The Health Benefits of Dairy for Black Americans with Lactose Intolerance

Some Black Americans avoid dairy foods due to lactose intolerance, a key reason dairy consumption is lower in the community than across other ethnic groups. Whether or not someone has the condition, research from the National Medical Association (NMA) — an organization of Black American doctors — reveals that avoiding nutrient-dense foods may not always be a healthy solution. 

Read on to discover the vital role dairy foods can play in bolstering the health of Black Americans. 

Fact vs. Fiction: Lactose Intolerance In African Americans

There are many narratives about the relationship between race and lactose intolerance, and what this means for diets. Unfortunately, a lot of the most popular narratives are false. 

“The biggest false narrative is that all Black Americans are lactose intolerant, so they should avoid all dairy foods,” says Kuda Lamin-Bangura, MPH, MS, RD, senior vice president of scientific affairs at National Dairy Council. “You hear people talking about, ‘My grandmother had it, my mother had it, so I’m lactose intolerant as well.’ [But] without getting an official diagnosis from a doctor, it’s a perceived lactose intolerance.” 

And this perception might miss the mark. More common than lactose intolerance is lactase non-persistence — a condition where individuals experience a decline in the production of lactase, the enzyme responsible for digesting lactose. This decline leads to lactose malabsorption, meaning the body struggles to break down and absorb the lactose (natural sugar) from milk and dairy foods. Lamin-Bangura says lactase non-persistence exists in seven of 10 Black people. While related to lactose intolerance, it’s a relatively minor condition, with many people being asymptomatic unless a large amount of lactose is consumed. 

Registered dietitian Tamara S. Melton, founder of LaCarte Wellness and co-founder and executive director of Diversify Dietetics, finds that people also commonly confuse lactose intolerance and dairy allergy, erroneously calling and treating the former as the latter. Since lactose intolerance is a condition where people may still tolerate different dairy types and quantities — whereas a dairy allergy means dairy should be avoided entirely — this mistake can establish an unnecessary avoidance that passes down generationally. 

Are Black Americans More Prone To Lactose Intolerance?

To address the misconception Black people are more prone to lactose intolerance, it’s important to understand how it affects families and their dietary choices. According to registered dietitian Tamara S. Melton, this confusion often begins within households: “I have found that Black parents experience symptoms of lactose intolerance, and, because they are not sure how to manage or avoid these symptoms, they will pass their avoidance behavior to their children.”

Worrisomely, this misunderstanding can extend beyond individual families and their home kitchens with potentially extreme ramifications. The NMA research finds that dairy avoidance due to lactose intolerance may put Black populations at higher risk for inadequate consumption of multiple nutrients and several preventable diseases. 

Even if someone has lactose intolerance, “there are a lot of choices in the dairy case that are either lactose-free like lactose-free dairy milk and most hard, natural cheeses (e.g., Cheddar, Swiss) or lower-lactose like yogurt and kefir that can often be tolerated and consumed by Black people,” Lamin-Bangura continues. “And they could still gain all of the nutritional benefits of dairy foods by consuming those.” 

The Health Impact of Avoiding Dairy Foods

The perception of widespread lactose intolerance in Black people can lead to the avoidance of dairy foods — and skipping out on these nutrients can result in significant health risks.  

Consistent evidence demonstrates that healthy eating patterns are associated with beneficial outcomes across the lifespan. This includes better outcomes for:  

• All-cause mortality 

• Cardiovascular disease  

• Overweight and obesity  

• Type 2 diabetes  

• Bone health  

• Breast and colorectal cancers  

Common characteristics of eating patterns associated with positive health outcomes include relatively higher consumption of:  

• Vegetables  

• Fruits  

• Legumes  

• Whole grains  

• Low- or non-fat dairy foods  

• Lean meats and poultry  

• Seafood  

• Nuts  

• Unsaturated vegetable oils  

and relatively lower consumption of red and processed meats, sugar-sweetened foods and beverages, and refined grains.  

“Dairy foods including milk, cheese and yogurt are a nutritional powerhouse and provide a unique package of nutrients that are hard to replace and play a key role in brain development and growth in early childhood,” Lamin-Bangura says. “Dairy foods also provide nutrients that support lifelong bone, muscle and immune health.” This is particularly relevant for people of color who are already at a disadvantage for nutrition-related health disparities. Vitamin D is one of these nutrients that is hard to replace—and it is especially important for Black people.  

