Full-text of the article is available for this language: Español.
Dietary guidelines universally recommend the consumption of 2–3 daily servings of dairy products, without considering regional population-level genetic variation. In the province of Jujuy, Argentina, genetic evidence documents between 53% and 69% Indigenous ancestry in the general population, suggesting a high prevalence of primary hypolactasia. This essay analyzes the disconnection between universal nutritional policies and the genetic composition of populations with high Indigenous ancestry through four analytical axes: 1) hypolactasia as the global majority condition (affecting 65%–70% of the world population) and the cultural mediations surrounding dairy consumption; 2) the historical trajectories of dairy policies in Latin America since the mid-twentieth century, documenting how scientific research since the 1960s identified high prevalences of hypolactasia in Latin American populations; 3) food practices within health and educational institutions in Jujuy, documenting how the systematic rejection of liquid milk is conceptualized as a cultural-educational rather than a physiological phenomenon; and 4) the design of culturally situated public nutritional policies. The analysis shows that, half a century after the scientific literature identified this phenomenon, Argentine policies continue to naturalize the minority European metabolic pattern as a universal norm. The article proposes the development of a supplement to the national dietary guidelines for Jujuy that explicitly acknowledges population genetic diversity and offers multiple pathways to meet calcium requirements, following the model of other Argentine public health interventions based on population prevalences.
Keywords: Lactose Intolerance, Genetic Variation, Nutrition Programs and Policies, Indigenous Peoples, Food Guide, Argentina
Categories: Anthropology, Feeding, Policies
Funding: Agencia Nacional de Promoción Científica y Tecnológica | PICTO-2017-0111 , Consejo Nacional de Investigaciones Científicas y Técnicas
Full-text of the article is available for this language: Español.
1. Alzate H, Ramírez E, Echeverry MT. Intolerancia a la lactosa en un grupo de estudiantes de medicina. Antioquia Médica. 1968;18:237-246.
2. Alzate H, González H, Guzmán J. Lactose intolerance in South American Indians. American Journal of Clinical Nutrition. 1969;22(1):122-123.
Crossref
| Google Scholar
3. Vasconcellos D, Gonçalves A. Deficiência de lactase en adultos. Arquivos de Gastroenterologia. 1968;5:159-164.
4. Bayless TM, Rosensweig NS. A racial difference in incidence of lactase deficiency: A survey of milk intolerance and lactase deficiency in healthy adult males. JAMA. 1966;197(12):968-72.
Crossref
| Google Scholar
5. Paige DM, Bayless TM, Ferry GD, Graham GG. Lactose malabsorption and milk rejection in Negro children. Johns Hopkins Medical Journal. 1971;129(4):163-169.
6. Torún B, Solomons NW, Viteri FE. Lactose malabsorption and lactose intolerance: implications for general milk consumption in Latin America. Archivos Latinoamericanos de Nutrición. 1979;29(4):445-494.
7. Argentina, Ministerio de Salud. Guías Alimentarias para la Población Argentina [Internet]. 2016 [citado 10/09/2025]. Disponible en: https://tinyurl.com/3ze9yfz7
8. Alfaro EL, Dipierri JE, Gutierrez NI, Vullo CM. Genetic structure and admixture in urban populations of the Argentine North-West. Annals of Human Biology. 2005;32(6):724-737.
Crossref
| Google Scholar
9. Toca MC, Fernández A, Orsi M, Tabacco O, Vinderola G. Intolerancia a la lactosa: mitos y verdades, Actualización. Archivos Argentinos de Pediatría. 2022;120(1):59-66.
Crossref
| Google Scholar
10. Instituto Nacional de Estadística y Censos (INDEC). Censo Nacional de Población, Hogares y Viviendas 2022: Resultados definitivos: pueblos indígenas u originarios [Internet]. Buenos Aires: Instituto Nacional de Estadística y Censos; 2024 [citado 10/09/2025]. Disponible en: https://tinyurl.com/muh77c78
11. Demarchi DA, Claria DM, Dipierri JE, Gardenal CN. Genetic structure of native Andean populations from Argentina inhabiting different altitudes. Human Biology. 2000;72(3):519-525.
12. Cardoso S, Palencia-Madrid L, Valverde L, Alfonso-Sanchez MA, Gomez-Perez L, Alfaro E, et al. Mitochondrial DNA control region data reveal high prevalence of Native American lineages in Jujuy province, NW Argentina. Forensic Science International: Genetics. 2013;7(3):e52-55.
Crossref
| Google Scholar
13. Guimarães Alves AC, Sukow NM, Adelman Cipolla G, Mendes M, Leal TP, Petzl-Erler ML, et al. Tracing the distribution of European lactase persistence genotypes along the Americas. Frontiers in Genetics. 2021;12:671079.
