“The bottom line is that the bad reputation that cheese has regarding its adverse effects on cholesterol, and hence on heart disease, is undeserved for the most part,” says Ronald Krauss, a professor at the UCSF School of Medicine and an expert on diet and cholesterol. “The saturated fat is really composed of saturated fatty acids in a structure that forms a fat. Those saturated fatty acids come in many different forms, and they can have very different biochemical effects. And most of them can raise blood cholesterol, but not all of them do.”
Both Krauss and Mozaffarian say that, despite the promising research, there still isn’t enough good data to say conclusively that cheese prevents heart disease or obesity. What is clear, however, is that eating normal amounts of cheese at least doesn’t appear to raise the risk, on average. “I spend a lot of my time with patients giving dietary advice, and I tell them, ‘Don’t worry about cheese,’” Krauss says. “They love it.”
Of course, there are reasons for some people to avoid cheese. Krauss cautions that everyone’s body is different, and people with stubbornly high cholesterol might still benefit from cutting out cheese. Highly processed varieties, in particular, can be high in sodium and other ingredients people might be trying to limit. If you’re vegan, whether it’s because of animal cruelty or climate change, I’m not trying to change your mind. (According to an analysis by Helen Harwatt, a fellow at Harvard Law School, global dairy production accounts for about 3.6 percent of greenhouse gas emissions.) The point is merely that a lot of people love eating their aged Gouda, their sharp cheddar, and indeed their funky Gorgonzola, and as far as health is concerned, they don’t need to feel guilty about it.
Perhaps the real reason the good news hasn’t caught on widely is that the evidence so far reveals cheese to be neither a superfood, like yogurt, nor a mass killer, like sugary soda. (That might change if more research confirms a 2020 study that found that cheese protected against age-related cognitive decline.) This makes it harder to know what exactly to do with the information.
Mozaffarian puts cheese in the middle of his personal three-tier food pyramid. At the top are “protective” foods, which include fruits, beans, nuts, fish, yogurt, and minimally processed whole grains, of which Mozaffarian advises eating a lot. At the bottom are foods that he avoids, like refined carbohydrates and processed red meat. Neutral foods, like cheese, go in between.
“We can’t always eat the healthiest possible thing,” he says. “We need neutral foods for variety, fun, palatability, so cheese is up there on my list. If I’m not going to have the absolute best—fruits, nuts, seeds, fish—cheese is great. And if you add it to those other foods, it’s fantastic.”
Personally, I find this advice liberating. I used to avoid adding cheese when I made pasta, on the assumption that it was just making my dinner more fattening. Now I realize that I’m better off getting full from a bit less pasta—a refined grain—and a bit more cheese, perhaps a nice aged Parmesan. It’s also an easy way, almost a hack, to improve a healthy but unexciting meal, like the leftover quinoa with vegetables that I had for lunch this week. It was fine—until I stirred in about a tablespoon of goat cheese, which made it amazing. Is a guilty pleasure as pleasant when you remove the guilt? In this case, I’m inclined to say yes.
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