Eating more high-fat cheese and cream may be associated with a lower risk of developing dementia, according to a study published Wednesday in the journal Neurology. The analysis is based on data from almost 30,000 people and refutes previous scientific belief that a low-fat diet could have a protective effect against dementia. Although its findings are very grandiose, it is an observational study that does not demonstrate causality.
“For decades, the debate between high-fat and low-fat diets has shaped health advice, even categorizing cheese as an unhealthy food that should be limited,” said Emily Sonestedt, an epidemiologist at Lund University in Sweden and lead author of the study. “Our study found that some high-fat dairy products might actually reduce the risk of dementia, challenging some long-held assumptions about brain health.”
The researchers analyzed data from 27,670 people in Sweden, with an average age of 58 at the start of the study. At that time, participants recorded their diet for a week and answered questions about how often they ate certain foods over the past few years. They were then followed for an average of 25 years. During this period, 3,208 people developed dementia. After adjusting for age, gender, education and overall diet quality, researchers found that people who reported eating the highest fat cheese had a 13 percent lower risk of developing dementia than those who ate the least. High-fat cheeses are those that contain more than 20% of this component. Manchego, Parmesan, Roquefort or Cheddar would fall into this category.
Naveed Sattar, professor of cardiometabolic medicine and honorary consultant physician at the University of Glasgow, strongly criticizes the study. In statements to the scientific portal SMC, he begins by emphasizing that this does not demonstrate causality, he also explains that there may be a variable to take into account, namely that people who consumed more cheese had, on average, a higher level of education. “This raises the possibility of residual confusion,” he adds. The expert therefore does not believe that this study will change the paradigm regarding fat and dementia. “We already know several well-established and proven factors that reduce dementia risk, such as maintaining healthy blood pressure, weight control, and preventing heart disease or stroke. These interventions should remain the priority, given their strong evidence base, rather than focusing on unproven dietary associations,” he says.
Tara Spiers-Jones, director of the Center for Brain Science Discovery at the University of Edinburgh, also at SMC, agrees. The neurologist believes that “although these are interesting data, this type of study cannot determine whether the reduction in dementia risk is due to differences in cheese consumption.” Spiers-Jones also points out a detail: the subjects only detailed their diet at the start of the study and the diet a person follows changes over 25 years, so the study’s conclusions eventually fade. Finally, he adds the importance of following a healthy diet and reminds that “there is no solid evidence that any specific food protects people from dementia.”
Dementia is a growing disease. In an aging world, its incidence continues to grow. The scientific community estimates that by 2050, the number of people with dementia on the planet will almost triple, from 57 million in 2019 to 153 million within three decades. Age and genetics are the main risk factors for the development. This is why there are few possibilities to prevent it, but there are some environmental factors that could predispose you to suffer from it. In the summer of 2024, the Lancet Commission on Dementia released a report suggesting that nearly half of dementias – 45%, according to study models – could be prevented or delayed if 14 preventable risk factors closely linked to their development were eliminated. Among them were diabetes and high cholesterol.
Excess LDL cholesterol – called bad cholesterol – is responsible for the development of 7% of cases of dementia, according to this study. High-fat cheeses are one of the foods that increase LDL the most. Excess cholesterol in the brain is associated with a higher risk of stroke and the deposition of beta-amyloid and tau proteins, which are closely associated with the development of Alzheimer’s disease.
The subject has been widely studied, although the conclusions are not devastating. A meta-analysis from Peking University, which included nine studies and more than 23,000 participants, reached similar conclusions. Higher intake of saturated fats (such as those in fatty cheeses and creams) was associated with a higher risk of cognitive decline and Alzheimer’s disease. However, the methodological diversity used in the different studies requires these conclusions to be taken with caution.
Although all experts emphasize the importance of lifestyle and healthy choices to keep the brain as healthy as possible, most of the factors that determine whether or not a person develops dementia are beyond their control. Experts caution that it is not appropriate to claim that people with dementia could have avoided it if they had chosen a different lifestyle, because all of these ideas are hypotheses based on observational evidence. In reality, there is no causal, categorical evidence that dementia cases can be prevented through diet. Much less encourage the consumption of a specific food.
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