The American Journal of Digestive Diseases

, Volume 15, Issue 7, pp 679–692 | Cite as

Primary lactase deficiency: Genetic or acquired?

  • T. D. Bolin
  • A. E. Davis
Progress Report


From a critical review of the literature, it would appear that, in animals, intestinal lactase is an adaptive enzyme, with adaptation occurring in 5–8 weeks. In man, short-term attempts at adaptation have not been successful, although a fall in lactase activity or lactose absorption has been found after substrate withdrawal in some subjects.

The expression of any biologic phenomenon is related to the sum of the effects of numerous genetic or environmental factors. It would seem that in the Chinese, at least, and presumably in other ethnic groups, the major factor influencing lactase activity is the dietary content of lactose. Adaptation of intestinal lactase occurs, provided milk intake continues at the high level found in most Western European populations, beyond the normal age of weaning. If lactose intake is reduced at or shortly after weaning, then lactase activity appears to decline over a period of years. This is analogous to the postweaning decline in lactase activity found in animals.


Enzyme Ethnic Group Lactose Critical Review European Population 
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Copyright information

© Hoeber Medical Division • Harper & Row, Publishers, Incorporated 1970

Authors and Affiliations

  • T. D. Bolin
    • 1
  • A. E. Davis
    • 1
  1. 1.School of MedicineUniversity of New South Wales, Prince Henry HospitalSydneyAustralia

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