Hidden Burden of Lactose Intolerance in Urban Gujarat: A Cross-Sectional Community Survey

Abstract

Background: Lactose intolerance (LI) is a widespread but underdiagnosed condition in India, particularly in regions with high dairy consumption such as Gujarat. Limited community-level data are available regarding its prevalence, symptom characteristics, and awareness in healthy adults. Methods: A cross-sectional observational study was conducted over three months among healthy adults aged 18 years and above in Vadodara, Gujarat. An electronic questionnaire assessed demographics, dairy consumption habits, gastrointestinal symptoms after dairy intake, awareness, family history, and use of lactose-free or plant-based milk alternatives. Responses from 1,091 eligible participants were analyzed using descriptive statistics and chi-square tests. Results: Regular dairy consumption was reported by 83.1% of participants, with daily intake predominant (56.0%). Discomfort after dairy was reported by 22.1%, most commonly as bloating (10.0%), gas (7.6%), stomach pain (6.8%), nausea (5.2%), and diarrhoea (4.9%). The majority (65.5%) experienced no symptoms. Onset of symptoms was most frequently within several hours after dairy intake. Awareness of LI was reported by 64.5% of respondents; however, only 8.6% documented a family history, and 15.5% believed LI is inherited. Plant-based alternatives were considered by just 18.1%. All frequency parameters and symptom associations were statistically significant (p < 0.001). Conclusion: Lactose intolerance symptoms affect a substantial minority of adults in Vadodara despite high levels of regular dairy consumption. Awareness is moderate but gaps exist in knowledge about genetic inheritance and family recognition. Few individuals adopt lactose-free or plant-based alternatives. Improved public health education, diagnostic access, and dietary options are warranted to address the under recognized burden of LI in western India.