Mrs Maria Qibtia Tahir and Dr Ali Raza Awan - Calcium is a key nutrient in the human body. More than 99% that is 1.2-1.4kg of calcium is stored in bones and teeth. Calcium level is maintained in the body with the help of three systems: kidneys, intestine and bones. A daily dietary intake of 1000mg of calcium would potentially result in 800mg available for tissue nutrient requirements and 200mg for maintaining serum levels. Extra intestinal calcium is processed through kidneys and removed from body through urinary excretion. Calcium is involved in vascular contraction, vasodilation, muscle functions, nerve transmission, intracellular signaling and hormonal secretions. The minimum calcium requirement is 700mg/day. Predominant sources of calcium in the diet include dairy products (milk, yogurt, cheese) and commercially made food cereals, orange juice and breads. Calcium metabolism has close association between: phosphorous, Vitamin D and protein. Milk and several dairy products contain lactose: a disaccharide that is hydrolyzed into glucose and galactose by lactase enzyme present in the brush border of human intestinal wall.

Lactose intolerance is a disorder caused by incomplete hydrolysis of lactose due to lactase deficiency. It may occur as a primary disorder, secondary to other intestinal diseases or it may be congenital in rare cases. Generally lactose restricted diet is followed in suspected individuals, and avoiding milk & milk containing products can result in dietary calcium intake that is below recommended levels:1g/day for adults and adolescents. The perceived major health risk associated with lactose intolerance includes osteoporosis, fractures due to weak bones and colonic carcinoma. Primary lactose intolerance could be treated by enzyme replacement with lactase, probiotics and in case of secondary ailments by antibiotics. On the other hand it could also be managed by using pre-hydrolyzed lactose milk, consuming fermented dairy products, ingesting milk with other foods, taking small amounts of milk in snacks so that colon could adapt the lactose present in daily food. Diagnosis for this disorder includes: blood sugar levels, hydrogen breath test, stool pH-test and with advent of latest molecular biology techniques; DNA based tests have been developed. The Single Nucleotide Polymorphism (SNP) in the genes especially LCT-gene can be diagnosed at pre-natal stage. It is recommended that the families with lactose intolerance history should have the genetic counseling before deciding their marriages. Genetic counseling is a new concept in Pakistan and this arena of genetics should be commonly introduced for masses at local levels, so that the genetic mutations prevailing in many families could be diagnosed and proper remedies could be provided.