Are Pakistanis Lactose Tolerant? The Surprising Truth About Dairy Digestion

January 12, 2026 •

6 min read

Despite a cultural and culinary reliance on dairy products, research indicates that a significant portion of the Pakistani population is genetically predisposed to lactose malabsorption. So, are Pakistanis lactose tolerant? The answer is often no, creating a widespread and frequently misunderstood digestive challenge for many.

Quick Summary

Over half of adults in Pakistan struggle to digest dairy due to lactose malabsorption, a genetic condition where the body produces insufficient lactase. Symptoms like bloating and gas are common, yet dairy remains a staple in cuisine, necessitating awareness and management strategies.

Key Points

High Prevalence: Studies show over 50% of the adult Pakistani population has lactose malabsorption, meaning they cannot fully digest milk sugar.
Cultural Contradiction: Despite a rich history of dairy consumption in Pakistani cuisine, a genetic predisposition to intolerance is common and often undiagnosed.
Yogurt is Better Tolerated: The fermentation process reduces lactose content, making products like dahi (yogurt) and some cheeses easier to digest than fresh milk.
Modern Alternatives Available: Lactose-free milk, plant-based milks (almond, soy, oat), and lactase enzyme supplements are modern solutions available in the Pakistani market.
Ghee is Generally Safe: As a clarified butter, ghee contains minimal lactose and is usually well-tolerated by individuals with intolerance.
Digestive, Not Allergic: Lactose intolerance is a digestive issue, not an immune-system allergy, and while uncomfortable, it is not life-threatening.
Symptoms Vary by Amount: The severity of symptoms often depends on the amount of lactose consumed. Some people can handle small quantities without discomfort.

Prevalence and the Genetic Predisposition

Contrary to common assumptions, lactose intolerance is widespread throughout South Asia, including Pakistan. A 2022 article in The Juggernaut reported that approximately 58% of the Pakistani population is lactose intolerant. This finding is supported by earlier scientific studies, including a 1983 abstract examining adult Pakistani subjects, which identified 60% as lactose malabsorbers. This high prevalence is a genetic trait known as primary adult-type hypolactasia, which causes a natural decrease in lactase production after infancy. This genetic predisposition means that for many, the ability to digest lactose is not a lifelong trait but one that fades over time.

The Contrast with a Dairy-Rich Diet

The prevalence of lactose intolerance presents a striking contrast with Pakistan's prominent dairy culture. As one of the world's largest milk-producing and consuming nations, dairy is deeply integrated into Pakistani cuisine and daily life. Common foods and drinks featuring dairy include:

Lassi: A yogurt-based drink, often sweetened or salted.
Dahi: Yogurt, consumed plain, in raita, or as a cooling accompaniment.
Kheer: A traditional rice pudding made with milk.
Ghee: Clarified butter used extensively in cooking.
Chai Doodh Patti: Strong milk tea, a national favorite.

This cultural immersion in dairy means many individuals, unaware of their condition, may attribute their discomfort to other issues. This lack of awareness can lead to unnecessary suffering and a reduced quality of life.

Symptoms and Diagnosis

When undigested lactose reaches the large intestine, gut bacteria ferment it, producing gases and drawing water into the colon. This process causes the characteristic symptoms of lactose intolerance, which typically appear anywhere from 30 minutes to a couple of hours after consuming dairy.

Symptoms may include:

Bloating and abdominal distention
Gas (flatulence)
Stomach pain and cramping
Nausea and, in some cases, vomiting
Diarrhea
Gurgling or rumbling sounds in the abdomen

For an accurate diagnosis, a doctor may recommend specific tests, such as a hydrogen breath test, which measures hydrogen levels in the breath after consuming a lactose solution. An elimination diet can also help identify if lactose is the root cause of digestive issues. It is important to differentiate lactose intolerance from a milk protein allergy, which involves the immune system and can cause more severe reactions.

Managing Lactose Intolerance in a Dairy-Rich Culture

Living with lactose intolerance in Pakistan does not require a complete elimination of all dairy. With awareness and strategic adjustments, individuals can manage their symptoms effectively. Fermented dairy products and certain processed options are often better tolerated.

Tolerability of Different Dairy Products


Dairy Product	Tolerability for LI Sufferers	Reason
Fresh Milk	Low	High lactose content; can trigger significant symptoms.
Yogurt (Dahi)	High	The fermentation process converts much of the lactose into lactic acid, making it easier to digest.
Hard Cheese	Medium to High	The cheese-making process and aging remove a large portion of the lactose.
Ghee	Very High	Clarified butter, with nearly all milk solids and lactose removed during processing.
Ice Cream	Low	Typically high in milk solids and sugar, a common trigger for symptoms.

Modern Alternatives and Solutions

As awareness of lactose intolerance grows, so do the available options in Pakistan. Several local and international brands now offer solutions for those with digestive sensitivities.

Lactose-Free Milk: Products like Dayfresh Lactose-Free Milk provide all the nutritional benefits of regular milk without the lactose. This is a convenient alternative for everyday use, from tea to cooking.
Plant-Based Milks: A growing market offers alternatives made from nuts and grains, such as almond, soy, and oat milk. These are naturally lactose-free and suitable for those seeking non-dairy options.
Lactase Supplements: These oral supplements contain the enzyme lactase, which helps break down lactose. Taken before a meal, they can allow individuals to consume dairy with fewer symptoms.
Gradual Reintroduction: Some individuals can build tolerance by gradually introducing small amounts of dairy. This can help the gut adapt over time and reduce sensitivity.

