Cheese and Your Low-Cholesterol Diet

Patients with high cholesterol are often confused about whether cheese can be part of their diet.

Some choose to avoid eating cheese altogether, while others don't change their cheese intake at all.

A more appropriate strategy falls somewhere in the middle. In fact, thinking on dietary cholesterol is changing, as evidence mounts that saturated and trans fats have the greatest influence on cholesterol levels in the body. So it isn't necessary to avoid cheese entirely. 

But if you have high cholesterol, you’ll need to make some changes—in particular, by lowering your overall calorie and saturated and trans fats intake. The American Heart Association recommends limiting saturated fat intake to 5% or 6% of daily calories, an amount that translates to 11 to 13 grams of saturated fat on a 2,000-calorie-a-day diet.

While it's true that regular-fat cheeses can be a considerable source of calories and saturated fat ("bad fat" that contributes to high cholesterol), this is not true of all varieties.

Instead, read labels and look for reduced-fat, light, and non-fat cheeses, which are much lower in saturated fat. They can be used regularly but should be considered accessory toppings rather than the focus of a meal. Even standard (full-fat) cheeses can be enjoyed in moderation. Again, think of them as "sometimes" foods, rather than the main focus of a meal. 

Frequency and Portion Control

For a diet to be successful, dietitians promote the concept that there are "no entirely forbidden foods." Like any food, cheese can be included in your low-cholesterol plan as long as frequency and portion size are considered—especially when it’s replacing less-healthy fats, such as butter.

Alison Massey MS, RD, an outpatient dietitian at St. Joseph Medical Center (Towson, Md.), encourages her patients to stick to 1-ounce portions when enjoying cheese. (A 1-ounce portion of cheese is equivalent to roughly four playing dice or an adult-sized thumb).

Alternatives to Standard-Sized, Full-Fat Cheeses

"Many companies now sell their cheeses in the 'perfect portion' or snack sizes," Massey says. "Two of my favorites are Cabot and The Laughing Cow. They also have reduced-fat and light options."

Lower the Amount of Full-Fat Cheese Consumed

While it's true that full-fat cheese can be high in unhealthy saturated fat, making smart dietary decisions can help you lower the amount you regularly consume.

"If you can't do without full-fat cheese, why not try to lower the total amount of cheese overall?" says Jessica Butcher, RD, a dietitian in Grand Haven, Mich.

Butcher provides three tips to modify the amount of full-fat cheese in your meal:

1. Order pizza with half the restaurant's standard amount of full-fat cheese.
2. Enjoy your sandwich or burger without cheese and add delicious healthy toppings—such as caramelized onions, avocado, or tomato—or a couple of extra pickles instead.
3. Opt for a more flavorful or stronger-tasting full-fat cheese to help you reduce the amount needed. Feta, blue cheese, and goat cheese, for example, are amazing as toppings for your salad, pasta, burger, or wrap.

Consider Alternatives

Also, keep in mind that cow's milk cheese is not your only option for enjoying dairy products.

"Choose low-fat or fat-free cheeses, or try cheese made from soy, almond, or goat's milk," suggests Beth Ellen DiLuglio, MS, RD, a nutrition educator in Florida.

As researchers continue to delve into the effects of dairy fats, particularly fermented products like cheese and yogurt, some studies suggest they could have a neutral or even beneficial effect on overall cardiovascular health, as a 2018 meta-analysis found.

Still, the same study suggests replacing dairy fats with the super-healthy polyunsaturated fats found in plants and plant-based oils is still your best move for reducing cholesterol and significantly improving heart health. Consider trying cheeses made from nuts and seeds—check your local market for varieties made from heart-healthy ingredients such as almonds, sunflower seeds, and pumpkin seeds. 

Bottom Line

Enjoy full-fat cheese in moderation or opt for non-fat or low-fat cheeses. Omit cheese toppings when you can, or consider non-cow's-milk cheese alternatives.