43. Cheese intake, LDL-cholesterol concentrations and the putative role of calcium, protein and fermentation

Cardiovascular diseases (CVDs) continue to be the leading cause of death worldwide. Saturated fat increases cholesterol concentrations in the blood and thereby the risk of CVD. Cheese is a dairy product commonly known to contain high amounts of saturated fat and is therefore considered unhealthy. However, some studies suggest that cheese intake is not related to CVD risk. Thus, this review looks into the existing evidence of the effect of cheese intake on low-density lipoprotein (LDL)-cholesterol concentrations, a well-established risk factor of CVD. Surprisingly, most studies suggest that cheese intake does not increase LDL-cholesterol concentrations despite the high content of saturated fat. The mechanisms behind the neutral or cholesterol-lowering effect of cheese intake are not fully elucidated. Several possible mechanisms exist: The high calcium and protein content in cheese may affect the LDL-cholesterol concentrations. The fact that cheese is a fermented dairy product may also alter the LDL-cholesterol concentrations. Nevertheless, cheese is a very complex dairy product and the composition depends on the means of production. Whether cheese should be categorised as ‘unhealthy’ regarding CVD risk needs to be reconsidered.