Are Dairy Products Bad for Japanese People? The Effects of Eating Too Much, Differences from Foreigners, Dairy in Japan and Abroad, and Bulgaria, the “Land of Yogurt”

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“Milk doesn’t suit Japanese people.” “Eating too much dairy causes cancer.” At the same time, you also hear “You don’t get enough calcium, so drink milk.”

Which is true? In this article, we check the following against national statistics and studies:

• How much dairy do people eat in Japan and in other countries?
• How does the share of people who can digest lactose (the sugar in milk) differ between Japanese and foreign populations?
• In studies that followed Japanese people over many years, how do dairy and disease relate? How do they differ from foreign studies?
• Do people in Bulgaria, the “land of yogurt,” really handle dairy well?
• How to tell milk, yogurt, and cheese types apart on the back label

Conclusions

• Japanese people eat one-third to one-quarter of the dairy that people in Europe and North America do (per person per year: Japan 90 kg, the U.S. 262 kg, France 393 kg; raw milk equivalent)
• In studies of Japanese people, within the range of what Japanese people eat today, many results show that people with more dairy have less stroke, less death (in men), and fewer fractures (in postmenopausal women). Because Japanese people get less calcium than the recommended amount, dairy may be filling that gap
• The foreign study that drew attention to the harm of “eating too much” (Sweden) was about people who drank 3 or more glasses of milk a day (600 ml or more). The average for Japanese people aged 20 and over is 108 g a day for dairy as a whole
• However, for prostate cancer, two studies of Japanese people also found that men with more dairy or milk had about 1.4 to 1.6 times as many cases. The World Cancer Research Fund also says it “may increase risk (limited evidence).” The National Cancer Center Japan’s assessment is “insufficient data”
• People who can still digest lactose as adults are over 90% in Denmark and the U.K., but a minority among Japanese people. However, many people who digest it poorly are said to have few symptoms up to about one glass of milk (about 12 g of lactose). Yogurt and cheese have less lactose
• We found no evidence for the claim that “Bulgarians handle dairy best.” In a small 2025 survey in Bulgaria, 74% had the gene type that digests lactose poorly. Bulgaria is a country with a culture of fermented yogurt, not raw milk

Products Featured in This Article

In the article, we introduce the following products to match each point (Rakuten Ichiba and A8.net links).

Dairy in Japan and Abroad

Japan’s amount is one-third to one-quarter of the West’s

This is the amount of milk and dairy products per person per year, estimated by MAFF from data of the Food and Agriculture Organization of the United Nations (FAO). Cheese and butter are also converted to the weight of the original raw milk.

Japan’s 90.1 kg (about 250 g a day) is roughly one-third to one-quarter of the countries of Europe and North America.

Asian countries and Bulgaria are not in this table. Comparing with FAO figures on the same basis (excluding butter), they are as follows.

(Milk - Excluding Butter from the FAO “Food Balance Sheets,” obtained via Our World in Data. Japan’s figure differs because the basis of calculation is different from MAFF’s table.)

Japan sits above China and South Korea and far below the West.

How Japan has changed: milk went down, cheese and yogurt went up

• It grew about fourfold, from 22 kg in fiscal 1960 to 94 kg in fiscal 2000. The fact that milk (at first skim milk powder) began to be served in postwar school lunches was one of the triggers for its spread
• After that it stayed almost flat: 90.7 kg in fiscal 2024 and 88.2 kg in fiscal 2025 (estimate)
• The contents changed. Drinking milk peaked at 40.8 kg in fiscal 1996 and was 30.2 kg in fiscal 2024. In its place, dairy products such as cheese and yogurt rose from 10.5 kg in fiscal 1960 to 60.3 kg

Japanese people differ a lot by age

In the 2023 National Health and Nutrition Survey, the amount of dairy (milk, yogurt, cheese, and so on) eaten per day is as follows.

(From the MHLW “Summary of Results, 2023 National Health and Nutrition Survey”)

The highest is ages 7 to 14, who have milk at school lunch. In adulthood it falls to less than one-third, and people in their 40s have the least.

