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Is Cheese Bad for You? The Evidence Says No—with Some Exceptions

By Julia Reedy, MNSP, September 18, 2020

cheese healthy

Cheese’s standing as a component of a healthy diet has long been debated. And it’s true that some animal products promote disease, but is cheese bad for you? Perhaps not—evidence shows that cheese doesn’t deserve to be treated the same as meat or milk. It’s a good source of protein and calcium, and research largely doesn’t support the theory that cheese contributes to chronic disease.

 

As an animal product, cheese has long been considered unhealthy

Along with other animal food products, cheese has had a reputation for being unhealthy. But the tide started to change when large cohort studies found that dairy’s relationship with chronic disease and mortality was not to be confused with that of meat. In particular, a 2011 study from a team at Harvard found the consumption of dairy products was not associated with mortality and was even mildly protective against cardiovascular disease.[1]

But of course, dairy products vary substantially in nutritional content (like full-fat vs. fat-free) and how they’re produced (like whether they’re fermented, as is the case with yogurt and cheese). This variability leads us to today’s central question: how does cheese specifically affect health?

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Saturated dairy fat can negatively affect health—but cheese fat acts differently

Research shows that some dairy fat can be dangerous for LDL (bad) cholesterol levels, but at different degrees. One randomized controlled trial, for example, found that butter raised LDL cholesterol significantly more than cheese did.[2] And in large studies of overall dairy on health, this finding usually holds up; butter is among the least healthy dairy foods, and cheese among the most healthy.

And interestingly, it seems that the overall amount of fat in cheese (which is typically largely saturated fat) doesn’t have a meaningful effect on cardiovascular or metabolic disease risk factors. Two separate randomized controlled trials tested the effects of regular-fat cheese on cholesterol levels and other metabolic disease risk factors. In one, neither fat-free (50g serving) nor regular-fat (80g serving) cheese increased total cholesterol, LDL cholesterol, triglycerides, or blood glucose after 8 weeks of daily intake.[3] The other, which compared 80g-servings of low-fat (13%) and regular-fat cheese, found that the regular-fat cheese did not increase total or LDL cholesterol, blood glucose, CRP (a major marker of inflammation), or waist circumference more than its low-fat counterpart.[4] These findings suggest that the saturated fat content in cheese doesn’t quite have the effect on disease risk once assumed.

Cheese studies blog

Large epidemiological studies show cheese doesn’t worsen the risk of heart disease, diabetes, or most cancers

Multiple studies (covering hundreds of thousands of subjects) have found that cheese either does not increase—and may even lower—the risk of cardiovascular disease.[5,6] Similar effects have been found for diabetes and glycemic control—cheese has either a neutral or mildly protective effect.[7-9]

Similar but varied results were found for cancer. Separate meta-analyses of cheese intake on endometrial, colorectal, and all-cause cancer mortality found no association between cheese intake and increased risk of cancer [10-13]. There is one notable exception to this rule, however. Multiple meta-analyses have found that regular cheese intake is associated with increased risk of prostate cancer.[12-14] It’s also important to note that dairy consumption has also shown an increased risk of breast cancer, though this association hasn't been found for cheese alone.[15]

 

Dairy’s effect on inflammation remains in the spotlight

It seems that cheese’s effects on inflammation follows a similar pattern. A 2017 systematic review found that, among clinical trials associating cheese intake and inflammatory markers, 13 found anti-inflammatory effects, 13 found no effect, and 4 found pro-inflammatory effects.[16]

Inflammatory bowel disease (IBD) follows a similar pattern—some studies have found no association between cheese intake and IBD.[17] Interestingly, though, meta-analyses of various food groups on IBD have found that people with IBD diagnoses tend to eat significantly more cheese than undiagnosed people.[18,19] Does that mean cheese causes inflammation in the gut? It's possible, but this is not confirmed. For the most part, high cheese intake was found to be paired with intake of known pro-inflammatory foods like soda and processed meat. Meaning, in general, cheese was a component of a larger diet pattern that was relatively common in IBD patients. In general, it’s best to stick with no more than 1-2 servings of cheese per day (50-80g).

The relationship between cheese intake and acne, an inflammatory condition, has also been evaluated. Observational studies have concluded that cheese (and total dairy) intake is associated with acne prevalence.[20] And though a separate meta-analysis concluded the relationship was largely specific to milk and not cheese, it's probably worth testing removing dairy from your diet to address acne concerns.[21]

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Still, not all cheeses are equal

When choosing which cheese to add to your diet, there are plenty of factors to consider. If you typically don’t tolerate lactose, well, for example, you’re better off sticking to hard cheeses like Parmesan—lactose is removed during the ripening process, so the harder the cheese, the less lactose. Fresh, soft cheeses, on the other hand, are usually lower in sodium and calories per gram. Here are some healthier cheese options and their key characteristics:

  • Fresh cheeses (mozzarella, ricotta, goat cheese, cottage cheese, feta) – These cheeses are typically not fermented, but coagulated using traditional acid or heat treatments. They’re usually lower in sodium and calories and higher in water content than other cheeses. For someone with a family history of heart disease or high cholesterol, fresh cheeses are best due to their low cholesterol content.
  • Harder cheeses (cheddar, Swiss, Parmesan) – While typically higher in sodium and saturated fat, these cheeses also tend to have a higher concentration of calcium and protein than their fresh counterparts.
  • Blue cheese (Gorgonzola, Roquefort, Stilton) – Blue cheeses are relatively high in sodium and saturated fat but are great sources of calcium and vitamin K, giving them a middle-of-the-pack ranking in healthfulness.

