Holy Cow! Cheese May Actually Cut Cardiovascular Risk

A new 2025 study finds a protective association between dairy and heart health. But it's never so straight forward... Brie Ready... This is going to get Gouda!

Jan 12, 2025

Many health ‘experts’ are Down on Dairy given its high saturated fat content.

After coconut, dairy has among the highest percent fat as saturated fat of any food, certainly more than beef, bacon or eggs. And this has contributed to its Muenster status with respect to heart health.

But let’s bust that myth with new data.

There is now a video covering these data. If you prefer to watch, click below. If you prefer to read… read on!

New Study on Dairy and Cardiovascular Disease

In this new 2025 study, researchers looked at the association between dairy consumption and incidence of cardiovascular disease in a Chinese cohort and UK Biobank and complemented these analyses with another meta-analysis of existing studies.

In a sentence, they found “total dairy consumption is associated with a 3.7% reduced risk of cardiovascular disease and a 6% reduced risk of stroke.”

Cheese lovers rejoice!

But if these data read as straightforward as “all dairy did X in all populations,” … well … then I wouldn’t Brie writing a full newsletter, which would be a shame as I wouldn’t have the time to churn out these puns.

Methods & Main Findings on Total Dairy Intake

First, let’s give a high-level overview of the methods and results.

In this study, they followed ~900,000 participants from the UK Biobank (UKB) study and the China Kadoorie Biobank study for a cumulative ~9 million person-years to evaluate the associations of dairy consumption with the incidence of cardiovascular disease and stroke.

In the UK cohort, they found more total dairy intake was associated with 7% lower risk of new cardiovascular disease and 14% lower risk of ischemic stroke.
However, in the Chinese cohort, they found no association with cardiovascular disease after the multivariable adjustment, a 9% increased risk of coronary heart disease, but 6% lower risk of stroke.

So, the relationships in the two cohort both suggested lower risk of stroke, but in the UK cohort total dairy consumption associated with less heart disease, and in the Chinese cohort, if anything, there was a positive association.

Weird?

Now, it’s not fully explained why this was the case, but there are at least two possibilities.

First, the average intake of total dairy products in the UK cohort was more than 4X higher than in the Chinese cohort. So, it is plausible that the cardiometabolic benefits of dairy consumption may require a relatively high level of intake. (Aside: I love this interpretation by the authors!)
Second, genetic differences between the populations may play a role, i.e. there may be something about the genetics of people in the UK that allow them to benefit more from dairy as compared to the population in China, as a whole.

Results Based on Dairy Type

And, as you can imagine, another complicating factor is that there are lots of different types of dairy. So, the researchers then did a breakdown based on dairy types, and found:

CHEESE

Cheese consumption was associated with lower cardiovascular disease risk, with a 12% decreased risk among those consuming cheese at least 7 times/week of cheese versus those consuming cheese less than 2 times/week.

Who knew your heart and cheese could be such Brie-lliant friends? Speaking of Brie…

And they found a protective association for both softer, fresh cheese and hard cheese, as well as a protective association between high-fat cheese intake of at least 1 serving every other day and cardiovascular disease.

Quoting from the paper, “Although cheese, especially hard cheese, is rich in salt, saturated fat, and calories, we still detected protective relationships for hard cheese and high-fat cheese...”

ICE CREAM

And, in case you couldn’t have guessed it, no protective effects were observed for ice cream. I know what you’re thinking: Ah, No Whey!

MILK

In terms of milk, there also appeared to be a generally protective effect. Although I’ll note that the abstract specifies, “…semi-skimmed/skimmed milk contributing to reduced CVD risk,” suggesting that whole milk was not protective.

*Nuance Note: This is actually a statistical quirk, as if you look at the data, you’ll see the numbers for semi-skimmed and skimmed and whole milk are all nearly identical. I’m going to note these with some jargon, then give you the simple take away: All types of milk had hazards ratios for cardiovascular disease of 0.91-0.93, meaning a 7-9% reduced risk. The only reason whole milk is excluded from the abstract is because the 95% confidence interval upper bound for whole milk 1.00 vs that for skimmed/semi-skimmed which end at an upper bound of 0.98.

So, for the non-statistically minded, it’s basically that the confidence interval for the whole milk finding fell exactly on the threshold of the arbitrarily selected boundary, whereas the statistics for non-whole milk fell just to the right side of favorable side, even though in real life they all looked the same.

Results from the Meta-Analysis

Now, I mentioned at the beginning they also did a meta-analysis of previously published studies. Therein, they found a small inverse association between total dairy intake and incident cardiovascular disease (RR = 0.963, below) and found each serving/day increment of total dairy products was related to a ~2% lower cardiovascular disease risk.

And looking at all the data for cardiovascular disease risk, they found the strongest associations for cheese and fermented dairy, with weaker or not associations for yogurt and milk.

Why the Data Are A Bit “Messy”

However, it’s very important to note there was a lot of heterogeneity across studies, which was largely attributable to heterogeneity in subtypes of dairy.

Simply put, different forms of dairy likely have different health impacts. Even within a category, sugar- or artificial sweetener-filled fruity yogurt isn’t the same as a high-protein, full fat simple Greek yogurt.

This is also why there was probably no protective associated noted for yogurt overall, since so much of the yogurt supply has added sugar, offsetting what would be protective effects. Sneaky, right?

Conclusion

Okay, let’s synthesize: Like all nutritional epidemiology, these are associations, and these data do NOT prove causation.

However, they do combat the stigma against dairy, especially cheese, since they document generally beneficial relationships between higher cheese and dairy intake and cardiovascular health.

I’ll also emphasize, if this isn’t clear: I’m not trying to apply double standards – as I have my qualms with the use of nutritional epidemiology being used to vilify healthy whole foods. However, when even the large-scale ‘hypothesis generating’ nutritional epidemiology studies fail to toss, cheese, meat and eggs under the bus – and even report an association between higher cheese intake and better cardiovascular health.

Well… I suppose this paper was cheese in a mousetrap. And… “squeak!”

In summary:

Dairy – including full fat dairy – and especially cheese is a health food. It can be a great source of protein, calcium, vitamins like K2, odd chain saturated fats (for more, click here), and probiotics.
Full fat dairy can help maintain a stable blood sugar as well, which can promote maintenance of a healthy weight. And good blood sugar control is generally good for vascular health.

A Quick Caution on A1 vs A2 Casein Protein

Before I close, I want to issue one word of caution about A1 vs A2 dairy.

The A1 and A2 refer to different forms of the casein protein found in dairy, and it’s very common to have intolerance to A1, but not A2. This is highly relevant, because most cow dairy has A1 casein. But dairy from sheep, goat, and buffalo is always A2, with no A1.

Why is this important?

Well, the A1 casein protein can be broken down in the body into a compound called beta-casomorphin-7, which activates μ-opioid receptors and can cause gastrointestinal upset, including diarrhea and abdominal pain.

So, it’s worth considering if you may be A1 sensitive. I certainly am, and it’s why I almost exclusively eat sheep, goat and buffalo dairy. My favorites, for taste and health, are Roquefort, Manchego, and Pecorino (all sheep), goat cheese, and buffalo mozzarella. That said, I enjoy these to my heart’s content! See what I did there?

Nicholas’s Substack

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