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Home » Culinary Geography, Cultural Geography, Genetics, World

Global Geography of Milk Consumption and Lactose (In)Tolerance

Submitted by on March 11, 2013 – 9:07 pm 22 Comments |  
Milk-Comsumption-per-CapitaTo follow up on the recent GeoNote on wine, beer, and cider consumption in France in 1870s, let’s consider the worldwide spatial patterns of another drink—milk. To North Americans and especially Europeans, both drinking and eating dairy products is very common, but this is far from the global norm, as can be seen in the map reposted on the left from Nordic countries, such as Finland and Sweden, top the list of milk consumption per capita, with over 350 kg (770 lbs) of dairy per person per year. Much of the dairy consumed in these countries is in the form of milk, though Finland is the leading consumer of ice cream in Europe, with 13.7 liters per person in 2003. The third spot in the list of milk-loving countries is occupied by the Netherlands, which ranks as the 5th top cheese producer, the 3rd top cheese exporter, and the 6th top cheese consumer. Among the other top ten dairy consuming countries are such cheese-loving countries as Greece and Switzerland (ranking #1 and #5 in the list of cheese consumption, respectively). I was surprised that Norway placed a mere 13th in dairy consumption, as milk is a common drink there, and ice cream is a popular dessert, even in the coldest winter months. Cheeses too are a favorite as part of the Norwegian breakfast spread, lunch or supper, though the traditional sweet geitost (or brunost, “brown cheese”, which is not a true cheese, but rather caramelized lactose from goat milk or a mix of goat and cow milk) is an acquired taste: the best description I can give is “a cross between mozzarella and butterscotch candy”. The high fat and sugar content of geitost was responsible for the ferocious cheese fire in January 2013 that destroyed Brattli Tunnel near Tysfjord in northern Norway.

The highest ranking non-European country by dairy consumption is Kazakhstan, which ranks #13 with over 260 kg (573 lbs) of milk per capita. For centuries, Kazakhs were herders who raised fat-tailed sheep, Bactrian camels, and horses, relying on these animals for transportation, clothing, and food, in the form of both meat and dairy. Because of their traditional nomadic way of life, the Kazakh prefer sour milk, as it is easier to save. It is drank plain or with tea, and is often added to other dishes, such as soups. Butter, sour cream, and irimzhik, which resembles cottage cheese, are popular as well. Outside of Eurasia, United States ranks #16, Australia #24, Argentina #28, and Canada closes off the list of the top 30 dairy consuming countries (all other countries among the top 30 are in Europe).

lactose-intolerance-mapLactose intoleranceGlobal-Lactose-Intolerance

This mostly Eurocentric pattern of milk consumption can be partially explained by the spatial distribution of lactose (in)tolerance, or more precisely lactase persistence. The term “lactose intolerance” refers to any form of allergy to lactose, the form of sugar found in milk, while “lactase persistence” means the continued activity of the enzyme lactase in adulthood. In early humans, as in most mammal species, the activity of the enzyme was dramatically reduced after weaning. However, in some populations lactase persistence has evolved as an adaptation to the consumption of non-human milk and other dairy products beyond infancy. The majority of people around the world remain lactase non-persistent, and consequently are affected by varying degrees of lactose intolerance as adults (although the correlation between genetically transmitted lactase persistence and lactose intolerance is not perfect). Most maps on the subject, such as the ones reproduced on the left, represent the spatial distribution of lactose intolerance rather than lactase persistence, though the two notions are often confused. While the figures differ from source to source, the overall pattern is the same, and it complements closely the pattern of global dairy consumption, illustrated above: countries with high levels of lactose intolerance, especially in sub-Saharan Africa, South and East Asia, are also low in dairy consumption. As can be seen from some of these maps, in the U.S. the levels of lactose (in)tolerance differ by race, with Caucasians being most lactose tolerant, followed by Hispanics and African Americans; Native Americans are said to have the highest levels of lactose intolerance.

