A few years ago we reported that “cheese may not be especially good for the heart—but ... it may not be so bad for it either.” Since then, there has been a growing body of evidence that, despite its saturated fat, cheese may indeed be healthful in several ways. Some researchers have even proposed that perhaps it’s the cheese, not wine, that’s largely responsible for the so-called French Paradox (which attempts to explain why the French, with their diets rich in animal fat, have relatively low rates of heart disease).
Here’s a fresh look at the possible health benefits of one of America’s (and of course France’s) favorite foods. Most of the studies discussed here are observational, so they don’t prove cause and effect. It’s possible that the apparent benefits are due to other things that cheese eaters do, not to the cheese itself, though researchers attempt to control for such “confounding” factors in their analyses.
Cheese and heart health
Several studies in recent years have linked cheese to either no increase in cardiovascular disease or lower risk. For example, a study in the International Journal of Cardiology found no evidence that dairy foods (including cheese) increased the risk of heart disease or stroke in a large sample of Dutch people who were followed for 13 years. And in a study in the Journal of Nutrition, which followed a large group of Swedish women for 12 years, those who ate the most cheese had about a 25 percent lower risk of heart attacks than those who ate the least. Some research has also shown that while butter raises LDL (“bad”) cholesterol, cheese has little or no effect.
Why might cheese be okay, or even beneficial, for the heart? Though all dairy products are made from the milk of cows (or goats or sheep), they appear to have different health effects. For one thing, many cheeses are fermented. Thus they alter intestinal bacteria, which produce substances that may affect cholesterol metabolism, blood pressure, and inflammation. In support of this idea, a small study in the Journal of Agricultural and Food Chemistry found different metabolites in the urine and stool of people who consumed milk versus cheese, including one reflecting differences in intestinal bacteria. Other possible explanations are that the calcium in cheese increases fecal fat and bile excretion and that the specific saturated fatty acids in cheese increase LDL particle size (bigger particles are less harmful).
Cheese and diabetes
Some, but not all, studies suggest that cheese may help keep blood sugar in check. For instance, a Brazilian study of 10,000 people published in the American Journal of Clinical Nutrition found that dairy foods—particularly fermented ones like cheese and yogurt—were associated with improvement in insulin sensitivity and blood glucose control. Another study in the same journal looked at 14 years of Swedish data and found a link between high-fat dairy foods and reduced risk of diabetes, especially among women consuming cheese. The mechanism isn’t clear, but changes in intestinal bacteria, along with the types of saturated fat and protein in dairy, may play a role in improving glucose metabolism. Cheese, like other high-fat foods, also slows gastric emptying, which can blunt rises in blood sugar.
Cheese and cancer
Dairy consumption has long been linked to a reduced risk of colon cancer, attributed in part to the calcium. For example, a study in the online journal PLOS ONE found that cheese (whether high or low in fat) was protective over an 11-year period. On the other hand, an analysis of 15 studies, published in Critical Reviews in Food Science and Nutrition, found no association between cheese and colon cancer.
For other cancers there is more conflicting evidence about whether cheese affects cancer risk. A large study in the International Journal of Cancer linked hard cheese with a reduced risk of ovarian cancer, for example, while an analysis of data from 14 studies, published in Annals of Oncology, found no association between cheese consumption and pancreatic cancer. It’s possible that dairy foods have different effects on different types of cancer.
Cheese and weight control
The role of dairy foods in weight control remains controversial, but some recent studies suggest that diets that include cheese are associated with less weight gain and may even help with weight control. An analysis of data from the Framingham Heart Study published in the International Journal of Obesity found that cheese was not associated with weight gain over a 13-year period. And in a clinical trial in the Journal of Nutrition involving overweight and obese premenopausal women who restricted calories and exercised, those who ate a high-protein, high-dairy diet (that included Cheddar cheese) for 16 weeks lost more fat (and gained more muscle) than those who consumed less protein and dairy.
Conjugated linoleic acid (in dairy fat) and calcium (in combination with other dairy components) may help reduce body fat, researchers say. Cheese is also satiating, so it may help reduce appetite. Still, because of its high calories (about 110 to 125 per ounce in hard cheeses), you should watch how much you eat.
Cheese and dental cavities
Ever since lab studies more than 30 years ago found that rats fed cheese didn’t develop cavities, this dairy food has been touted as being good for teeth. Some human research also supports the idea that cheese does not promote cavities and may help prevent them. Cheese boosts the flow of saliva (which washes away debris and neutralizes acids, thereby decreasing tooth erosion) and increases mineralization of enamel (thanks to its calcium, phosphorus, and protein), among other proposed mechanisms. But it’s not known how much cheese you have to eat or how often to get a benefit.
Bottom line: Cheese can be part of a healthy diet when eaten in moderation—an ounce or two a day is reasonable, but watch out for the calories. Like all dairy foods, cheese provides calcium and protein, along with some vitamin A, vitamin B12, riboflavin, zinc, and other nutrients. A downside is that most cheeses are high in sodium (100 to 300 milligrams or more per ounce). But compare nutrition labels, since products vary a lot in sodium, calories, and calcium, depending on the type and serving size. Low-sodium versions are available (though less tasty). Strong and savory cheeses have more flavor so you can use less. A cheese slicer will allow you to cut very fine slices to make a little go a longer way.