Cheese and high cholesterol

Dairy products are important foods because of their nutritive properties, as well as being rich in flavor; at the same time, however, they may contain considerable quantities of saturated fats. Guidelines recommend limiting the amount of these fats in your diet, especially if you have high cholesterol, in order to reduce the risk of cardiovascular illness.
How can you keep your heart healthy, follow a correct lifestyle, and still continue to eat and enjoy these products?


Current recommendations

Following a healthy diet is fundamental to reducing the level of “bad” cholesterol (LDL) and keeping your weight under control.
The foods to include in your daily regimen break down as follows: above all, fruit and vegetables, with more than 5 portions a day, dairy products and low fat cheese follow, with 2 to 4 portions per day, carbohydrates (pasta, bread, rice, seeds), lean meat, fish and dried fruit and nuts. For an optimal nutritional result, it is better to avoid eating foods with a high saturated fat content.
In fact, saturated fats are critical to the values of LDL cholesterol and should not make up more than 10% of your total caloric intake. The foods to avoid are those made with whole milk, fatty meats and tropical oils. If you have excessively high levels of LDL, the average amount of saturated fats consumed should be further reduced.
Limiting your intake of saturated fats can be achieved by replacing the foods that contain them in high amounts with others that instead contain mono and polyunsaturated fats, like vegetable oils, including extra virgin olive oil.
Some polyunsaturated fats have a beneficial effect on the heart, particularly the Omega-3 fats found in some fish, which have been shown to have properties that protect the heart. On the contrary, unsaturated trans fats have the effect of increasing LDL cholesterol levels in your body and reducing HDL levels. Trans fats form during hydrogenation and are found in industrial products, like some margarines.


The Mediterranean diet

People who follow the Mediterranean diet show lower rates of heart disease. This nutritional regimen is in line with the most authoritative guidelines. In fact, it consists of the constant use of fruit, vegetables, legumes, whole grains, fish and unsaturated fats (especially olive oil). The Mediterranean diet calls for alcoholic beverages to be consumed in moderation (wine is thought best, and only during meals) as well as a lower proportion of red meat, dairy products and saturated fats.


Cheese and dairy products: nutritional properties

Dairy products and cheese are important components of a healthy diet. The nutrients they contain include vitamins (like vitamin K) and minerals (like calcium, of which they supply 60% of the recommended daily intake). Calcium,especially that contained in dairy products, has been shown to bind with fatty acids in the intestine, reducing their absorption. Moreover, dairy products and cheese are sources of micronutrients and macronutrients critical for the growth, development and maintenance of bodily tissues.
Fermented dairy products and cheese are probiotic foods that can have positive effects on your microbial balance, your gut bacteria in general, with potential benefits for your entire organism.


Good or bad?

But qualitatively speaking, dairy products are not all the same. Ice cream, for example, is considered a ‘good’ food, but if we look at industrially produced ice cream, with added sugar and vegetable fats (like coconut or palm oil), the nutritional profile is quite different.

Cheese often contains high amounts of salt, loaded with sodium. Fresh cheese (like, for example, ricotta or stracchino) has less fat than aged cheese, but usually contains less calcium, which, as mentioned above, can be useful in absorbing fats in the intestine. And the type of fat contained in dairy products can also differ widely, depending on the kind of milk used, the condition the animals are in and the production process.


The relationship between cholesterol and cheese

Dairy products contain a combination of saturated and polyunsaturated fatty acids, which can have different effects on how you metabolize fat. In addition, they also contain substantial quantities of other nutrients that can affect cardiovascular risk, like phospholipids, milk proteins, calcium and vitamin D.
Several recent studies re-examine the relationship between cheese and blood cholesterol levels. One of these compared the increase in cholesterol due to the consumption of aged cheese to that resulting from other dairy products with a high fat content.
Fresh cheese and tofu (soy cheese) did not cause any increase in cholesterol levels, compared to aged cheese. But butter, although it has a similar combination of fats (in terms of the ration between polyunsaturated fat and saturated fat), increases cholesterol levels more than aged cheese.
Generally, the latest scientific data do not show such a negative impact on cholesterol levels or cardiovascular risk due to the consumption of cheese. The findings suggest that the increase in cholesterol caused by saturated fats is mitigated by the presence of precious proteins and minerals, present in complex foods like cheese and yogurt, which apparently limit the absorption of saturated fats.


How to eat cheese

Today, the most authoritative guidelines recommend 2-4 portions of dairy products per day, while with regard to cheese, they suggest consuming low fat cheese, with a frequency of 2 times per week maximum.


  • Società Europea di Cardiologia, Società sulla Prevenzione delle Malattie Cardiovascolari nella Pratica Clinica, Associazione Europea per la Prevenzione e Riabilitazione Cardiovascolare (EACPR). Linee guida europee 2016 sulla prevenzione delle malattie cardiovascolari nella pratica clinica. SG Ital Cardiol 2017;18(7-8):547-612.
  • Ministero della Salute. Linee Guida per la prevenzione dell’aterosclerosi. 2004.
  • Lordan R, et al. Dairy Fats and Cardiovascular Disease: Do We Really Need to Be Concerned? Foods. 2018 Mar 1;7(3).
  • De Goede J, et al. Effect of cheese consumption on blood lipids: a systematic review and meta-analysis of randomized controlled trialsNutr Rev. 2015 May;73(5):259-75.
  • Drouin-Chartier JP, et al. Comprehensive Review of the Impact of Dairy Foods and Dairy Fat on Cardiometabolic Risk. Adv Nutr 2016; 7:1041–51.