 

Is cheese bad for you? A summary of key points

  • Though often assessed as a food group in studies, individual dairy products vary substantially in their effects on disease risk
  • Cheese does not appear to be significantly associated with markers of heart disease like LDL-cholesterol, triglycerides, or CRP, regardless of its fat content
  • Across multiple randomized controlled trials, cohort studies, and meta-analyses, results show that cheese has a neutral effect on the risk of cardiovascular disease and diabetes
  • Multiple meta-analyses show that, with the exception of prostate cancer, cheese does not increase cancer risk
  • Cheese is typically not associated with inflammation markers, though high cheese intake is common in people with IBD and acne
  • Results show that it's best to limit your cheese intake to 1-2 servings (50-80g) per day for optimal health
  • If you want to be deliberate in your cheese choices, consider sodium, calcium, calorie, and protein content

 

 


Reedy Headshot (3)Julia Reedy, MNSP
      • Julia is a Written Content Strategist & Editor at InsideTracker. She loves to use her experience in cutting-edge nutrition research and writing to spin complex health and nutrition topics into clear, approachable info everyone can relate to. As an inquisitive food shopper, she's constantly reading ingredient lists—and leaving shelves of backward products in her wake.

 

References

1. Sabita S Soedamah-Muthu, Eric L Ding, Wael K Al-Delaimy, Frank B Hu, Marielle F Engberink, Walter C Willett, Johanna M Geleijnse, Milk and dairy consumption and incidence of cardiovascular diseases and all-cause mortality: dose-response meta-analysis of prospective cohort studies, The American Journal of Clinical Nutrition, Volume 93, Issue 1, January 2011, Pages 158–171, https://doi.org/10.3945/ajcn.2010.29866
2. Brassard, D., et al., Comparison of the impact of SFAs from cheese and butter on cardiometabolic risk factors: a randomized controlled trial. Am J Clin Nutr, 2017. 105(4): p. 800-809.
3. Nilsen, R., et al., Effect of a high intake of cheese on cholesterol and metabolic syndrome: results of a randomized trial. Food & nutrition research, 2015. 59: p. 27651-27651.
4. Raziani, F., et al., High intake of regular-fat cheese compared with reduced-fat cheese does not affect LDL cholesterol or risk markers of the metabolic syndrome: a randomized controlled trial. Am J Clin Nutr, 2016. 104(4): p. 973-981.
5. Dehghan, M., et al., Association of dairy intake with cardiovascular disease and mortality in 21 countries from five continents (PURE): a prospective cohort study. Lancet, 2018. 392(10161): p. 2288-2297.
6. Key, T.J., et al., Consumption of Meat, Fish, Dairy Products, and Eggs and Risk of Ischemic Heart Disease. Circulation, 2019. 139(25): p. 2835-2845.
7. Aune, D., et al., Dairy products and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of cohort studies. Am J Clin Nutr, 2013. 98(4): p. 1066-83.
8. Mitri, J., et al., Dairy intake and type 2 diabetes risk factors: A narrative review. Diabetes Metab Syndr, 2019. 13(5): p. 2879-2887.
9. Gao, D., et al., Dairy products consumption and risk of type 2 diabetes: systematic review and dose-response meta-analysis. PLoS One, 2013. 8(9): p. e73965.
10. Li, X., et al., Dairy Products Intake and Endometrial Cancer Risk: A Meta-Analysis of Observational Studies. Nutrients, 2017. 10(1).
11. Vieira, A.R., et al., Foods and beverages and colorectal cancer risk: a systematic review and meta-analysis of cohort studies, an update of the evidence of the WCRF-AICR Continuous Update Project. Ann Oncol, 2017. 28(8): p. 1788-1802.
12. Nilsson, L.M., et al., Dairy Products and Cancer Risk in a Northern Sweden Population. Nutr Cancer, 2020. 72(3): p. 409-420.
13. Lu, W., et al., Dairy products intake and cancer mortality risk: a meta-analysis of 11 population-based cohort studies. Nutr J, 2016. 15(1): p. 91.
14. Aune, D., et al., Dairy products, calcium, and prostate cancer risk: a systematic review and meta-analysis of cohort studies. Am J Clin Nutr, 2015. 101(1): p. 87-117.
15. Fraser, G.E., et al., Dairy, soy, and risk of breast cancer: those confounded milks. International Journal of Epidemiology, 2020.
16. Bordoni, A., et al., Dairy products and inflammation: A review of the clinical evidence. Critical Reviews in Food Science and Nutrition, 2017. 57(12): p. 2497-2525.
17. Tasson, L., et al., Influence of Diet on the Course of Inflammatory Bowel Disease. Dig Dis Sci, 2017. 62(8): p. 2087-2094.
18. Han, M.K., et al., Examination of food consumption in United States adults and the prevalence of inflammatory bowel disease using National Health Interview Survey 2015. PLoS One, 2020. 15(4): p. e0232157.
19. Cohen, A.B., et al., Dietary Patterns and Self-Reported Associations of Diet with Symptoms of Inflammatory Bowel Disease. Digestive Diseases and Sciences, 2013. 58(5): p. 1322-1328.
20. Adebamowo, Clement A., et al. "High school dietary dairy intake and teenage acne." Journal of the American Academy of Dermatology 52.2 (2005): 207-214.
21. Aghasi, Mohadeseh, et al. "Dairy intake and acne development: A meta-analysis of observational studies." Clinical Nutrition 38.3 (2019): 1067-1075.