Food is one of the ways people express their love. Whether it’s your mom insisting you drink that glass of milk or your partner taking you out on a wine and cheese date, food often conveys affection.
We all have that one friend who cannot process lactose (I’m that friend) but still insists on finishing that slice of pizza, thinking they’ll deal with the consequences later.
But have you ever wondered what exactly it means to be lactose intolerant, and why in India it seems like a new concept even though we have been suffering from it for years?
What is lactose intolerance?
Dr Shyam Sharma, a general physician from Assam, explains that lactose intolerance is a common digestive disorder where the body cannot properly digest lactose, a type of sugar found in milk and dairy products.
“This condition occurs due to a deficiency in lactase, an enzyme produced in the small intestine that is necessary for breaking down lactose into glucose and galactose, which can be absorbed into the bloodstream,” he says.
What happens if a lactose-intolerant person consumes dairy?
When a person with lactose intolerance consumes dairy products, according to Dr Sharma, their body lacks enough of the enzyme lactase to break down lactose into its simpler forms, glucose and galactose.
As a result, the undigested lactose moves from the small intestine into the colon, or your large intestine.
“In the colon, there are many types of bacteria that help with digestion. These bacteria ferment or break down the undigested lactose. This fermentation process produces gases like hydrogen, methane, and carbon dioxide, as well as short-chain fatty acids,” adds Dr Sharma.
This gas build-up and the presence of these fatty acids cause the uncomfortable symptoms associated with lactose intolerance, such as:
- bloating
- diarrhoea
- gas
- stomach cramps
- nausea
The severity of symptoms can vary depending on the amount of lactose consumed and the individual’s level of lactase deficiency.
‘1/3rd of Indians are lactose intolerant’
Lactose intolerance is more common than you think. In fact, several studies show that Indians have the most lactose intolerance than any other demographic in the world.
For instance, a 2015 study shows that three out of four Indians have no tolerance for milk.
“We took subjects from different centres including Lucknow and Bengaluru and found that over 74% were lactose mal absorbers, which means they cannot digest milk,” said Dr Uday C Ghoshal, who led the study project.
This study was further corroborated by various chefs that IndiaToday spoke to.
For instance, Chef Ratan Kumar, an executive chef at Courtyard by Marriott in Gurugram, agrees with the study and tells us that lactose intolerance in India could be attributed to genetic factors and dietary habits.
He says that historically, many regions in India did not have a culture of consuming unfermented dairy products, which means there was less evolutionary pressure to maintain lactase production into adulthood.
This lactose tolerance also varies between northern and southern parts of India, with southern Indians having a lower lactose tolerance.
A 2018 study shows that 66.6% of ‘healthy volunteers from South India’ and 27.4% of ‘healthy volunteers from North India’ were lactose intolerant.
But why?
Chef Ramesh, a senior sous chef at Club Florence (KAARA Hotels & Resorts) in Gurugram, says that the North Indian population is less likely to be lactose intolerant compared to their Southern counterparts.
According to him, this is because the North Indian population has been consuming milk and milk products for a long time. They have also been consuming dairy products well beyond the infancy stage.
“This has made their genetics more suitable for digesting dairy products, compared to the culinary habits of the South Indians, who include more leafy greens and meat products in their daily consumption,” says Chef Ramesh.
Chef Gauri Varma, the founder of Confet, says, to understand this, we need to look into the history of North Indians. Here’s what she said:
- The Aryans (the majority of the North Indian population are descendants of them) migrated to the Indian subcontinent around 1500 BC, bringing a pastoral lifestyle (a nomadic or semi-nomadic lifestyle where people raise domesticated animals) based mainly on cattle and dairy products.
- Continued consumption of dairy products over generations causes a genetic mutation called lactase persistence.
- Through this mutation, people continue to produce lactase (the enzyme needed to digest lactose) into adulthood.
- This genetic trait leads to a reduced incidence of lactose intolerance in North Indians.
In contrast, the dietary habits of South Indians, which are characterised by a lower consumption of dairy products, have contributed to the higher prevalence of lactose intolerance in this region, according to Chef Gauri.
“The traditional diet in South India, rich in rice, lentils, and vegetables, places less emphasis on dairy products. As a result, there is little evolutionary pressure for the persistence of lactase in humans, leading to a decrease in lactase production after childhood. This is a key reason why lactose intolerance is more common in South Indians,” explains Chef Gauri.
From the West
Even though lactose intolerance is genetically prevalent amongst Indians, there has recently been a surge in awareness.
More and more Indians are becoming aware of lactose intolerance and recognising that they might be affected by it. This change can be seen, as many people are now opting to turn vegan or simply choosing lactose-free milk.
Credit? Western influence.
Remember ‘The Big Bang Theory’, where one of the main characters, Leonard Hofstadter, occasionally mentions his lactose intolerance and how he cannot process food with milk or any dairy products? Or Alan Harper from ‘Two and a Half Men’, who also mentions his lactose intolerance during the series?
Well, they are not the only ones. Over time, we have seen many series, especially from the West, featuring characters with lactose intolerance who openly (quite openly, iykwim) discuss or show their condition (by one of the symptoms).
There is no doubt that several movies and series (whose popularity has increased in India) like these have made many Indians curious about lactose intolerance, leading them to realise they might also have it.
Another reason, according to Chef Ramesh, is the advent of social media, which, for a change, is a good thing here.
“Social media has brought about a positive change in India’s understanding of lactose intolerance. It has opened up a platform for more and more people to become aware of conditions they may not have previously been aware of,” says Chef Ramesh.
Chef Ratan also agrees with this. According to him, people are now more proactive about addressing digestive discomfort and are exploring diets that cater to their specific health needs, including plant-based and dairy-free alternatives.
“It is more evident in restaurants and the food habits of younger people, who are now keen on more protein intake and natural sugars,” says Chef Ramesh.
How to find out if you are lactose intolerant?
Chef Akshay, head chef at Zylo by Kakapo, Gurugram, says that there are a few ways you can try to determine at home if you are lactose intolerant. Here’s how.
1. Symptom tracking
Keep track of your symptoms after consuming dairy products.
2. Elimination diet
Try eliminating dairy products from your diet for some time, typically two to four weeks, and then gradually reintroduce them while monitoring your symptoms.
3. Lactose intolerance test kits
“You can also try some over-the-counter lactose intolerance test kits that are available,” says Akshay.
Bottomline
Increased digestive health awareness is becoming more prevalent globally, including in India.
With access to information through the internet and social media, people are learning more about the importance of maintaining a healthy digestive system and how it can impact overall well-being.