Conclusion

To answer the question, are Pakistanis lactose tolerant?, the evidence strongly suggests that a majority of the adult population is not. While the high prevalence of lactose malabsorption may be surprising given the centrality of dairy in Pakistani cuisine, it highlights a crucial public health issue. By raising awareness, individuals can identify the root cause of their digestive discomfort and adopt effective management strategies, from choosing fermented products and ghee to exploring modern alternatives. This shift towards informed dietary choices can significantly improve the health and well-being of many Pakistanis who currently suffer in silence.

For more information on digestive disorders, including lactose intolerance, the Aga Khan University Hospital provides useful resources on its website.

Key Takeaways

Lactose Malabsorption is Common: Over 50% of the adult population in Pakistan has a reduced ability to digest lactose.
Cultural Discrepancy: This high prevalence exists despite dairy being a staple in traditional Pakistani cuisine, leading to widespread but often undiagnosed digestive issues.
Fermented Dairy is Easier: Products like yogurt (dahi) and hard cheeses are often better tolerated due to a lower lactose content resulting from fermentation.
Modern Alternatives Exist: Lactose-free milk, plant-based milks, and lactase enzyme supplements are readily available to help manage symptoms.
Misconceptions Are Problematic: A lack of awareness means many mistake their symptoms for other digestive problems rather than identifying lactose intolerance.
Ghee is Safe: Clarified butter (ghee) is virtually lactose-free and safe for consumption by those with lactose intolerance.
Not an Allergy: It is crucial to remember that lactose intolerance is a digestive issue, not an immune system-based allergy.

FAQs

Question: What is lactose intolerance? Answer: Lactose intolerance is a digestive condition in which your body cannot properly digest lactose, the sugar found in milk and dairy products. It is caused by a deficiency of the enzyme lactase.

Question: What are the common symptoms of lactose intolerance in Pakistan? Answer: Common symptoms include bloating, gas, stomach pain, diarrhea, and nausea, which occur after consuming dairy products.

Question: Can Pakistanis who are lactose intolerant still consume dairy? Answer: Many lactose-intolerant Pakistanis can still consume some dairy, especially fermented products like yogurt or lactose-free alternatives. The tolerance level varies by individual.

Question: Is ghee safe for someone who is lactose intolerant? Answer: Yes, ghee is generally safe for people with lactose intolerance. It is clarified butter, and the clarification process removes the milk solids and almost all the lactose.

Question: How is lactose intolerance diagnosed? Answer: Diagnosis can involve an elimination diet, where dairy is temporarily removed and then reintroduced. A doctor may also recommend a hydrogen breath test to confirm the condition.

Question: Are there alternatives to dairy milk available in Pakistan? Answer: Yes, alternatives are widely available, including lactose-free cow's milk from brands like Dayfresh and various plant-based milks such as almond, soy, and oat milk.

Question: Is lactose intolerance the same as a milk allergy? Answer: No, they are different conditions. A milk allergy involves the immune system reacting to milk proteins, while lactose intolerance is a digestive issue caused by the inability to break down the milk sugar, lactose.

Question: Can lactose intolerance cause other health issues? Answer: Untreated lactose intolerance is not life-threatening but can lead to long-term issues like nutritional deficiencies (particularly calcium and Vitamin D), potentially affecting bone health.

Question: Does the amount of dairy consumed affect symptoms? Answer: Yes, the severity of symptoms is often dose-dependent. A person with lactose intolerance might tolerate a small amount of dairy but experience symptoms with a larger quantity.

Question: How can I manage my lactose intolerance without giving up my favorite Pakistani dishes? Answer: You can use lactose-free milk for chai, opt for traditional ghee in cooking, and choose fermented items like well-made dahi. For sweets like kheer, lactose-free milk can be used as a substitute.

Frequently Asked Questions

Lactose intolerance is a digestive condition in which your body cannot properly digest lactose, the sugar found in milk and dairy products. It is caused by a deficiency of the enzyme lactase.

Common symptoms include bloating, gas, stomach pain, diarrhea, and nausea, which occur after consuming dairy products.

Many lactose-intolerant Pakistanis can still consume some dairy, especially fermented products like yogurt (dahi) or lactose-free alternatives. The tolerance level varies by individual.

Yes, ghee is generally safe for people with lactose intolerance. It is clarified butter, and the clarification process removes the milk solids and almost all the lactose.

Diagnosis can involve an elimination diet, where dairy is temporarily removed and then reintroduced. A doctor may also recommend a hydrogen breath test to confirm the condition.

Yes, alternatives are widely available, including lactose-free cow's milk from brands like Dayfresh and various plant-based milks such as almond, soy, and oat milk.

No, they are different conditions. A milk allergy involves the immune system reacting to milk proteins, while lactose intolerance is a digestive issue caused by the inability to break down the milk sugar, lactose.

Untreated lactose intolerance is not life-threatening but can lead to long-term issues like nutritional deficiencies (particularly calcium and Vitamin D), potentially affecting bone health.

Yes, the severity of symptoms is often dose-dependent. A person with lactose intolerance might tolerate a small amount of dairy but experience symptoms with a larger quantity.

You can use lactose-free milk for chai, opt for traditional ghee in cooking, and choose fermented items like well-made dahi. For sweets like kheer, lactose-free milk can be used as a substitute.