Dairy products have been a key component of dietary guidance in the United 
States for more than 100 years. In light of major advances in the understanding 
of dietary intake and metabolism, the aim of this review was to examine whether 
dairy should remain a single commodity in federal guidance. Considerations 
include recognizing that a substantial proportion of the world's adult 
population (65%-70%) exhibits lactase nonpersistence, a reduced ability to 
metabolize lactose to glucose and galactose. Shifts in the US population, 
including a greater proportion of African Americans and Asians, are of key 
importance because several studies have shown a markedly higher prevalence of 
lactase nonpersistence and, consequently, a lower dairy intake among these 
groups. While cow's milk alternatives are available, families who use them will 
pay up to an additional $1400 per year compared with those who are able to 
consume dairy products. Dietary guidance also contains downstream effects for 
government assistance, such as the US Department of Agriculture's National 
School Lunch Program and School Breakfast Program. For reasons like these, 
Canada has recently removed dairy as a separate food group in national dietary 
guidance. The results of the present review suggest that consideration of this 
modification when developing population-level guidelines in the United States is 
warranted.