Crossref
| Google Scholar
14. Paim JS. Desafíos para la salud colectiva en el siglo XXI. Remedios de Escalada: De la UNLa - Universidad Nacional de Lanus; 2021.
Crossref
| Google Scholar
15. Williams GC, Nesse RM. The dawn of Darwinian medicine. Quarterly Review of Biology. 1991;66(1):1-22.
Crossref
| Google Scholar
16. Mignolo WD. La colonialidad a lo largo y a lo ancho: el hemisferio occidental en el horizonte colonial de la modernidad. En: Lander E, (ed.). La colonialidad del saber: eurocentrismo y ciencias sociales, Perspectivas latinoamericanas. Buenos Aires: CLACSO, UNESCO; 2000. p. 55-85.
17. Gerbault P, Roffet-Salque M, Evershed RP, Thomas MG. How long have adult humans been consuming milk? IUBMB Life. 2013;65(12):983-990.
Crossref
| Google Scholar
18. Ségurel L, Bon C. On the evolution of lactase persistence in humans. Annual Review of Genomics and Human Genetics. 2017;18:297-319.
Crossref
| Google Scholar
19. Mattar R, de Campos Mazo DF, Carrilho FJ. Lactose intolerance: diagnosis, genetic, and clinical factors. Clinical & Experimental Gastroenterology. 2012;5:113-121.
Crossref
| Google Scholar
20. Martini MC, Savaiano DA. Reduced intolerance symptoms from lactose consumed during a meal. American Journal of Clinical Nutrition. 1988;47(1):57-60.
Crossref
| Google Scholar
21. Savaiano DA, AbouElAnouar A, Smith DE, Levitt MD. Lactose malabsorption from yogurt, pasteurized yogurt, sweet acidophilus milk, and cultured milk in lactase-deficient individuals. American Journal of Clinical Nutrition. 1984;40(6):1219-1223.
Crossref
| Google Scholar
22. Hertzler SR, Clancy SM. Kefir improves lactose digestion and tolerance in adults with lactose maldigestion. Journal of the American Dietetic Association. 2003;103(5):582-587.
Crossref
| Google Scholar
23. Fernández CI, Montalva N, Arias M, Hevia M, Moraga ML, Flores SV. Lactase non-persistence and general patterns of dairy intake in indigenous and mestizo Chilean populations. American Journal of Human Biology. 2016;28(2):213-219.
Crossref
| Google Scholar
24. Paz-Y-Miño C, Burgos G, López-Cortés A, Herrera C, Gaviria A, Tejera E, et al. A study of the molecular variants associated with lactase persistence in different Ecuadorian ethnic groups. American Journal of Human Biology. 2016;28(6):774-781.
Crossref
| Google Scholar
25. Gaudin RGN, Figueiro G, Flores-Gutiérrez S, Mut P, Vega-Requena Y, Luna-Andrada L, et al. DNA polymorphisms associated with lactase persistence, self-perceived symptoms of lactose intolerance, milk and dairy consumption, and ancestry, in the Uruguayan population. American Journal of Human Biology. 2023;35(6):e23868.
Crossref
| Google Scholar
26. Friedrich DC, Santos SE, Ribeiro-dos-Santos ÂK, Hutz MH. Several different lactase persistence associated alleles and high diversity of the lactase gene in the admixed Brazilian population. PLoS One. 2012;7(9):e46520.
Crossref
| Google Scholar
27. United States Department of Agriculture, Economic Research Service. Fluid Milk Consumption Continues Downward Trend, Proving Difficult to Reverse [Internet]. 2022 [citado 11/09/2025]. Disponible en: https://tinyurl.com/bd57za32
28. Behera S. How is milk utilisation trending in the UK? [Internet]. Agriculture and Horticulture Development Board; 2024 [citado 10/09/2025]. Disponible en: https://tinyurl.com/4vz8ux8y
29. United States Department of Agriculture, Economic Research Service. Dairy Data [Internet]. 2025 [citado 10/09/2025]. Disponible en: https://tinyurl.com/mw3xmft5
30. Scrimshaw NS, Murray EB. The acceptability of milk and milk products in populations with a high prevalence of lactose intolerance. American Journal of Clinical Nutrition. 1988;48(4 Suppl):1079-1059.
Crossref
| Google Scholar
31. Brinkmann S, Buschini J. Presentación. La “cuestión de la leche” en América Latina: expertos, mercados y políticas públicas en el siglo XX. História, Ciência & Saúde-Manguinhos. 2021;28(4):1161-1164.
Crossref
| Google Scholar
32. Reyna C. “Mejor nutrición no significa necesariamente más comida”: educación alimentaria y fomento agrícola en Argentina (1960-1970). Revista Ciencias de la Salud. 2023;21(2):1-21.