Tyrolean Iceman

Since these differences are thought to have been caused by recent natural selection favoring lactase-persistent individuals in cultures in which dairy products are available as a food source (cf. Beja-Pereira et al. 2003), it was first hypothesized that populations in Europe, India, and parts of Africa had high frequencies of lactase persistence because of a particular mutation. More recently, it has been shown that lactase persistence is caused by several independently occurring mutations (cf. Ingram et al. 2009). But even in populations that have eventually developed some degree of lactase persistence, the relevant mutations and consequently the ability to consume dairy products did not spread quickly, nor did they affect the entire populations. For example, the Tyrolean Iceman (see image on the left), who lived several millennia after the arrival of agriculture to southern Europe, was genetically lactose intolerant (cf. Keller et al. 2012). To this day, southern Europe has higher levels of lactose intolerance than northern Europe, though agriculture developed earlier in the south than in the north. Moreover, the Fertile Crescent, where agriculture is said to have originated with the domestication of several plant and animal species, remains highly lactose intolerant.



Beja-Pereira A et al. (2003) Gene-culture coevolution between cattle milk protein genes and human lactase genes. Nat Genet 35: 311−313.

Ingram CJ, Mulcare CA, Itan Y, Thomas MG, Swallow DM (2009) Lactose digestion and the evolutionary genetics of lactase persistence. Hum Genet. 124(6): 579-91.

Keller, A.; A. Graefen; M. Ball; M. Matzas; V. Boisguerin; F. Maixner; P. Leidinger; C. Backes; R. Khairat; M. Forster; B. Stade; A. Franke; J. Mayer; J. Spangler; S. McLaughlin; M Shah; C. Lee; T. Harkins; Al. Sartori; A. Moreno-Estrada; B. Henn; M. Sikora; O. Semino; J. Chiaroni; S. Rootsi; N. Myres; V. Cabrera; P. Underhill; C. Bustamante; E. Egarter Vigl; M. Samadelli; G. Cipollini; J. Haas; H. Katus; B. O’Connor; M. Carlson; B. Meder; N. Blin; E. Meese; C. Pusch; & A. Zink (2012) New insights into the Tyrolean Iceman’s origin and phenotype as inferred by whole-genome sequencing. Nature Communications. DOI: 10.1038/ncomms1701


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  • Peter Rosa

    It is surprising that India has a fairly high rate of lactose intolerance, given the ubiquity of paneer and ghee, among much else, in Indian cuisine.


    • Asya Pereltsvaig

      excellent question, Peter! Ghee, being clarified butter, contains virtually no lactose, only fat. Perhaps its use was developed precisely because of low lactose tolerance… As for paneer, I’m not totally sure, but typically curdled cheeses have little lactose too, as lactose remains in the whey.

      • Gaurang Karmakar

        Paneer is essentially “congealed milk” in pure scientific terms; it is the most easily manufactured cheese ever! All ones does is heat milk in a vessel and pour easily available acidic liquids (lemon juice, vinegar etc.). Animal proteins always coagulate when heated and coagulate quicker when an acid is used as a catalyst. The lactose does remain in the whey, as lactose intolerant Indians like me will tell you!

        • Asya Pereltsvaig

          Thanks for clarifying matters, Gaurang! Paneer appears to be much like the Russian “tvorog” that my mother used to make…

          • Gaurang Karmakar

            Tvorog! Just looked it up on Wikipedia; it is classified under Quark (cottage cheese or curd cheese).

          • Asya Pereltsvaig

            I am not sure about Quark, but TVOROG is certainly not like cottage cheese!

          • James T. Wilson

            I have seen both paneer and tvorog usually referred to as farmer cheeses in foodie publications. That term seems to be used for any sort of freshly curdled milk that is pressed to remove the whey. Cottage cheese is usually left as loose curds and is washed, but I don’t know if there are other differences. The culinary magazines tend to use the term farmer cheese, though, of something one is going to make at home.

          • Asya Pereltsvaig

            I guess then we were farmers in St. Petersburg :)

  • RightPaddock

    Two of the maps are not linked to the bigger versions

    • Asya Pereltsvaig

      Thanks for your comments and the links. And for pointing out the problem with the maps—I’ve fixed that now.

