More risk of osteoporosis in lactase persistent populations?

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In summary, the conversation discusses the confusion between lactose intolerance and lactase non-persistence in relation to dairy consumption. The speaker mentions a paper that suggests a high prevalence of lactase non-persistence in pre-agricultural populations and questions the amount of calcium needed in diets without dairy. They also mention another paper that proposes a co-evolution of a mechanism to adapt to lactase persistence, potentially leading to higher rates of osteoporosis in lactase persistent populations. The speaker asks if anyone has further knowledge or experience in this topic and considers the potential implications for public health.
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Graeme M
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Lactose intolerance and lactase non-persistence are frequently confused when people talk about the effects of dairy in human diets. We often see mention of how 75% of the global population may be lactose intolerant when in fact what is meant is lactase non-persistent.

The curious thing about this is that lactase non-persistence was probably typical prior to agriculture and in fact is typically the case for many people today. This raises the question of just how much calcium people really need in their diets given that a lack of dairy in pre-agricultural populations would have meant that much lower levels of calcium would have been available dietarily. I recently came across this interesting paper that talks about this exact possibility. The author has compared osteoarthritis rates worldwide and noted they are highest in populations who consume the most milk. She has also compared the genetic profile of East and West African populations and found that lactase persistent (LP) groups present the highest disease rates whilst lactase non-persistent (LNP) groups the lowest.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4926535/

A related paper discusses this finding and proposes a hypothesis to explain how this may be - the proposal is what the authors have termed the derived calcium homeostasis mechanism. Essentially, they argue for a co-evolution of this mechanism along with the genetic adaptation to lactase persistent and outline just why LP populations may be at higher risk of osteoporosis. Conversely, LNP populations may retain the ancestral mechanism and require far less calcium in their diets than is usually recommended.

https://cedar.wwu.edu/orwwu/vol7/iss1/6/

I am wondering if anyone is familiar with this research and whether further work has been done around this? Is there anyone with experience in this field who might be able to comment on the proposals?
 
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It is certainly an interesting idea and one that could have implications for public health policy.
 

1. What is lactase persistence and how does it relate to osteoporosis risk?

Lactase persistence is the ability to digest lactose, the sugar found in milk and other dairy products, into adulthood. This trait is most commonly found in populations with a long history of dairy farming. Studies have shown that individuals with lactase persistence may have a higher risk of developing osteoporosis due to their increased intake of dairy products, which can lead to excess calcium loss from the bones.

2. Are there any other factors that contribute to the increased risk of osteoporosis in lactase persistent populations?

While dairy intake is a major factor, other lifestyle and genetic factors can also contribute to the risk of osteoporosis in lactase persistent populations. These include low vitamin D levels, lack of physical activity, and genetic predisposition to bone loss.

3. Is there a difference in osteoporosis risk between lactase persistent populations and non-lactase persistent populations?

Research has shown that there is a significant difference in osteoporosis risk between these two populations. Lactase persistent populations have a higher prevalence of osteoporosis and related fractures due to their higher dairy intake and potential for excess calcium loss.

4. Can individuals with lactase persistence reduce their risk of osteoporosis?

While lactase persistence is a genetic trait, individuals can still take steps to reduce their risk of osteoporosis. This includes maintaining a balanced and varied diet, including calcium-rich foods other than dairy, getting enough vitamin D, and engaging in regular weight-bearing exercise.

5. Are there any benefits to lactase persistence despite the increased risk of osteoporosis?

Yes, there are potential benefits to lactase persistence, such as increased calcium and vitamin D intake, which can have positive effects on bone health. Additionally, dairy products provide other essential nutrients like protein and potassium. However, it is important to balance these benefits with a healthy lifestyle to mitigate the increased risk of osteoporosis.

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