Is cheese bad for you? This doctor says we should all give it up for good.
The foreword to the Dr. Neal D. Barnard's newest book, The Cheese Trap: How Breaking a Surprising Addiction Will Help You Lose Weight, Gain Energy and Get Healthy, opens with the cautionary tale of your everyday American, saving money by purchasing "cheese ends" at her local specialty store and envisioning a gourmet meal to include dishes like cheese fondue and cheesecake.
This cheese-loving individual, later identified as actress and author Marilu Henner, recalls that back in her cheese-obsessed days she was "fat, constipated and had pimples" — the worst of fates, clearly. And then on Aug. 15, 1979, a date she refers to as her "true health birthday," Henner gave up cheese forever, sacrificing a lifetime of potential cheddar-induced joy for what she calls a "happier, healthier" life.
But how happy can one be without indulging in the lure of an oozing round of brie? Or a wedge of sultry gouda waiting in the fridge for one of those must-eat-night-cheese evenings?
Barnard advocates for a cheese-free lifestyle, postulating and proving through his scope of research and citations that a life without cheese is a healthier, and allegedly happier one.
To introduce his readers to the atrociousness of what Barnard labels the "ultimate processed food," Barnard writes about the cheese-making process, a stinky method involving bacterial growth, coagulated dairy and in some cases (Velveeta), heavy industrial processing.
When you think about it, however, with the proper adjectives the process of making pretty much any food can be made to sound gross. Vegetables start as seeds grown in dirt crawling with slimy insects? Ew. Would you eat dirt? Or worms? And did you know that even in — or perhaps especially in — organic farms, vegetables are grown in animal feces, or fertilizer, as it's called. How appealing. While some forms of cheese are indeed overly processed (See: Cheetos), cheesemaking dates back to over 4,000 years ago, with ancient peoples making soft, hard and crumbly cheeses for their eating enjoyment.
Bernard compares cheese to Coke, a processed product our ancestors certainly wouldn't recognize, noting that cheese has more calories. What he fails to mention: Unlike Coke, cheese is not made up of empty calories, but rather satiating protein, fat and some nutrients, like vitamin D and calcium.
Bernard also notes that cheese doesn't have fiber, which is indeed necessary in a balanced diet, but the same can be said of meat or simple carbohydrates — neither of which is particularly healthy, but both of which can have a place in your healthy diet in moderation.
Most problematic of this book, however, may be Bernard's main thesis that cheese keeps us "hooked" and you may just be addicted to your favorite dairy product. In order to help you determine if you're addicted to cheese, Bernard includes the American Psychiatric Association's questionnaire on how to determine if you have an Opioid Use Disorder.
Cheese addicts may be:
• Taking in larger amounts than intended (ever go in for that extra sliver of Manchego?)
• Sustaining a persistent desire or unsuccessful attempts to cut down or control use (you didn't plan to go to the cheese store, but you just happened to walk by)
• Having a craving or strong desire for the substance (a cheese plate before dinner? YES!)
• Continued use despite having a problem that has been caused or exacerbated by the substance (you don't have Lactaid, but that mac and cheese looks damn good)
Your love is not a drug
Categorizing an adoration for cheese as an addiction disorder can be dangerous, especially when cutting cheese completely out of your diet isn't necessary for a healthful lifestyle.
Despite those click-baity headlines that came out in the beginning of 2016, comparing cheese to crack, cheese, is not, in fact, an opiod nor a drug. "I was horrified by the misstatements and the oversimplifications ... and the statements about how it's an excuse to overeat," Ashley Gearhardt who led the study at the University of Michigan told Science News following the study's release. "Liking is not the same as addiction. We like lots of things. I like hip-hop music and sunshine and my wiener dog, but I'm not addicted to her. I eat cheese every day. That's doesn't mean you're addicted or it has addictive potential."
When Mic reached out to Barnard to counter this point, he disagreed that cheese is not addictive.
"The old notion was that heroin and morphine are addicting because they actually attach to brain receptors, but foods can't be addicting because they just taste good," Barnard responded via email. "However, we now know that the casomorphins from cheese actually attach to the same brain receptors that heroin and morphine attach to. In addition, the salt in cheese stimulates dopamine release."
While Bernard discusses the casomorphins in his book, the science is murky, as clarified by Gearhardt. Bernard told Mic that "what really matters is to just ask yourself if you are hooked or not."
His advice: "If you do feel hooked and are paying a price in weight gain or health problems, you can use the techniques we learned from dealing with treating additions: for example, making a clean break is easier than teasing yourself with occasional small amounts, and social support helps enormously." Mic couldn't find an official chapter of Cheese-aholics Anonymous, but that doesn't necessarily mean it doesn't exist!