      As for the “Indian cuisine”, you are absolutely right that it’s a collection of varied cuisines rather than one uniform cuisine. Same about “Chinese cuisine”. I am not even sure if there are any overarching culinary sensibilities that are shared by all the Indians/Chinese… I am toying with the idea of doing posts on both “Indian cuisine” and “Chinese cuisine”, so stay tuned…

      • RightPaddock

        Look forward to that

        “How the Chilli Conquered Asia” could be an interesting topic.

        • Asya Pereltsvaig

          Indeed. I’ve not thought of that—thanks for the suggestion!

  • Frederico Freitas

    This might be a problem with the way the original data was agregated, but is important to remember that “Hispanic” is not a “race” (not in the sense of a phenotype or a shared genetic ancestry). It is an ethnonym usually almost exclusively in the U.S. and it can include a wide variety of people. The U.S. census classifies people under (problematic) racial categories (white, black, etc.) and then, on top of that, classifies them under general Hispanic/non-Hispanic ethnic labels. Of course one can question such racial and ethnic categories, but for the sake of clarity, specially when the issue is genetic traits that are not universal among human populations, it is better to avoid conflating the two.

    • Asya Pereltsvaig

      That’s an excellent point, Frederico! Thanks for bringing it up. Indeed, Hispanics probably shouldn’t be aggregated when it comes to genetic traits such as lactase persistence. Most studies I’ve seen actually look at differences between African-Americans and Caucasian Americans…

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  • Evan (PolGeoNow)

    These generalizations about lactose intolerance have always confused me. I’ve lived in Taiwan for almost four years, and although cheese is generally sparse, grocery stores are stocked with multiple shelves of different brands and flavors of milk (chocolate, strawberry, papaya, etc.). Eating pizza and ice cream and drinking lattes and cappuccinos are both normal among upper middle class people, if not as common as in the U.S., and milk tea is very common (I’m told a lot of it is made with non-dairy creamer, but that’s presented as a dodgy cost-saving measure rather than concern for customers’ digestion).

    And yet I’ve never even heard my friends here talk about feeling bad after consuming dairy products, despite these maps claiming that over 90% of people are lactose intolerant. What’s going on? It makes me wonder where the data is coming from. Is it possible that we have the causation backwards, and countries with historically low dairy consumption just have much lower thresholds for declaring someone “lactose intolerant”?

    • Asya Pereltsvaig

      Yeah, I don’t have a good explanation for it, except that “lactose intolerance” seems to be a gradable property, so some lactose might work for many people who are “lactose intolerant”, but they would have a limit on how much of it they can ingest, I suppose.

      • Evan (PolGeoNow)

        I’ve been thinking about it, and I think maybe the most plausible explanation is just that “lactose intolerance” is being defined across the board much more liberally than we think of it in popular culture. In other words, it must be generally a lot milder than what I grew up thinking of as lactose intolerance, such that even these “lactose intolerant” people are able to handle a fair amount of dairy products without problem. I think we do eat even more dairy products in the U.S. (by a long shot), and perhaps that much higher volume would be noticeably disagreeable to people without the persistence genes. Though my Taiwanese friends don’t complain about having problems in the U.S. either…

  • Karina

    Studpid mention of ‘hispanics’ as a race. People from Latin American countries are from different races and they do not form a race. It’s unbelievavle the stupidity that Americans live with.

    • Asya Pereltsvaig

      It is hardly stupid of us to mention hispanics in this context: this is how demographic data is categorized and that’s how we discuss it. The issue of race is extremely complicated, and different categories are accepted in different parts of the world. No more stupid than the use of “Americans” to mean people from the US rather than from the Americas (something another reader has complained not long ago!).

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  • uncleben

    one look at this article and i can easily say this is flawed in many. it brings the question if this is based on any research or proper research. throughout my carrier i’ve seen thousands of scholars taking shortcuts in surveys by either just filling in random data or manipulating data to support thier facts. many of the surveyers are underqualified and unskilled but still do it or made to do it becuase of various reasons.

    • Asya Pereltsvaig

      Before you make accusations of this sort, perhaps you should make sure you are on a firm ground there. Any specific data that you think are faulty?

  • Ocea

    Mongolians have very high lactose tolerance. Since their tradition diets are only meat and diary. But there is no data from Mongolia and the only data available is from Inner Mongolia. More than 80% of Inner Mongolian population is chinese. So this graphics are very wrong.