The recommended calcium amounts (Dietary Reference Intakes for Japanese, 2025 edition) are 750 to 800 mg a day for adult men and 650 mg for adult women. The average of 482 mg for those aged 20 and over falls short of the recommended amount for both men and women.

Comparing what governments recommend

(From the MHLW and MAFF “Shokuji Balance Guide” (Japanese Food Guide), Dietary Reference Intakes for Japanese 2025, U.S. Dietary Guidelines for Americans 2025–2030, the U.K. Eatwell Guide, and EFSA dietary reference values)

Japan’s guideline is about one-third of America’s. The recommended amount itself differs greatly from country to country.

The Share of People Who Can Digest Lactose

Over 90% in Northern Europe and the U.K., a minority among Japanese people

The sugar in milk (lactose) is broken down by an enzyme in the small intestine (lactase). In many people this enzyme decreases after weaning, and it is known that people whose enzyme keeps working into adulthood (lactase persistence) are common in regions with a long history of drinking milk.

(Calculated from the supplementary table of Itan 2010, BMC Evolutionary Biology, weighted by number of people for each country. Because the test methods and years are not uniform, please treat these as a rough guide.)

The data on Japanese people is old and covers only a small number of people. Looking at genes, none of the 62 Japanese people examined had the type (-13910T) involved in lactose digestion in Europe (same supplementary table).

In a Japanese survey published in 2025 (843 residents of the Iwaki district of Hirosaki City, 2023 health checkups), 22.7% of people said they got stomach symptoms from dairy. People with symptoms tended to have lower milk and calcium intake and lower bone density.

Note The figure that “68% of the world digests lactose poorly” is often quoted from a 2017 paper (Lancet Gastroenterology & Hepatology), but that paper was retracted in January 2025. We do not use it in this article.

Many people who digest it poorly are fine with a small amount

Even people who digest lactose poorly do not get symptoms right away. A U.S. review of studies (Wilt 2010) says many people have few symptoms up to 12 to 15 g of lactose (about one glass of milk). Symptoms become clear above 24 g.

The amount of lactose in each food is as follows.

• Yogurt has less lactose than milk because lactic acid bacteria break down part of it. In 2010, the EU’s food safety agency (EFSA) accepted that “live bacteria in yogurt (Lactobacillus bulgaricus and Streptococcus thermophilus) help people who digest lactose poorly to digest lactose”
• Aged cheese has almost no lactose left. Lactose is removed with the liquid (whey) when cheese is made, and the rest is broken down during aging
• In a small Japanese study (2023, 32 people), starting milk at 30 ml and building up to 200 ml over about 6 weeks eased symptoms in 90% of people. However, it was a trial with no comparison group. If you try it, watch how you feel, and people with strong symptoms should consult a doctor

How to Choose If Lactose Bothers You

This is how to choose if you get a rumbling stomach from milk but want to keep having dairy.

1. Choose milk with the lactose broken down

There are milk drinks in which lactose has been broken down in advance with an enzyme. Megmilk Snow Brand’s “Akadi” has about 80% of its lactose broken down. The product type (種類別) is “milk drink” (乳飲料), and the ingredient list (原材料名) is “milk (made in Japan), dairy products.” The enzyme used for the breakdown does not appear in the ingredient list, so on the back label you can tell by the “lactose-reduced” (乳糖分解) wording.

2. Get calcium from aged cheese

Parmesan (grated cheese) has 0 g of lactose in the food composition tables, and calcium is 1,300 mg per 100 g (milk has 110 mg). Parmigiano-Reggiano is a hard cheese whose production method is set by Italian rules of protected designation of origin, and its ingredient list (原材料名) is only “raw milk, salt.” Grated over food, it adds calcium in a small amount. It does contain salt, so about 1 tablespoon (about 5 g) is a guide.

3. Don’t drink a lot at once

Even the same amount is said to cause fewer symptoms when taken with a meal and split into several times.

Please note Milk allergy is a reaction to the proteins in milk, not to lactose. Even lactose-reduced milk and cheese cause symptoms. People with the allergy cannot use them.

