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Cheese is high on many people's list of favorite foods. But it's also one of the foods that is suggested to "eat in moderation", especially for those with heart disease. Cheese has beneficial nutrients, like protein and calcium, as well as other nutrients that are best to limit, like saturated fat and sodium. The good news is that a little bit of cheese goes a long way in the flavor department. So, how much can you really have if you have heart disease? Here are the details on whether or not cheese can and should be part of a heart-healthy diet, plus some of the healthiest ways to include cheese to your eating pattern.
How Cheese Affects Your Heart Health
"Cheese's biggest drawback is it can be high in saturated fat," says Cheryl Mussatto, M.S., RD, LD, author of The Nourished Brain, and outpatient dietitian at Cotton O'Neil Heart Center. It's well documented that eating too much saturated fat can increase the risk for heart disease and raises LDL (bad) cholesterol. As such, the American Heart Association recommends limiting saturated fat to 5% to 6% of total daily calories, or about 13 grams per day for a 2,000-calorie diet. Yet, research has not found a direct link between eating cheese and developing cardio-metabolic diseases, like heart issues and type 2 diabetes.
In addition, cheese is a good source of calcium and protein, and it contains vitamins A and B12, nutrients that play an important role in keeping the heart and body strong. "If you enjoy cheese, it can fit in a heart-healthy diet as long, as you are keeping the portion small," says Michelle Routhenstein, M.S., RD, CDE, CDN, preventive cardiology dietitian at EntirelyNourished.com and author of Truly Easy Heart Healthy Cookbook.
Health Benefits of Eating Cheese
Keeps Bones Strong
Cheese is a good source of calcium, a mineral that makes up bone structure. Adults need 1,000 milligrams of calcium per day, and most hard cheeses are an excellent source. For example, one ounce of cheddar cheese has 200 milligrams of calcium (20% of the daily value). A calcium deficiency can reduce bone strength and increase the risk of osteoporosis. A 2021 review of the research in Aging Clinical and Experimental Research concluded that dairy products make a positive impact on bone mass and bone turnover in children and adults, and fermented dairy products (like cheese) may reduce the risk of hip fracture.
Promotes Heart Health
Given the saturated fat in cheese, many would assume that it's damaging to heart health, but the research actually points to the opposite. A 2022 study in Nutrients found an inverse association between cheese intake and type 2 diabetes, heart failure, coronary heart disease, hypertension and ischemic stroke (meaning that the more cheese was consumed, the lower the risk was). However, more studies need to be done to clarify these conclusions. The authors believe this finding is due to the calcium and probiotics in the cheese, both of which have advantageous properties for the heart. "Cheese is a rich source of calcium, which is important for proper electrical activity and the pumping action of the heart," says Routhenstein.
"Cheese's protein content makes it a quick and easy way to quench hunger, especially when paired with carbohydrate-rich snacks like crackers or fruit," says Mussatto. Hard cheeses, such as parmesan, cheddar, gouda and mozzarella, contain the highest amounts of protein. "Another great protein-rich option is cottage cheese," notes Mussatto. Notably, a ½ cup of low-fat cottage cheese has 12 grams of protein and only 2.7 grams of saturated fat, making it a great heart-healthy cheese option.
What to Consider About Cheese and Heart Health
Saturated Fat and Sodium
Although cheese can be part of a heart-healthy diet, it is one of the main contributors of saturated fat in the standard American diet. Too much saturated fat in the diet can raise LDL cholesterol levels and contribute to chronic illness and obesity, according to the National Institute of Health. The American Heart Association suggests people with heart disease choose low-fat cheeses instead of higher-fat options.
"Cheese is often high in sodium, a mineral that is over consumed in the American diet and contributes to hypertension, a known risk factor for heart disease," says Mussatto. The daily recommendation for sodium is 2,300 milligrams, but those who have high blood pressure should aim for about 1,500 milligrams per day. A one-ounce portion of cheddar cheese has 180 milligrams (8% of the daily value) of sodium. If you have heart disease, be aware of how the sodium in cheese lines up with the rest of your diet. If you're eating other higher-sodium foods, like canned soups, breads, snacks or frozen entrees, you may be going over the recommended daily sodium limit.
Let's be honest, it's easy to overeat cheese. "It's found in many foods in the American diet, from mac n' cheese to Mexican dishes to pizza to grilled cheese sandwiches," says Mussatto. The recommended serving size of cheese is one ounce, or a chunk of cheese about the size of your thumb or a domino. If you're not sure how much cheese you're eating, choose pre-portioned options like slices or cheese sticks.
Choosing the Best Cheese for Heart Disease
The best cheeses for heart disease are the ones with less saturated fat and sodium. Swiss cheese is probably the best choice, with only 53 mg of sodium per ounce. Mozzarella, goat and ricotta cheeses also fall on the lower side of the sodium scale, with about 130 milligrams per serving. Lastly, cottage cheese is usually higher in sodium, but you can find low-sodium varieties at most stores.
Tips for Including Cheese in a Heart-Healthy Diet
If you have heart disease, Mussatto suggests eating cheese sparingly as a complement to food, not as the main dish. "Instead of using cubes or slices of cheese, opt for sprinkling small amounts of your favorite shredded cheese on top of foods like salads or casseroles," she adds.
Try low-fat or reduced-fat cheese in a dish. One ounce of low-fat cheddar has only one gram of saturated fat, as compared to the regular variety with closer to five grams. Although low-fat cheese may not melt as well, it still gives that savory cheesy taste. And if you want to use a regular fat cheese for melting, try using a smaller portion to keep the saturated fat in check.
Cheese can be part of a heart-healthy diet, as long as you are mindful about the sodium and saturated fat it contains, and pair it with other heart-healthy foods, according to Routhenstein. Research even suggests that eating a small portion of cheese every day may be beneficial for your heart. If cheese is one of your favorite foods, pay attention to the portion size and enjoy it mindfully.