Which Races Can't Drink Milk? Understanding Lactose Intolerance

November 14, 2025 •

5 min read

It's a common misconception that all humans can digest milk without issue, but approximately 65% of the world's adult population has a reduced ability to digest lactose, the sugar in milk. While the ability to digest milk varies widely across individuals, a person's ancestry and genetic makeup play a significant role in determining who can't drink milk, or at least not without discomfort.

Quick Summary

This article explores the genetic and evolutionary roots of lactose intolerance, examining its prevalence across different ethnic and racial groups. It outlines symptoms, dietary management strategies, and available alternatives for individuals with this condition.

Key Points

Prevalence Varies: Approximately 65% of the world's adult population is lactose intolerant, but this is most prevalent among people of East Asian, African, and Indigenous American descent.
Genetic and Evolutionary Roots: The ability to digest milk into adulthood (lactase persistence) is a genetic mutation that developed in certain populations with a history of dairy farming. This is the exception, not the norm, for the human species.
Not a Race Issue, but an Ancestry One: Lactose intolerance is not tied to race, but rather to ancestral lineage and geographic history. Populations in Northern Europe and some parts of Africa and the Middle East, where dairy farming was prominent, have lower rates.
Intolerance vs. Allergy: Lactose intolerance is a digestive problem caused by the inability to break down the milk sugar lactose, while a milk allergy is an immune system response to milk proteins and can be more severe.
Managed, Not Cured: There is no cure for genetically determined lactose intolerance, but symptoms can be effectively managed by limiting lactose intake, consuming fermented dairy, or using lactase enzyme supplements.
Numerous Alternatives Exist: A wide range of lactose-free dairy products and plant-based milks are available, offering suitable options for anyone needing to avoid lactose.

Lactose Intolerance is the Norm, Lactase Persistence is the Exception

Contrary to popular belief in some Western societies, the natural state for most adult humans is to have some degree of lactose malabsorption. As infants, nearly all mammals produce the enzyme lactase to digest the lactose in their mother's milk. However, after weaning, the production of this enzyme typically declines dramatically. The ability to continue producing lactase into adulthood, a trait known as lactase persistence, is a relatively recent genetic adaptation in humans. This trait evolved independently in several dairy-farming populations across Europe and parts of Africa and the Middle East over the last 10,000 years.

Populations with a long history of cattle domestication and dairy consumption developed this genetic mutation, which provided a significant nutritional advantage, especially in regions with limited food sources or low sunlight. However, the majority of the global population did not evolve this trait and therefore experience lactose malabsorption, which can lead to symptoms of lactose intolerance when consuming fresh dairy.

Prevalence of Lactose Intolerance by Race and Ethnicity

The prevalence of lactose intolerance varies significantly based on ethnic and geographic heritage. The highest rates are found in East Asian populations, while the lowest are among Northern Europeans. It is not a matter of a single race being unable to drink milk, but rather a genetic predisposition being more or less common within certain population groups. The following provides a general overview based on broad categories, but it is important to remember that individual tolerance can vary greatly.

East Asian Descent: This group, including people of Chinese, Japanese, and Korean descent, has some of the highest rates, with studies indicating a prevalence of 90-100%. Historical and geographic factors, including a lack of traditional dairy farming, led to no selective pressure for lactase persistence.
African and African American Descent: Many people of African and African American descent have high rates of lactase nonpersistence, with estimates ranging from 75% to 80%. While some pastoralist groups in East Africa have high lactase persistence due to a long history of cattle herding, this is not representative of all African populations.
Indigenous American Descent: Native Americans and Mexican Americans also have very high rates of lactose intolerance, with some estimates reporting figures as high as 75-100%. Similar to East Asian populations, historical and dietary traditions did not favor the development of lactase persistence.
Hispanic Descent: Rates of lactose intolerance are also high among people of Hispanic origin, often falling between 50% and 80%. This is influenced by a mix of genetic heritages.
Southern European Descent: While lower than in many other groups, lactose intolerance is more prevalent in Southern European populations (e.g., Greek, Italian) compared to Northern Europeans, with rates often around 50%.
Northern European Descent: This group, which includes those of Scandinavian, British, and German ancestry, has the lowest rates of lactase nonpersistence, often cited as low as 5-20%. This is a direct result of strong selective pressure favoring the trait in these historic dairy-farming communities.