Studies of Japanese People and Foreign Studies

Summary by disease

We lined up the relationship between dairy and disease in studies that followed Japanese people over many years, and in foreign studies and reviews of studies. All are observational studies of “how people eat and disease”; they do not confirm that dairy is the cause.

(The multiples are values when the group with the least dairy [or people who do not eat it] is set at 1. JPHC = Japan Public Health Center-based Prospective Study, JACC = the Japan Collaborative Cohort Study, a large cohort study funded by MEXT, JPOS = the Japanese Population-based Osteoporosis cohort study of Japanese women)

Why do Japanese and foreign studies give different results?

1. The ranges of amounts are completely different

In Japanese studies, the “highest group” was 211 to 325 g a day in the Miyagi study. In the Swedish study, the higher death rate was among people who drank 600 ml or more of milk alone per day. Japanese studies compare ranges that correspond to “low to ordinary” abroad.

2. Japanese people are short on calcium

The JPHC stroke study says it was done “in Japanese people, whose average calcium intake is low.” Because most Japanese people fall short of the recommended amount, people who eat more dairy have a smaller shortfall, which is thought to make results in a good direction more likely. In people who already get enough, as in the West, increasing it further cannot be expected to have the same effect.

3. Prostate cancer is an exception

For prostate cancer, two studies of Japanese people also found “more in people who eat more,” within the range of amounts Japanese people eat. A candidate mechanism is that milk raises IGF-1 (a growth-related hormone) in the blood (in a survey of 10,000 Japanese people as well, IGF-1 was somewhat higher in people who drank more milk).

On the other hand, prostate cancer is one where the number found changes greatly with PSA screening, and there is also a bias in that people who take care of their health are more likely to be screened. Some reviews found no relationship when comparing advanced cancer or death, and the National Cancer Center Japan says “insufficient data.”

What “too much” means for Japanese people

• Governments and international bodies have not set an “upper limit” for dairy. Calcium has an upper limit, which in Japan’s standards is 2,500 mg a day for adults. It is rare to reach this from food alone; it is something to watch for when combined with supplements
• The amount that drew attention for harm abroad (600 ml or more of milk a day) is more than 5 times the average for Japanese adults
• Japan’s guideline of “2 servings” (about one glass of milk) falls within the range in which Japanese studies show results in a good direction
• For men worried about prostate cancer, it is conceivable to reconsider a habit of drinking large amounts of milk. However, from the abstracts of the papers we could not tell how much the “highest group” in the Japanese studies actually was

Are Bulgarians Strong with Dairy?

How it became the land of yogurt

• In the early 1900s, the researcher Mechnikov, from the Russian Empire, thought that people in Bulgarian villages might live long because they ate a lot of fermented milk (yogurt). From this, the idea linking bacteria in the gut with health spread
• One of the bacteria that make yogurt is named “Bulgarian bacillus” (Lactobacillus delbrueckii subsp. bulgaricus)
• Japan’s “Meiji Bulgaria Yogurt” came about after the Bulgarian Pavilion at the 1970 Osaka Expo, received permission from the Bulgarian government to use the country’s name in 1972, and went on sale in 1973 (from Meiji’s announcement)
• In Bulgaria, besides yogurt (kiselo mlyako), there are many traditions of fermented dairy such as white cheese (sirene) and kashkaval

Not many people can digest lactose

In a preliminary survey published in a Bulgarian medical journal in 2025 (Chengolova et al.), of 31 people who had a gene test,

• the type that digests lactose poorly (C/C): 23 people (74%)
• the type with both genes (C/T): 7 people (23%)
• the type that can digest it (T/T): 1 person (3%)

On the other hand, in a questionnaire of 203 people, only 6.7% said they had lactose intolerance. The researchers report that few people are aware of it, but many are genetically poor at digesting it.

It is a small preliminary survey, but a review of studies across Europe (Itan 2009) also says the share who can digest lactose as adults is 15 to 54% in Eastern and Southern Europe and 89 to 96% in the British Isles and Northern Europe. The people who are “strong with dairy” are in Northern Europe, the U.K., and Ireland, rather than Bulgaria.

