the global norm. Another reason is that lactose intolerance tends to be under-reported: lactose intolerant individuals can tolerate at least some lactose before they show symptoms, and their symptoms differ in severity. The large majority of people are able to digest some quantity of milk, for example in tea or coffee, without developing any adverse effects.<ref name="Savaiano and Levitt 1987">{{cite journal | vauthors = Savaiano DA, Levitt MD | title = Milk intolerance and microbe-containing dairy foods | journal = Journal of Dairy Science | volume = 70 | issue = 2 | pages = 397β406 | date = February 1987 | pmid = 3553256 | doi = 10.3168/jds.S0022-0302(87)80023-1 | doi-access=free | url=https://www.journalofdairyscience.org/article/S0022-0302(87)80023-1/abstract }}</ref> [[Fermented milk products|Fermented dairy products]], such as cheese, also contain significantly less lactose than plain milk. Therefore, in societies where tolerance is the norm, many lactose intolerant people who consume only small amounts of dairy, or have only mild symptoms, may be unaware that they cannot digest lactose. Eventually, in the 1960s, it was recognised that lactose intolerance was correlated with [[race (classification of humans)|race]] in the United States.<ref name="pmid5953213">{{cite journal | vauthors = Bayless TM, Rosensweig NS | title = A racial difference in incidence of lactase deficiency. A survey of milk intolerance and lactase deficiency in healthy adult males | journal = JAMA | volume = 197 | issue = 12 | pages = 968β72 | date = September 1966 | pmid = 5953213 | doi = 10.1001/jama.1966.03110120074017 }}</ref><ref>{{cite journal |vauthors=Welsh JD, Rohrer V, Knudsen KB, Paustian FF | year = 1967 | title = Isolated Lactase Deficiency: Correlation of Laboratory Studies and Clinical Data | journal = Archives of Internal Medicine | volume = 120 | issue = 3 | pages = 261β269 | doi=10.1001/archinte.1967.00300030003003}}</ref><ref name="pmid5694356">{{cite journal | vauthors = Huang SS, Bayless TM | s2cid = 33249040 | title = Milk and lactose intolerance in healthy Orientals | journal = Science | volume = 160 | issue = 3823 | pages = 83β4 | date = April 1968 | pmid = 5694356 | doi = 10.1126/science.160.3823.83-a | bibcode = 1968Sci...160...83H }}</ref> Subsequent research revealed that lactose intolerance was more common globally than tolerance,<ref name="pmid4159716">{{cite journal | vauthors = Cook GC, Kajubi SK | title = Tribal incidence of lactase deficiency in Uganda | journal = Lancet | volume = 1 | issue = 7440 | pages = 725β9 | date = April 1966 | pmid = 4159716 | doi = 10.1016/s0140-6736(66)90888-9 }}</ref><ref>{{cite journal |vauthors=Jersky J, Kinsley RH | year = 1967 | title = Lactase Deficiency in the South African Bantu | journal = South African Medical Journal | volume = 41 | issue = 46 | pages = 1194β6 |pmid=6080167}}</ref><ref name="pmid5701921">{{cite journal | vauthors = Bolin TD, Crane GG, Davis AE | title = Lactose intolerance in various ethnic groups in South-East Asia | journal = Australasian Annals of Medicine | volume = 17 | issue = 4 | pages = 300β6 | date = November 1968 | pmid = 5701921 | doi = 10.1111/imj.1968.17.4.300}}</ref><ref name="pmid5818369">{{cite journal | vauthors = Flatz G, Saengudom C, Sanguanbhokhai T | s2cid = 4201371 | title = Lactose intolerance in Thailand | journal = Nature | volume = 221 | issue = 5182 | pages = 758β9 | date = February 1969 | pmid = 5818369 | doi = 10.1038/221758b0 | bibcode = 1969Natur.221..758F }}</ref><ref name="pmid6016903">{{cite journal | vauthors = Elliott RB, Maxwell GM, Vawser N | title = Lactose maldigestion in Australian Aboriginal children | journal = The Medical Journal of Australia | volume = 1 | issue = 2 | pages = 46β9 | date = January 1967 | pmid = 6016903 | doi = 10.5694/j.1326-5377.1967.tb21011.x| s2cid = 44475025 }}</ref> and that the variation was due to genetic differences, not an adaptation to cultural practices.<ref name="Simoons_1969" /><ref name="pmid5114667">{{cite journal | vauthors = Flatz G, Rotthauwe HW | title = Evidence against nutritional adaption of tolerance to lactose | journal = Humangenetik | volume = 13 | issue = 2 | pages = 118β25 | year = 1971 | pmid = 5114667 | doi = 10.1007/bf00295793 | s2cid = 33253438 }}</ref>
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