Oddly although I’ve been in the snow for a week it has not seemed that Christmassy, but now back at home with the decorations up and presents to wrap the vibe has suddenly changed. I had a fantastic time away with my family skiing. We were lucky with the weather, plenty of sunny days and the hallmark of a good trip – no-one got injured! I have barely thought about work too, another hallmark of a good holiday! I also reaped the rewards of all the pre-holiday training I did. My legs felt fresher than ever despite being out on the slopes all day every day.
It occurred to me last week that one reason I think I really love skiing is that it has to be one of the most mindful experiences possible. By that I mean when I’m speeding down a slope I have to be totally present and focused on the task in hand, not wondering about stuff in the future or ruminating on things from the past as to do so could be really dangerous. It is a risky sport, and in fact tragically a 24 year old man lost his life in Les Arcs skiing off piste last Thursday.
My daughter has coeliac disease and every trip to France is often slightly fraught with concerns that the majority of French good contains gluten. I love France, but they are often lacking in the allergy awareness department. As such, we always self-cater, and bring gluten-free bread from home. I really feel for her on these trips, as there are few delights so heavenly as fresh croissants in the morning, and baguette for lunch.
Which brings me to the cheese. Full-fat, creamy, mouldy, stinky, runny…
I believe a common misconception is that these things are bad for you. Very little in the world of nutrition is black and white however, and this is no exception. This brings me to an article that caught my eye this week and I wanted to share my thoughts on it. The headline was variously reported, but was along the lines of ‘full fat dairy lowers dementia risk’. As regular readers know, my mum sadly has advanced dementia, and so I’m always interested in any research in this space. I’m also always interested in medical studies that make it into the mainstream media, as there is often so much mis-representation and scientifically dubious interpretation.
So what did this latest study suggest?
A large Swedish study followed nearly 28,000 adults for over 25 years to see whether different types of dairy products were linked to the risk of developing dementia. The researchers didn’t just look at “dairy” as a single category — they separated high-fat and low-fat versions of cheese, milk, cream, and yoghurt.
The report concluded that people who regularly ate higher amounts of full-fat cheese had a lower risk of developing dementia later in life. The strongest effect was seen in vascular dementia, and there was also a lower risk of Alzheimer’s disease in people who did not carry the APOE-ε4 gene (a common genetic risk factor for Alzheimer’s).
Those who consumed full-fat cream also appeared to have a slightly lower risk of dementia, although this finding was less consistent.
In contrast, low-fat dairy products showed no clear benefit; milk (full-fat or skimmed) showed no protective effect, butter was not protective and, in some analyses, was linked to higher Alzheimer’s risk.
One of the very first things to do when appraising any sort of medical study is to see that sort of a study it is, and what was the methodology used. In this case, this was an observational study, meaning it can show associations but cannot prove cause and effect. This is incredibly important. People who eat more cheese may differ from others in ways that are hard to fully measure, even with careful analysis. In this case, people who eat full fat cheese are more likely to be affluent, better educated, and with that a host of other attributes that may affect dementia risk.
This is not to say we should discount the study entirely, indeed many studies have to be conducted in an observational fashion as they simply do not lend themselves to higher calibre research like randomised controlled trials. Imagine randomising people to different cheese consumption for 25 years, impossible! Just think also for a moment how your own eating habits have changed over that time, I know mine have!
However, this study adds to a growing body of research suggesting that nutrition isn’t just about fat percentages or calorie counts, but about the whole food “matrix” — how nutrients are packaged together.
Cheese, for example, may contain fermented fats, protein, calcium, vitamin K2, bioactive compounds that may influence inflammation, cholesterol handling, and even the gut microbiome. The proportion of these compounds in different cheeses however will vary enormously. Interestingly, several clinical trials have already shown that full-fat cheese does not worsen cholesterol profiles compared with low-fat cheese — challenging long-held assumptions about saturated fat.
This study does not say that eating cheese will prevent dementia, or that everyone should increase their intake of full-fat dairy. Nor does it say that saturated fat is “good” in unlimited amounts. My interpretation is that food quality and food type matter more than simple labels like “low-fat” or “high-fat”. Within a balanced, whole-food diet, traditional foods like full-fat cheese may be neutral — or even beneficial — for long-term brain health, especially when compared with ultra-processed alternatives. This later point cannot be over-stated.
What also cannot be overstated is how much more influential other factors are likely to be with respect to the prevention of dementia. If you would like to catch up on a previous post on dementia you can check it out here
As always, dietary advice should be individualised, taking into account heart health, metabolic risk, genetics, and personal preferences. In my own case, I regularly eat good quality high fat cheese. However this week’s full-fat cheese intake has been considerable, and whilst very enjoyable, I’m very much looking forward to some plain old vegetables, and of course my Christmas dinner!
In this week’s research video, I discuss a study looking at the question ‘what is the importance of the situation when only the bottom number of the blood pressure reading is high?’ This is a question I get asked not-infrequently by patients in clinic, so hope you find it interesting.
All that is left is for me to say I wish you a very happy Christmas!