What was eaten in Bulgaria was not raw milk but yogurt and cheese, in which lactose is partly broken down. It makes sense to think that a culture of eating fermented dairy took root in a place where many people digest lactose poorly (however, we could not find a study that directly confirmed this).

About 3 times Japan’s amount, but less than the West

On the same FAO basis, Bulgaria’s dairy is 172 kg per person per year, about 3 times Japan’s (62 kg), but less than the Netherlands (311 kg) and Finland (265 kg).

“Long life from yogurt” does not match current data

Contrary to the image of “long-lived Bulgaria” from Mechnikov’s time, according to the EU statistics office (Eurostat), Bulgaria’s life expectancy in 2024 was 75.9 years, the shortest in the EU (EU average 81.7 years). Life expectancy is determined by many things, such as smoking and medical care, so the effect of yogurt cannot be singled out. We cannot say that “eating yogurt lets you live long.”

If you make yogurt at home

If you want to eat something close to Bulgarian yogurt, choose plain yogurt whose ingredients are only raw milk and dairy products. “Meiji Bulgaria Yogurt LB81 Plain” has the product type (種類別) “fermented milk” (発酵乳) and the ingredient list (原材料名) “raw milk (made in Japan), dairy products” (Meiji’s product page. It has FOSHU approval, but in this article we introduce only the ingredients and origin).

You can also grow it from milk, using commercial plain yogurt as a starter. A yogurt maker that keeps the temperature right in the milk carton makes it easy. Keep the containers and spoons clean, and refrigerate what you make and eat it soon.

People Who Should Take Care

• People with milk allergy: Even lactose-reduced milk and cheese cause symptoms. Follow your doctor’s instructions
• People who get stomach symptoms from lactose: You can reduce the amount, split it up, or switch to yogurt, cheese, or lactose-reduced milk. If symptoms are strong or you are worried about another illness, consult a gastroenterologist
• Men with a family history of prostate cancer: If you have a habit of drinking large amounts of milk, it is worth reconsidering. Talk with your doctor about screening
• People being treated for kidney disease: Dairy contains phosphorus and potassium. Follow the instructions of your doctor and registered dietitian for the amount
• People using calcium supplements: Make sure that food plus supplements does not exceed the upper limit (2,500 mg a day for adults)

Points to Check on the Back Label

For milk, look at the “type” (種類別)

Milk cartons have a “type” (種類別) field that shows the difference in contents (the Ministerial Ordinance on Compositional Standards, etc. for Milk and Milk Products).

Only four types are made from raw milk alone: “milk,” “component-adjusted milk,” “low-fat milk,” and “fat-free milk.” For milk drinks, the ingredient list (原材料名) may list sugar, flavorings, stabilizers, and so on.

For yogurt, look at the ingredient list (原材料名)

• Many plain yogurts have an ingredient list (原材料名) of only “raw milk, dairy products”
• With “sweetened” (加糖) and “fruit” (フルーツ) types, sugar, high-fructose glucose syrup, stabilizers (pectin, gelatin, and so on), and flavorings are added. For high-fructose glucose syrup, see also the article on fructose in fruit
• “Lactic acid bacteria drinks” (乳酸菌飲料) are a different type from fermented milk, with little milk content and, in some, a lot of sugar

Cheese: “natural” and “processed”

• Natural cheese: Made by curdling milk. Aged types have almost no lactose left
• Processed cheese: Natural cheese that is heated, melted, and set again. An “emulsifier” (such as sodium citrate or phosphates) is often used when melting, and it appears in the ingredient list (原材料名)

Some domestic natural cheeses also have an ingredient list (原材料名) of only “raw milk, salt” (生乳、食塩). Below is an example. Mozzarella is a fresh cheese that is not aged, so it is not an example of the point above about getting calcium from aged cheese.

Summary of Products Featured in This Article

(Checked on the Rakuten Ichiba sales pages on September 30, 2026. Prices and shipping fees may change.)

