Americans love cheese. While US dairy milk consumption has fallen, cheese consumption keeps on increasing year over year. According to an Agriculture Department report from 2018, per capita cheese consumption increased to a record 37.23 pounds (16.9 kilograms).
If you're a die-hard cheese fan, you're probably consuming your mozzarella and ricotta (Italian cheese are now the most popular in the United States) with a side of guilt.
After all, cheese has long gotten a bad rap because of its high saturated fat content, which is considered bad for heart health.
Research is starting to suggest, however, that the issue may be more complex. One study published in 2018 showed dairy fats such as cheese had a neutral-to-positive effect on the heart.
A 2018 review from Harvard researchers concluded there was a "null or weak inverse association between consumption of dairy products and risk of cardiovascular disease," though it said more research was needed.
A study from the Lancet medical journal found dairy products such as cheese were linked to a lower mortality risk.
According to Jennifer Glockner, a registered dietitian and creator of the Smartee Plate, recent studies have indicated "that cheese may actually offer protective properties on the heart," though she also noted that they were observational and did not prove cause and effect.
Cheese does provide some beneficial nutrients, she said, "including protein; calcium for bone and teeth health; zinc, which promotes wound-healing and immunity; vitamin A for eye and skin health, and B12."
None of this means you should start consuming cheese indiscriminately; you should take care when adding it to your diet. Which cheeses are most healthful?
It can be tough to offer hard-and-fast guidelines because each variety has its own nutritional profile, and cheeses can be broken up into categories in myriad ways, whether you group them by the kind of rind, milk source or production style.
But with the help of experts, we've come up with some general guidelines, as well as other factors to consider when making cheese part of a healthy diet.
Ranking by healthfulness
Fresh cheese. If you're looking for the leanest option, your best bet is fresh cheese. Such unripened cheeses include goat cheese, feta, ricotta and cottage cheese. "These cheeses are produced by the coagulation of milk and cream by chemical or culture acidification, or a combination of chemical acidification and high heat treatment," says Nicole Magryta, a registered dietitian and author of Nourish Your Tribe: Empowering Parents to Grow Strong, Smart, Successful Kids.
"They also tend to be lowest in fats and cholesterol."
A serving of cottage cheese or ricotta will pack a healthy dose of protein, and they're typically lower in calories; half a cup of cottage cheese is roughly 110 calories. Ricotta is higher in calories - about 180 calories for half a cup - but is loaded with calcium.
"While high in sodium, feta tends to be one of the lowest in calories. Plus, with its strong flavor, you often use less of it than other cheeses," says Kelli McGrane, a registered dietitian with the weight-loss app Lose It!
"Goat cheese is milder in flavor than feta, but also tends to be lower in calories as well as fat."
Depending on how it's processed, goat cheese can also pack probiotics, which are microorganisms that can aid digestion.
Fresh mozzarella, "tends to be one of the lowest in calories and sodium," McGrane says. "Additionally, fresh mozzarella contains Lactobacillus casei and Lactobacillus fermentum, two probiotic strains that are beneficial for gut health."
Harder cheeses. These hard, fermented cheeses have been aged longer than soft cheese, lending a richer flavor and increasing shelf life. They include varieties such as cheddar, Swiss and Parmesan and tend to be good sources of important vitamins and minerals such as calcium and vitamin A.
They also have a modest amount of fat, according to Glockner. "Hard cheeses such as cheddar and Parmesan usually have more calcium and less lactose, since the whey is removed during processing," she explains. That said, though there's less fat than there is in soft cheese, there's more sodium.
If you have lactose sensitivity or suffer from irritable bowel syndrome, hard cheeses such as Parmesan will probably be better for reducing your gut symptoms.
Sharon Collison, a registered dietitian and clinical instructor in nutrition at the University of Delaware, says you may end up only wanting a little bit of this variety.
"These cheeses are very low in moisture which increases their shelf life," Collison says.
"They are generally served grated and can be healthy choices because they have such intense flavor that small portions are usually enough."
Blue cheese. Blue cheese, which has been ripened with cultures of the mold penicillium, includes varieties such as Stilton and Gorgonzola. It can be considered soft or hard, depending on how it's processed, and falls somewhere in the middle of the pack in terms of health.