Barnard is president of the Physicians Committee for Responsible Medicine, a medical advocacy group strongly in favor of a vegan diet, and he does not believe dairy belongs in the adult human diet. He told Mic:
Biologically, dairy products are "designed" for one purpose — to fatten a calf. For humans, breast milk is important. After weaning, there is no biological need for milk or cheese at all. People defend it only because they are used to it. Speaking of dietitians, the dairy industry has been a major sponsor of the Academy of Nutrition and Dietetics, and it is no surprise that some dietitians have remained loyal to the industry.
Cheese can be healthy
"Cheese has very high protein quality — along with eggs, dairy protein is absolutely tops, it's even better than meat protein," Keith Ayoob, associate clinical professor of pediatrics at Albert Einstein College of Medicine and director of the Nutrition Clinic, Children's Evaluation and Rehabilitation Center at Montefiore Health System, said via email. "Cheese is also loaded with calcium and the majority of consumers don't get nearly enough calcium, so having dietary sources that are well-liked and nutrient-rich is a real plus."
Similarly, Elyssa Toomey, a registered dietitian at L'ifestyle Lounge does not believe that foods should be categorized as good or demonized as bad, but rather prioritized by nutrient density. "Cheese is a good vegetarian source of protein and contains a host of nutrients like calcium, phosphorus, zinc, vitamin A and vitamin B12," Toomey said in an interview, also noting that cheese is a great source of calcium, a nutrient many people do not get enough of through their diets.
The cheese doesn't stand alone
Cheese, like many, many other foods, can be part of a healthy diet when eaten in moderation and with the appropriate amount of variety in your diet.
"All foods can fit into a healthy diet," Toomey said. It's about listening to what your body wants and needs, as well as eating when you are physically hungry and stopping when you are full and satisfied, she explained. "Better health comes from incorporating many positive health behaviors, including eating a diet rich in nutritious foods, doing movement that makes you happy, getting adequate sleep and practicing mindfulness, to name a few." And did you forget that grilled cheese eaters have more sex?
While the fat content in some cheeses may concern some, it turns out that cheese may not be the worst food to worry about when it comes to saturated fat troubles.
Ayoob pointed out that recent research has found that cheese, while high in saturated fat, doesn't seem to increase health risks in the same way as other foods high in saturated fat, like butter. "Butter will increase the 'bad' cholesterol but cheese does not," Ayoob said. "Yet, butter and cheese have the same type of fat, so this difference interested me. It seems that they behave differently in the body and it's likely because the saturated fat in cheese is bound to the protein in cheese. This fat-protein matrix prevents the body from utilizing it in the same way."
If you're working to lose weight and love cheese, take a breath. A 2011 Harvard study found that weight increase is directly correlated with eating potato chips, potatoes, sugar-sweetened beverages, unprocessed red meats and and processed meats. Cheese was not included in that list. In fact, increased intake of vegetables, whole grains, fruits, nuts and yogurt were all correlated with weight loss in that study, so if cheese sauce is making your whole grains and vegetables more palatable, it may just be a health food.
Similar to any food, cheese comes in healthier and less healthy forms. For cheese, lower-fat cheeses may be better to eat if you're trying to monitor your calorie and fat intake. Softer, fresh cheeses like ricotta, mozzarella and cottage cheese may be lower in fat and calories than other, harder cheeses, which may contain more fat.
"Don't knock cottage cheese," Ayoob said. "It's one of the most under-appreciated protein supplements around." He recommends adding cottage cheese to smoothies for a protein boost.
If you're trying to evaluate the health of the cheese on your cheese plate, Ayoob recommends following this rule: The softer the cheese, the fewer the calories per ounce. "That's right — the double-cream brie actually has only about 75 calories per ounce, versus the 110 or so for cheddar and 140 or so for hard parmesan or romano," he said.
But beware of overdoing it with the soft, creamy, finger-licking cheese. "The thing is, you'll probably eat a larger amount of brie than romano, so attention should be paid," Ayoob said. "Cheese is a super-nutritious and enjoyable food in the diet but it's not one that can be eaten mindlessly. For that matter, no food should."
Keep it real with your cheese
One downside to having cheese in your diet: Over-cheesing is easy. "People love cheese, so it's easy to eat a lot of it. It has calories, so you just need to eat it in moderation," Ayoob said. He says limiting cheese intake to about 3-6 oz per week is a good goal. This rule of thumb is also consistent with what's considered to be the healthiest diet in the world: the Mediterranean diet.
If your life would truly be happier without cheese in it, feel free to eliminate it. Why keep something around that you doesn't bring you joy? But if you're a cheese fiend, be true to yourself. "I never advise anyone to cut out a food they really love," Ayoob said. "They probably wouldn't anyway, but they absolutely don't need to with cheese. Just keep it real."