How Urayomi Sees It

• Neither “dairy is bad for Japanese people” nor “dairy is good for you” can be said as it stands. Results change with the amount and the underlying diet
• The average for Japanese adults (108 g a day) is far less than the amount that drew attention for harm abroad, and in studies of Japanese people, many results within the guideline range are in a good direction
• For prostate cancer, there are results of concern even in studies of Japanese people, and it is not clear
• It is true that many people digest lactose poorly. However, many people are fine with a small amount, and there are choices such as yogurt, cheese, and lactose-reduced milk
• “Bulgarians are strong with dairy” and “the land of yogurt has long life” do not match current data

Sources

• MAFF, “Food Balance Sheet, Fiscal 2025” (August 2026), reference tables and time series by item (e-Stat)
• MHLW, “Summary of Results, 2023 National Health and Nutrition Survey”; Dietary Reference Intakes for Japanese (2025 edition); Shokuji Balance Guide
• MEXT, “Standards Tables of Food Composition in Japan (8th Revised Edition), 2023 Supplement” (updated March 27, 2026)
• National Cancer Center Japan, “List of Assessments of Cancer Risk and Preventive Factors” (May 26, 2026 edition)
• FAO Food Balance Sheets (via Our World in Data) / Eurostat (life expectancy in 2024)
• Kurahashi N, et al. Cancer Epidemiol Biomarkers Prev. 2008 (JPHC, prostate cancer)
• Mikami K, et al. Cancer Med. 2021 (JACC, prostate cancer)
• Ge S, et al. Eur J Nutr. 2023 (JPHC, death) / Lu Y, et al. Eur J Nutr. 2022 (Miyagi cohort, death)
• Umesawa M, et al. Stroke. 2008 (JPHC, stroke) / Wang C, et al. Nutrients. 2020 (JACC, stroke)
• Kojima A, et al. J Nutr Health Aging. 2023 (JPOS, fractures) / Nakamura K, et al. Br J Nutr. 2009 (JPHC, fractures)
• Arafa A, et al. J Epidemiol. 2022 (JACC, esophageal cancer), Br J Nutr. 2022 (JACC, pancreatic cancer)
• Maruyama K, et al. 2009 (JACC, IGF-1)
• Aune D, et al. Am J Clin Nutr. 2015 / Zhao Z, et al. Br J Nutr. 2023 (prostate cancer)
• Jin S, et al. Cancer Epidemiol Biomarkers Prev. 2020 (colorectal cancer)
• Michaëlsson K, et al. BMJ. 2014 (Sweden) / Ding M, et al. BMJ. 2019 (U.S.)
• Bischoff-Ferrari HA, et al. J Bone Miner Res. 2011 / Feskanich D, et al. JAMA Pediatr. 2014 / Bergholdt HKM, et al. J Intern Med. 2018 (fractures)
• Gijsbers L, et al. Am J Clin Nutr. 2016 (type 2 diabetes)
• Jiang W, et al. Eur J Epidemiol. 2014 / Yang D, et al. Public Health. 2026 (Parkinson’s disease) / Juhl CR, et al. Nutrients. 2018 (acne)
• Sharifan P, et al. Nutrients. 2025 (review of cardiovascular and bone studies)
• Itan Y, et al. BMC Evol Biol. 2010 / Itan Y, et al. PLoS Comput Biol. 2009 (share of people who can digest lactose)
• Wilt TJ, et al. Evid Rep Technol Assess. 2010 (lactose intolerance and health)
• Kawata D, et al. Eur J Nutr. 2025 (Hirosaki resident survey) / Hasegawa M, et al. World J Clin Cases. 2023 (trial of gradually increasing milk)
• Chengolova Z, et al. Acta Medica Bulgarica. 2025;52(1):53-63 (preliminary survey of lactose intolerance in Bulgaria)
• EFSA Journal 2010;8(10):1763 (live bacteria in yogurt and lactose digestion)
• Gasbarrini G, et al. 2016 (history of Mechnikov and probiotics) / Petrova P, et al. 2021 (traditional dairy products of Bulgaria)
• Meiji, “50 years since receiving permission to use the name of the Republic of Bulgaria” (April 20, 2022)
• Storhaug CL, et al. Lancet Gastroenterol Hepatol. 2017 is not used because it was retracted in January 2025