Could Cheese Actually be Healthy?

Cheese is very high in fat, and considered by many of us to be a food item that’s best enjoyed a little now and then. But does eating cheese actually have any negative health effects at all? Some interesting studies suggest that it might not.

Setting the Scene

Late last year, I reported on some studies that suggested eating cheese was protective against heart disease , purely because it was plastered all over UK newspapers.

Cheese is something that is enjoyed by a lot of people; in fact, it’s usually the one thing that makes the transition from vegetarianism to veganism difficult for many.

We moderate our consumption of it because it’s become so ingrained into our belief system that the high fat content of cheese will simply clog our coronary (heart) arteries.

Cheese is also high in salt, which is responsible for raising blood pressure – a major cause of strokes.

The main issue with so much of this scientific evidence that says otherwise is that it is very often funded by the dairy industry.

There’s nothing intrinsically wrong with this, as studies need funding – but it makes some of us cautious because clearly they have a vested interest in the study outcome.

If  opposite effects were discovered, would this lead them not being published?

Not publishing negative results causes a big problem in science called publication bias, and it means that later when we want to pool data from all conducted studies, a lot of it will be missing.

So what now?

The European Society of Cardiology has recently presented findings of many different studies at this year’s annual congress in Germany.

This involved a lot of studies looking at the effects of diets on heart disease, including cheese consumption!

Professor Maciej Banach, from the Department of Hypertension at Medical University of Lodz, Poland is behind this latest research presented at the Congress.

He believes that, based on current research, the recommendations on the daily consumption of cheese should be revised.

Banach and his co-researchers examined data from a US Survey of  just shy of 24,500 adults.

Over the course of around six years, 3,520 total deaths were recorded, including 827 cancer deaths, 709 cardiac deaths, and 228 deaths from strokes.

They found a lower risk of deaths from consuming any dairy, but it was particularly notable for cheese! So the research team decided to look at the existing research and conduct a meta-analysis (pooling of all known data from other researchers).

This involved collating the data from 12 different studies, which in total included over 600,000 people followed up over 15 years. They found that yoghurt but not milk did not contribute to additional deaths.

In light of the protective effects of dairy products, public health officials should revise the guidelines on dairy consumption. And given the evidence that milk increases the risk of CHD (coronary heart disease), it is advisable to drink fat-free or low-fat milk. (Prof M Banach)

This also adds weight to a meta analysis performed last year in 2017, which showed similar results, albeit neutral associations with milk, and lower mortality in fermented dairy products (typically yoghurt).

Lower rates of death from heart disease

In September 2018, the Lancet published a study that showed dairy consumption is linked to lower rates of death from heart disease.

The large, multi-national study looked at people aged 35-70 from 21 different countries, recording the consumption of dairy from just under 140,000 participants.

They looked at cheese, milk and yoghurt – and further grouped these into low and full fat consumption and found that those who consumed 3 servings of whole fat dairy per day had lower risks of cardiovascular disease and death from it than those who consumed less than one half of a portion.

However, this was a survey that used self-reporting and therefore the study will have limitations regarding the accuracy of the data gathered.

It does add some weight to the fact that dairy forms part of a healthy diet, and that the range of nutrients and natural bacteria found in dairy could out-weigh the harms of saturated fats – or that the types of saturated fat in dairy are not as unhealthy as once thought.

However, these measures are for heart disease and deaths, and not other causes of death such as bowel cancer.

Dairy and diabetes

In October 2018, a paper was published that pooled together the results of  multinational prospective cohort studies to perform a meta-analysis on the association between dairy consumption and type 2 diabetes.

The researchers gathered the results of 16 studies as part of the Fatty Acids and Outcomes Research Consortium (FORCE). This covered over 63,000 people who were followed-up for up to 20 years.

Participants had blood tests throughout the study period to test for markers of dairy consumption, so that that could correlate this with the development of type 2 diabetes.

These markers are not specific to dairy consumption, although they are most strongly correlated to it. So other factors could influence the findings.

The researchers found that dairy consumption was strongly correlated to lower risk of developing type 2 diabetes.

Word of caution

We can’t change the recommendations for dairy consumption just yet. All of the studies conducted are tending toward population (epidemiology) studies, which show association rather than cause and effect.

Whilst the evidence so far is interesting, many of the studies have too many differences between them – a problem we call heterogeneity.

What does this mean?

It means that the studies included in all of the meta-analyses (of which there are a few now) are quite different to each other in terms of methodology and design, outcomes or how outcomes were measured.

Some design flaws could impact upon the overall results affecting how meaningful they are.

When looking at the papers, it’s evident that many of the included studies had some significant design problems.

The 2017 meta analysis, however has taken steps to investigate the source of the heterogeneity and comment upon it.

We don’t yet know with the Banach analysis as it’s yet to be published.

Overall conclusion

I personally don’t think we’re quite ready yet to tear up existing recommendations on dairy until the research behind it is a bit more reliable.

Others may disagree as it’s possible that this is as good as it’s ever going to get – and one thing is certain, we don’t have much evidence that cheese is actually bad for us.

So unless you follow a vegan diet, there’s no reason at all that cheese, yoghurt or milk couldn’t be included in your daily intake.

Milk probably should be low or zero fat – although it’s not really clear why that should be.

And there’s yet to be any comment about dairy and male health (specifically as a risk factor for prostate cancer).

There is a definite need to look at the components of dairy to find out why, despite its high saturated fat and salt content, it doesn’t appear to adversely affect health – calcium perhaps? Or other nutrients such as dairy fatty acids, vitamin K, or even probiotics (live bacteria).

So enjoy cheese, but until more is known, don’t trash your way through a fromager/cheesemonger just yet!

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