Melanated skin blocks the body’s ability to make vitamin D from the sun as effectively,” Melton says. She sees vitamin D deficiency quite often in her practice, she says, especially in Black women who are pregnant or who may become pregnant. “I am always stressing the need for getting adequate vitamin D consumption to my clients.” 

Dairy can help fill these and other nutritional gaps. Lamin-Bangura explains that dairy foods are a key source of three of the four nutrients the Dietary Guidelines for Americans (DGA) recognize as being of public health concern: calcium, vitamin D, and potassium (fiber being the fourth nutrient, which isn’t in dairy). Dairy foods also contain significant amounts of other essential nutrients. Milk, for instance, contains 13 essential nutrients, including protein, zinc, iodine, and vitamin B12. 

Avoiding dairy due to a real or perceived lactose intolerance, as almost all of Melton’s Black clients have mentioned doing, can cause more harm than good. But the solution is simple. Just as avoiding dairy can lead to increased health risks, consuming lactose-free and lower-lactose dairy options can help reduce them. 

Embracing Dairy Can Help Reduce Health Risks–Even with Lactose Intolerance 

Dairy foods can be key for lowering health risks across the life continuum, whether consumed by itself or within something else (e.g.,cheesy grits, kefir-brined barbecue chicken).  

Diet-related chronic diseases can start in childhood and can be preventable, according to Lamin-Bangura. Between the quality and quantity of dairy foods’ nutrients, meeting daily dairy recommendations can help certain communities meet their nutritional needs and reduce the risk of poor health outcomes. This is a particularly important point in conversations around lactose intolerance in Black people. 

Whether it’s drinking more milk or including more yogurt and cheese into meals and snacks, eating the recommended daily servings of dairy foods has the potential to contribute to better nutrition and health outcomes for Black Americans across their lifespan. In fact, broader discussions around lactose intolerance and race are encouraging a more nuanced understanding of dairy’s role in health equity. 

The National Medical Association recommends:  

• Toddlers (ages 1-2) eat 2 servings of dairy foods daily  

• Children (ages 2-8) eat 2.5 servings of dairy foods daily  

• Adolescents (ages 9-17), adults and older adults eat 3 servings of dairy foods daily  

Importantly, Black people with lactose intolerance don’t have to miss out on these benefits. Between low-lactose and lactose-free options, it’s just a matter of figuring out the best dairy foods for them and their individual tolerance level. 

Identifying the Dairy Foods That Are Best for You 

Lactose intolerance doesn’t mean you shouldn’t consume dairy. It means you should be mindful of how you consume dairy, so you don’t overdo it with lactose and experience uncomfortable symptoms.   

What this looks like will vary by person. Generally, however, Black Americans with lactose intolerance may be able to handle more dairy in one sitting than they expect. According to the NMA research, most people with the condition can consume roughly 12 grams of lactose or more at a time without symptoms. For context, regular yogurt has less than 6 grams of lactose per 6-ounce serving; Greek yogurt has even less. 

Of course, not everyone with lactose intolerance will be able to tolerate this much lactose. So, it can be helpful to start by having just a small amount of it and slowly build up to figure out how much and of which dairy foods you can enjoy without discomfort. 

Melton recommends people focus on dose and delivery. For the dose, she says to “choose dairy foods that are lower in lactose, like yogurt, cheese or kefir.” Regarding delivery, she explains how dairy enters the stomach and gut is important. “Eating other foods along with dairy, like fruits, veggies, nuts, beans and legumes, slows the body’s release of lactose into the gut, which can help reduce symptoms of lactose intolerance. Those other foods also add nutrition like fiber and antioxidants and healthy fats, which is a win-win.” 

In instances where a person’s tolerance for lactose is very low, lactose-free products can be a game-changer too. There are lactose-free versions of milk, cheese, and yogurt — dairy’s big three (both in popularity and science-backed health benefits). So, dairy can still be an easy and practical way for these individuals to bolster their nutrition. 

By acting on these and other lactose-friendly tips, members of the Black community who have difficulty tolerating lactose can feel more confident in adding dairy foods back into their diets to benefit their health and actualizing Melton’s dream reality. 

“I would love for Black people to freely incorporate dairy into their families’ meals and snacks,” she says, “and feel empowered with knowledge of how to do so in practical ways.”