New Study: Patients May Not Have to Give up Cheese to Improve Metabolic Health

By Maria-Paula Carrillo, M.S., RDN, LD on 09/04/2019

Tags: Obesity, Research, Diet

No matter your culture, we are all aware that cheese  ̶  as well as other dairy products  ̶  is an essential part of most cuisines. But for some time now, there has been a lot of noise surrounding dairy fat; full-fat versus low-fat dairy has been the focus of many research studies over the past decade. Fortunately, although the science of nutrition continues to evolve, the nutritional benefits of dairy are not in question. It is well known that dairy foods provide essential nutrients for people of all ages. 

While the Dietary Guidelines for Americans, the American Heart Association and the American Diabetes Association continue to recommend low-fat and fat-free dairy foods as a means of moderating intake of saturated fat for overall health, we have learned that not all saturated fats are created equal. Newer research is beginning to point to a person’s overall diet composition (carbohydrate, protein and fat intake) as having a bigger effect on their risk for disease, specifically metabolic syndrome.

What Is Metabolic Syndrome?

Patients are diagnosed with metabolic syndrome (MetS) when they exhibit at least 3 out of 5 risk factors: high blood pressure, high blood triglycerides, low HDL cholesterol, high blood glucose and abdominal obesity (waist circumference > 102 centimeters for men and > 88 centimeters for women). These factors are associated with Type 2 diabetes, heart disease and cancer. More than a third of U.S. adults can be characterized as having MetS.

The traditional diet recommendations to manage MetS have been focused on decreasing fat and energy intake. However, a new study suggests that eating higher fat dairy foods, such as regular cheese, along with low-carbohydrate intake may be beneficial in the management of MetS, even independent of weight loss.

Key Takeaways From the Study

The study, published this summer in the Journal of Clinical Investigation, set out to examine the role of a low-carbohydrate diet on the improvement of MetS risk factors. Sixteen obese individuals were fed three different diets (low, moderate and high in carbohydrates) for four weeks in a randomized cross-over fashion. The diets were designed to keep body weight constant (to rule out the role of weight loss in the improvement of MetS risk factors). As part of all three diets, participants consumed 200 grams of cheese daily (the equivalent of about five servings of Gouda and cheddar cheese). Results indicate that the low-carbohydrate, higher fat diet improved risk factors related with MetS (blood triglycerides, glucose and HDL-C), independent of weight loss. Additionally, high saturated fat intake, in the context of the low-carbohydrate diet, did not increase LDL-C (bad cholesterol) but increased LDL particle size (positive result) and reduced the levels of the most atherogenic small dense LDL particles (positive result).

The dietary carbohydrate-to-fat ratio might be one of the most important factors to consider when making dietary recommendations to MetS patients. This study adds to the growing body of evidence pointing to the beneficial effects of low-carbohydrate/high-fat diets in the improvement of MetS risk factors.

Putting Science Into Practice

Low-carbohydrate diets are proving to be uniquely therapeutic for MetS patients, independent of traditional concerns about dietary fat and saturated fat intakes – but what’s a practitioner to do?

Look at your patients as individuals. Review their diet patterns and medical diagnosis.  Your recommendations should allow them to enjoy balance in their daily meals by including foods from all five food groups in portions that make sense for their overall health.

Tips like these are always helpful for those who need an extra idea or two:

  • For a satisfying low-carb snack, pair a serving of cheese with crunchy vegetables.
  • If the craving is for a sweet snack or quick breakfast choice, try a smoothie made by blending plain Greek yogurt with a serving of frozen fruit and a splash of whole milk.
  • When weight loss is part of the goal, educate clients about portion control. Full-fat dairy is a bit higher in calories but also richer in flavor. A small serving as part of a meal can add enjoyment while maintaining calorie balance. 

It will be interesting to see what changes come as new dietary recommendations are reevaluated and released in the years ahead. Meanwhile, you can learn more of the science behind dairy’s health benefits.