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Back to Lactose Intolerance and Milk Allergy

Gut Microbiota and Milk Products: Implications for Health

Emerging scientific evidence has demonstrated a link between human gut microbiota (gut bacteria) and a number of health conditions including obesity, cardiovascular disease and others. Diet appears to play an important role.

Wendy J. Dahl Wendy J. Dahl, PhD, RD, FDC

Assistant Professor, Food Science and Human Nutrition, University of Florida


  •  Gut microbiota – implicated in numerous health conditions, including obesity – can be modified by diet.
  •  Prebiotics are important modulators of gut microbiota, increasing the levels of beneficial bacteria.
  •  Lactose may have prebiotic properties.
  •  Milk products should not be avoided (even by lactose-intolerant individuals) as they have important health benefits, including a potential beneficial impact on gut microbiota.

Gut microbiota

The modern human gut is teeming with bacterial cells: about 100 trillion in total, representing over 1,000 species of bacteria.1,2 Numerous factors can affect the balance of microbiota in the gut, including: diet, stress, antibiotics and advancing age.1,2 When out of balance, the microbiotic environment may play a role in the development of obesity, ulcerative colitis, Crohn’s disease, colorectal cancer, irritable bowel syndrome, celiac disease and other conditions.1,2


Prebiotics have been defined as “selectively fermented ingredients that allow specific changes, both in the composition and/or activity in gastrointestinal microbiota, that confer benefits upon host well-being and health.”3 These nondigestible compounds, which include inulin, oligofructose, and other oligosaccharides, occur naturally in human milk, wheat, onions, and legumes, and are added to many foods. Prebiotics derived from the lactose in milk include:

  • Commercially-produced galactooligosaccharides (GOS), and
  • The synthetic disaccharide lactulose, consisting of fructose and galactose.

Lactose and lactose intolerance

Fermentation of undigested lactose increases the concentration in the gut of Bifidobacteria, a beneficial type of bacteria. As such, lactose may have prebiotic properties. Given that milk products have important health benefits, including a potential beneficial impact on the gut, they should not be avoided. In fact, the National Institutes of Health (NIH), in their most recent consensus statement on the subject, specifically recommends that milk and milk products not be avoided by those with lactose intolerance as they provide important nutrients and confer several health benefits.4

Strategies for management of lactose intolerance

  • Consume smaller servings of milk throughout the day.
  • Milk is better tolerated when consumed with meals.
  • Yogurt is generally well tolerated since active bacterial cultures facilitate lactose digestion.
  • Hard cheeses are usually well tolerated as they contain very little lactose.
  • Lactose-free milk and lactase tablets are another option.

Adapted from the NIH Consensus Statement4


  1. de Vos WM and de Vos EAJ. Role of the intestinal microbiome in health and disease: from correlation to causation. Nutr Rev 2012;70(suppl. 1):S45-S56.
  2.  Flint HJ. The impact of nutrition on the human microbiome. Nutr Rev 2012;70(suppl. 1):S10-S13.
  3.  Roberfroid M et al. Prebiotics: the concept revisited. J Nutr 2007;137(3):830S-837S.
  4.  National Institutes of Health. NIH Consensus Development Conference Statement: Lactose Intolerance and Health. NIH Consens State Sci Statements 2010; Feb 24;27(2).

Keywords: prebiotics , microbiota , lactose , lactose intolerance

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