Symptoms allegedly related to consumption of lactose have captured the interest of both the scientific community and the public. Different methods of treatment, lactose-reduced products, plant-based dairy substitutes, adaptation, prebiotics, exogenous lactase, probiotics, and some other dietary interventions are further discussed. In conjunction, effects of dairy products on 19 common diseases are reviewed. Treatments are discussed, including the inappropriateness of dairy avoidance. This narrative article reviews the complexities of the perception of lactose intolerance, its epidemiology, and pathogenesis. Industrial efforts to substitute with plant-based products is not completely successful at this time. However, withholding of dairy foods completely is not appropriate due to a more favorable impact on health. Partly because lactose maldigestion is often interpreted as lactose intolerance (symptoms), focus of therapy for these symptoms starts with lactose restriction. Gastrointestinal symptoms from lactose have expanded to include systemic effects and have also been confounded by other food intolerances or functional gastrointestinal disorders. While four causes are described, the most common is the genetically-determined adult onset lactose maldigestion due to loss of intestinal lactase governed by control of the gene by a 14,000 kb promoter region on chromosome 2. Lactose intolerance refers to symptoms related to the consumption of lactose-containing dairy foods, which are the most common source for this disaccharide.
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