Symptoms of Lactose Intolerance

When undigested lactose reaches the large intestine, gut bacteria ferment it, leading to a variety of uncomfortable symptoms. These symptoms can vary in severity depending on the amount of lactose consumed and an individual's level of lactase production. Common signs include:

Bloating and gas
Abdominal pain and cramps
Diarrhea
Nausea and sometimes vomiting

Managing Lactose Intolerance: A Comparison of Options

Individuals can manage their symptoms without completely eliminating dairy from their diet. For many, simply reducing the amount of lactose or choosing certain dairy products is enough. For those with greater sensitivity, alternatives are widely available.


Option	Description	Benefits	Considerations
Limit Dairy Intake	Consume small amounts of lactose-containing foods at a time.	Provides a slow introduction of lactose, allowing the small amount of existing lactase to work more effectively.	Tolerance varies widely; some people need a stricter limit.
Fermented Dairy	Include products like yogurt with live cultures, kefir, and aged hard cheeses (e.g., cheddar, parmesan).	The fermentation process reduces the lactose content. The bacteria in these products also help with digestion.	Some individuals may still react to the remaining lactose, particularly from yogurt.
Lactose-Free Dairy	Standard dairy products treated with lactase to pre-digest the lactose.	Retains the nutritional profile of regular milk (calcium, Vitamin D) but without the digestive side effects.	May not be suitable for those with a milk protein allergy.
Plant-Based Alternatives	Milk-like products made from soy, almond, oat, coconut, or other plant sources.	Completely dairy-free. Fortified versions can provide similar nutritional benefits to milk.	Nutritional content varies greatly; some are lower in protein or higher in sugar.

Can you develop lactose intolerance over time?

Yes, the most common form of lactose intolerance, known as primary lactase nonpersistence, develops gradually as lactase production naturally decreases after childhood. The timing and severity of this decline are genetically determined, which explains why symptoms often begin in adolescence or adulthood. Secondary lactose intolerance, on the other hand, can be caused by diseases or injuries that damage the small intestine, and may be temporary.

What about a milk allergy?

It is crucial not to confuse lactose intolerance with a milk allergy. An allergy is an immune system response to milk proteins (casein or whey), while intolerance is a digestive issue related to the milk sugar, lactose. Symptoms of an allergy can be severe and life-threatening, unlike the discomfort associated with lactose intolerance.

Conclusion

The question "What race can't drink milk?" is based on a misconception, as it's not a matter of racial capability but rather a natural genetic variation in lactase persistence. The overwhelming majority of the world's population, particularly those of East Asian, African, and Indigenous American descent, lose the ability to fully digest lactose after infancy due to a process called lactase nonpersistence. For these individuals, consuming fresh dairy can lead to uncomfortable digestive symptoms. However, the condition can be managed effectively through dietary changes, using lactase supplements, or opting for a wide range of lactose-free and plant-based alternatives. Ultimately, understanding the genetic roots of lactose intolerance empowers individuals to make informed dietary choices that fit their body's needs and heritage.

Frequently Asked Questions

The most common cause of lactose intolerance is primary lactase deficiency, where the small intestine naturally produces less of the enzyme lactase after childhood. Lactase is required to break down lactose, the sugar in milk, for absorption.

Yes, lactose intolerance is more common in people of East Asian, West African, Arab, Jewish, Greek, and Italian descent due to historical and genetic factors tied to dairy consumption patterns. Northern Europeans have the lowest rates.

Many people with lactose intolerance can tolerate small amounts of lactose, especially if consumed with other foods. Fermented dairy products like yogurt and hard cheeses, which have lower lactose content, are also often well-tolerated.

Effective alternatives include lactose-free cow's milk and a variety of plant-based milks made from soy, almond, oat, or coconut. These products can be fortified with calcium and vitamin D.

Yes, it is possible to develop secondary lactose intolerance suddenly due to an illness, injury, or surgery affecting the small intestine. This type can sometimes be temporary if the underlying condition is treated.

No, they are different conditions. Lactose intolerance is a digestive issue caused by the inability to break down lactose, whereas a milk allergy is an immune system reaction to milk proteins and can cause more severe symptoms.

You can get calcium from non-dairy sources such as leafy green vegetables, fortified cereals, and fish with soft bones (like canned salmon). Fortified plant-based milks and calcium supplements can also help meet daily needs.

Oral lactase enzyme pills can be taken just before consuming lactose-containing products to help the body digest the lactose and reduce symptoms. They are a helpful tool for many people with lactose intolerance.