"It's high in calories, total and saturated fat, yet it is also one of the highest in calcium," McGrane says.
Again, its potent flavor profile may mean you're satisfied with less of it.
Softer cheeses. Bloomy, mold-ripened varieties of cheese tend to have a firm rind and creamy interior, as they ripen from the outside in. Although extremely tasty on that cheese plate, soft cheeses such as Camembert, brie and triple-crème (cheese enriched with cream) fall into the "less healthy" category because of their saturated fat content.
"A key thing to remember is that the softer the cheese, the higher the fat," says Emily Tills, a dietitian and nutrition coach. "Fat makes things creamier."
It's also very easy to overeat a gooey brie slathered on a slice of bread with a sweet jam.
Processed cheeses. In the camp of cheeses better avoided completely, you can toss out the processed types, such as American cheese singles, Velveeta, spray can varieties or shredded cheeses in plastic bags.
"These products shouldn't even be considered real cheese, as they have been manipulated and engineered and pumped with preservatives," Magryta says. "Sweetened cottage cheeses should also be avoided; labels that read 'fruit flavored' mislead consumers when, in truth, the product is just cheese with sugar, additives and preservatives."
Other factors to consider
If eaten in moderation, "quality cheeses can be enjoyed as part of a healthy, whole-food, plant-focused diet," Magryta says. But there are some factors you can keep in mind to improve the health of your cheese choices.
Magryta suggests keeping portion sizes small. "Most cheeses are between 60 and 90 percent fat and have between 75 and 120 calories per ounce," she says.
"Aim to keep your serving size of cheese to 1.5 ounces or less of hard cheeses - that's about the size of four dice or a third of a cup shredded - or a half-cup portion size of cheeses like ricotta or cottage cheese."
Also, stick to just one serving a day - and savor it.
"Remember, cheese is not a [primary] source of protein, it is more so a source of fat and sodium," Amy Shapiro, a registered dietitian and founder of Real Nutrition NYC.
"People tend to put a health halo on it since it doesn't contain many carbs, but that doesn't make it a 'free food.' " If you really love cheese, Shapiro's favorite way to consume it is by making it "the star of the show, when it is worth it" instead of adding it as an extra to "sandwiches, salads, omelets," and so on.
Expert opinions differ on whether turning to low-fat cheese is a smart strategy. Though some dietitians continue to recommend low-fat or part-skim options, recent research suggests that this, too, might be a more complex issue.
A 2016 study in Circulation linked the real deal to a lower risk of diabetes, and another study published the same year linked full-fat cheese consumption with a lower risk of obesity among women.
Magryta recommends choosing full-fat or whole-milk cheese.
"When the fat is processed out of dairy foods, you lose not only the flavor but the food's natural ability to keep you full," she says. "Whole-fat cheese also helps to balance blood sugars, which may have to do with its high amounts of vitamin K, vitamin D and calcium."
Furthermore, low-fat cheese can be "a highly processed food".
Look at the ingredients. Unhealthy additions include "acids, emulsifiers, thickeners, stabilizers, gums and other nondairy ingredients to make up for the lost fat." You should be wary if the ingredient list on the cheese feels long.
As long as you're consuming cheeses in moderation as part of a diet rich in whole foods, Magryta believes the higher amount of saturated fat shouldn't be an issue.
"The healthiest cheese depends first on its quality," she says. "Cheeses that are unprocessed, raw, full-fat, grass-fed and certified organic, if possible, are the best. Fermented [or cultured] cheese products are also excellent choices. You don't always have to have all of these characteristics, but shoot for as many as you can."
For specific health needs
The dietitians we talked to recommended these cheeses to address specific health concerns.
- To reduce sodium: Swiss, goat, Emmental, or Wensleydale
- To boost calcium: Manchego, Emmental, Parmesan, Romano, Gruyere, or Swiss
- To increase protein: cottage cheese, ricotta, Romano or Parmesan
- To boost gut health: Raw, unpasteurized cheddar, feta, Gouda, Edam, caciocavallo, Emmental, or Gruyere
- To cope with lactose sensitivity: hard cheeses such as cheddar, Parmesan, Swiss, asiago, manchego and Pecorino Romano
- To be safe during pregnancy: pasteurized cheeses.
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This article was originally published by The Washington Post.