Crossref
| Google Scholar
33. Argentina, Gobierno de Jujuy. Ley 5343: Plan Social Nutricional Provincial (PLASONUP) [Internet]. 2003 [citado 10/09/2025]. Disponible en: https://tinyurl.com/mupd8efd
34. Food and Agriculture Organization, World Health Organization. Preparation and use of food-based dietary guidelines: Report of a joint FAO/WHO consultation [Internet]. Geneva: WHO; 1998 [citado 10/09/2025]. Disponible en: https://tinyurl.com/5ycsf59j
35. Food and Agriculture Organization, World Health Organization. Human vitamin and mineral requirements: Report of a joint FAO/WHO expert consultation, Bangkok, Thailand [Internet]. Rome: FAO; 2001 [citado 10/09/2025]. Disponible en: https://tinyurl.com/47r54p4b
36. Winham DM. Culturally Tailored Foods and Cardiovascular Disease Prevention. American Journal of Lifestyle Medicine. 2009;3(1 Suppl):64S-68S.
Crossref
| Google Scholar
37. Vincze L, Wilson A, Burgess C, Strugnell C, Lee A, Brimblecombe J. Cultural adaptation of health interventions including a nutrition component in Indigenous peoples: a systematic scoping review. International Journal for Equity in Health. 2021;20(1):125.
Crossref
| Google Scholar
38. Mozaffarian D, Rosenberg I, Uauy R. History of modern nutrition science—implications for current research, dietary guidelines, and food policy. BMJ. 2018;361:k2392.
Crossref
| Google Scholar
39. Kuhnlein HV, Erasmus B, Spigelski D, Burlingame B. Indigenous peoples’ food systems and wellbeing: Interventions and policies for healthy communities [Internet]. FAO; 2013 [citado 10/09/2025]. Disponible en: https://tinyurl.com/mu96znsn
40. Browne J, Gilmore M, Lock M, Backholer K. First Nations peoples’ participation in the development of population-wide food and nutrition policy in Australia: a political economy and cultural safety analysis. International Journal of Health Policy and Management. 2020;10(12):871-885.
Crossref
| Google Scholar
41. Elliott B, Jayatilaka D, Brown C, Varley L, Corbett KK. “We are not being heard”: Aboriginal perspectives on traditional foods access and food security. Journal of Environmental and Public Health. 2012:130945.
Crossref
| Google Scholar
42. Haraway DJ. Situated knowledges: The science question in feminism and the privilege of partial perspective. Feminist Studies. 1988;14(3):575-599.
Crossref
| Google Scholar
43. Nazarea VD. Ethnoecology: Situated knowledge/located lives. Tucson: University of Arizona Press; 1999.
Crossref
| Google Scholar
44. Carrasco E, Soto JL. Importancia de los granos andinos. En: Rojas W, Soto JL, Pinto M, Jäger M, Padulosi S, (eds.). Granos Andinos: avances, logros y experiencias desarrolladas en Quinua, Canihua y Amaranto en Bolivia. Roma: Biodiversity International; 2010. p. 6-10.
45. Repo-Carrasco R, Espinoza C, Jacobsen SE. Nutritional value and use of the Andean crops quinoa (Chenopodium quinoa) and kañiwa (Chenopodium pallidicaule). Food Reviews International. 2003;19(1–2):179–189.
Crossref
| Google Scholar
46. Ayala G. Aporte de los cultivos andinos a la nutrición humana. En: Seminario J, (ed.). Raíces Andinas: Contribuciones al conocimiento y a la capacitación. Lima: Centro Internacional de la Papa; 2004. p. 101-112.
47. Argentina. Ley 17259: La sal para uso alimentario humano o animal, deberá ser enriquecida con yodo [Internet]. 1967 [citado 10/09/2025]. Disponible en: https://tinyurl.com/df7btpu5
48. López Linares S, Martín Heer I. Contenido de yodo en sal a nivel de puestos de venta provenientes de distintas localidades en tres regiones argentinas. Revista Argentina de Endocrinología y Metabolismo. 2014;51(2):48-54.
49. Argentina. Ley 25630: Anemias y malformaciones del tubo neural [Internet]. 2002 [citado 10/09/2025]. Disponible en: https://tinyurl.com/mvkb7udt
50. Calvo EB, Biglieri A. Impacto de la fortificación con ácido fólico sobre el estado nutricional en mujeres y la prevalencia de defectos del tubo neural. Archivos Argentinos de Pediatría. 2008;106(6):492-498.
51. Rose G. Sick individuals and sick populations. International Journal of Epidemiology. 2001;30(3):427-432.
Crossref
| Google Scholar