Lactase has been shown in a number of careful investigations to be the same enzyme in the infant as in the adult who can digest lactose, and in the residual activity found in the nondigester. In general, the lactose digester has 10 times more enzymatic activity than the lactose nondigester. Thus, the biochemical genetics of lactose digestion is related to the amount and activity of lactase.

Today, lactose malabsorbers who would like to be able to drink milk can purchase various "lactase" preparations now on the market that "digest" the lactose in milk before it is ingested. Others who do not drink milk can overcome the potential dietary calcium deficiency by consuming fermented milks, pressed cheeses, dark-green vegetables, and small bones as in sardines.

The worldwide distribution of an inability to digest lactose after weaning in most human adults and all other mammals argues for this condition to be the normal physiological state. The ability to digest lactose would seem then to be evidence of a genetic polymorphism. It is only the bias of the milk-oriented societies of northern Europe and North America that casts lactose malabsorption as an abnormality.

Norman Kretchmer

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