Waking up to the scent of a traditional Vietnamese breakfast is distinct from that of a typical American breakfast. Yogurt, milk, cheese omelets or other dairy-containing dishes are replaced by the fragrant aromas of phô, rice, soybean milk, tropical fruits and perhaps small pastries reminiscent of French influence. After all, cow’s milk was not easily obtained in Vietnam.

But why is it that even today, in a land thousands of miles from their native homeland and from the birthplace of their parents, Vietnamese Americans are still reluctant to accept typical American breakfast foods as a staple of their diet? Is it because Vietnamese taste buds reject the popular treats of American acculturation?

Considering the obesity problem that currently plagues our nation—which is not exclusive to Asian Americans—it would be difficult to convince anyone that Vietnamese children somehow escaped the genius tactics of the advertisement industry in the “good ol’ U.S. of A.” Subsequently, the traditional Vietnamese diet is a deficient source of calcium and vitamin D, hence increasing the risk for osteoporosis via lactose intolerance.

Over half of the world’s population is lactose intolerant, with some sources citing up to over 90 percent of Vietnamese and Vietnamese Americans suffering from some degree of lactose intolerance.

While seemingly benign in nature, lactose intolerance can indirectly cause anxiety, embarrassment, dehydration and malnutrition. Symptoms range from mere flatulence and upset stomach to diarrhea and vomiting. Affected individuals experience these soon after ingestion of lactose-containing foods and drinks.

Normally, the body is able to break down the sugar lactose into simpler sugars via an enzyme found in the lining of the small bowel. Those who are lactose intolerant have decreased, or in rare cases, absent ability to break down lactose due to reduced levels of activity of the enzyme, and the undigested lactose travels quickly to the large intestine where it acts as a laxative and causes diarrhea.

An article published on www.usa today.com in 2003 revealed that actor Dustin Nguyen, most well-known for his roles in 21 Jump Street and V.I.P., struggled silently with lactose intolerance as a child and was self-diagnosed as an adult. A majority of Vietnamese and Vietnamese Americans do not seek medical diagnosis and treatment of the condition, because of the discomfort they feel discussing flatulence or because they do not even consider it a medical disorder. Most figure out that a diet low in, or avoiding, lactose products provides the sought-after relief.

Think you don’t have a problem? Individuals with minimal symptoms or no symptoms even with smaller quantities of dairy products also seem to develop a greater intolerance as they age. Lactose intolerance is diagnosed clinically through resolution of symptoms with a lactose-restricted diet. If necessary, a hydrogen breath test or blood test similar to the test for diabetes can confirm the diagnosis, although the treatment is always the same: restrict lactose-containing foods and drinks.

With the advances in the pharmaceutical industry, a synthetic lactase—the enzyme found in the small lining of the bowel—can be added to milk and other dairy products to digest the lactose prior to human consumption. In addition, milk and ice cream products with pre-digested lactose as well as those with soy as a base are now readily available and sold in grocery stores.

Of course, there are the issues of vitamin D and calcium deficiencies which accompany decreased intake of dairy products. Fortunately, in our land of plenty, Americans have easy access to vitamin supplements, and many of our non-dairy foods and drinks such as bread and orange juice are enriched with vitamins and minerals. And thankfully, gone are the days of chalky tablets being the only source for calcium supplementation. Newer and more palatable alternatives are now available, such as chocolate chews with the recommended daily allowance of calcium.

As the new year arrives and people resolve to lose weight through diets restricting sweets and foods high in fat, many Vietnamese and Vietnamese Americans will have one less category of foods to eliminate since dairy products like ice cream become easy to avoid. I suppose there is always a silver lining.

For more information about lactose intolerance, visit: www.webmd.com/digestive-disorders/tc/lactose-intolerance-topic-overview