Fermented Foods · Fermented food
Aged Cheese
Hard and semi-hard cheeses (cheddar, Parmesan, Swiss, Gouda) · also called Hard cheese, ripened cheese, mature cheese
Aged cheese is milk that has been curdled, drained and left to ripen for weeks to years. It gives protein and calcium, and it is also high in salt and saturated fat. In short trials, hard cheese raised LDL cholesterol less than butter did, but that is not the same as lowering it. The main cautions are MAOI antidepressants (tyramine), cow's milk allergy, raw-milk and soft cheeses in pregnancy, histamine, salt and saturated fat.
General information, not medical advice. Last substantive update · Not medically reviewed. A named clinician has not signed off on this page. How this page is made
About Aged Cheese
Aged cheese is milk that has been curdled, drained and ripened so that microbes keep changing it. It is a source of protein and calcium, and also of salt and saturated fat. It is a food, not a proven remedy: the cholesterol findings compare it with butter, and the long-term findings are observational.
What it is
Aged cheese covers hard and semi-hard cheeses left to ripen for weeks, months or years. The ISAPP expert panel defines fermented foods as foods made through desired microbial growth and enzymatic conversions of food components, and says a fermented food is not automatically a probiotic.
USDA data for cheddar, per 100 g: 403 kcal, 22.87 g protein, 33.31 g fat (18.9 g saturated), 0.48 g sugars, 710 mg calcium, 653 mg sodium, 1.1 mcg vitamin B12 and 99 mg cholesterol. One ounce (28.35 g, about one slice) has about 114 kcal, 6.5 g protein, 5.3 g saturated fat, 185 mg sodium and 201 mg calcium.
Cheddar, Parmesan, Swiss and Gouda compared
Per 100 g, USDA lists sodium of 1,175 mg in hard Parmesan, 819 mg in Gouda, 653 mg in cheddar and 187 mg in Swiss. Calcium is 1,184 mg in Parmesan, 890 mg in Swiss, 710 mg in cheddar and 700 mg in Gouda. Saturated fat is 14.85 g in Parmesan, 17.6 g in Gouda, 18.2 g in Swiss and 18.9 g in cheddar. Total sugars are 0.0 to 2.22 g.
USDA also lists 0.987 g of total trans fat per 100 g in Swiss. No source read said how much of this is the naturally occurring dairy kind. Values vary with the milk, the age and the maker, so check the label. Processed cheese slices, spreads and powders were not read.
What the research shows
In a pooled analysis of 5 trials, hard cheese (about 145 g a day) lowered LDL cholesterol by 6.5% compared with butter, and lowered HDL by 3.9%. Compared with tofu or fat-modified cheese, it raised total or LDL cholesterol. These are blood markers in short trials, and a large amount of cheese.
The American Heart Association advisory strongly concludes that replacing saturated fat with unsaturated fat lowers cardiovascular disease. It is about saturated fat overall, not cheese alone.
Follow-up studies found no clear link between cheese and death from any cause (RR 1.02). A dairy review found neutral or beneficial links for dairy overall, but did not report cheese alone. One small trial of a mixed dairy diet moved two inflammation markers and not the main one.
No trial showing that aged cheese improves gut health was found.
Lactose and milk allergy are different
NIDDK says many people could have 12 g of lactose, the amount in about 1 cup of milk, without symptoms or with only mild ones, and suggests trying hard cheeses like cheddar or Swiss, which are lower in lactose than other milk products. Aged cheese is not lactose-free.
A milk allergy is an immune reaction and is not the same as lactose intolerance. A 2025 review found the evidence that fermentation lowers allergenicity is limited.
At a glance
Traditional uses history, not proof
- Eaten as a staple food in many cuisines
- Long use as food is not proof that it treats any condition
Studied for research
- Protein, calcium and other nutrients, high certainty for the nutrient content
- Blood cholesterol compared with butter, low certainty (short trials, large amounts)
- Death from any cause, low certainty of no clear link (observational)
- Heart disease and diabetes (dairy overall), insufficient evidence for cheese alone
- Inflammation markers, insufficient evidence (cheese was one of three foods)
- Gut health, insufficient evidence
- Lactose tolerance, low certainty (agency guidance)
Main compounds
- Milk protein
- Calcium
- Saturated fat
- Sodium (salt)
- Biogenic amines (tyramine, histamine)
- Vitamin B12, zinc and selenium
Common forms
- Cheddar, hard Parmesan, Swiss and Gouda as food (USDA values read)
- Processed cheese slices, spreads and powders (not read)
- Soft and fresh cheeses (different advice, not covered)
Research links: 2015 review: cheese and blood lipids (5 trials versus butter) · 2017 review: cheese and all-cause death · MedlinePlus: tranylcypromine and high-tyramine foods · Research Library · Genes & Biomarkers Library
What it is and its history
- Accepted scientific name
- Aged cheese (hard and semi-hard cheeses such as cheddar, Parmesan, Swiss and Gouda)
- Naming authority
- A processed food, not a species: milk curdled, drained and ripened so microbes keep changing it.
- Common names
- Aged cheese (English); Hard cheese (English); Ripened cheese (English); Mature cheese (English); Queso curado (Spanish)
- Family or group
- Fermented dairy foods. The ISAPP expert panel defines fermented foods as foods made through desired microbial growth and enzymatic conversions of food components, and separates them from probiotics.
- What it looks like
- Fruit: USDA household portions: 1 oz = 28.35 g (about one slice), 1 cup shredded cheddar = 113 g, 1 cup diced = 132 g.
- Harvest and processing
- Not verified from a source beyond the general description in the ISAPP statement. How each cheese is made and ripened was not read. Processed cheese slices, spreads and powders are different products and were not read.
- Look-alikes and adulterants
- Name: Soft and fresh cheeses (brie, camembert, queso fresco, cottage cheese); Note: Different moisture, salt and Listeria advice; not covered here.; Name: Processed cheese slices, spreads and powders; Note: Differ in salt and additives; not read.; Name: Other fermented dairy (yogurt, skyr, kefir); Note: Have their own pages and different lactose, probiotic and sodium profiles.
Photographs
What is inside, and how it may work
What it contains and how those compounds act in cells and animals. Laboratory and animal mechanisms are not proven effects in people.
Main compounds
| Compound | Family | Where it is concentrated | Activity studied | Level of evidence |
|---|---|---|---|---|
| Protein | macronutrient | Curd USDA per 100 g: cheddar 22.87 g, Parmesan 35.75 g, Swiss 26.96 g, Gouda 24.94 g | Milk protein is also the source of the milk allergen. 21 18 20 19 | Human data |
| Saturated fat | fat | Milk fat USDA per 100 g: cheddar 18.867 g, Parmesan 14.85 g, Swiss 18.227 g, Gouda 17.614 g | The AHA advisory links replacing saturated fat with unsaturated fat to lower cardiovascular disease; it is about saturated fat overall. 21 18 20 19 6 | Human data |
| Sodium | mineral | Added salt USDA per 100 g: Parmesan 1,175 mg, Gouda 819 mg, cheddar 653 mg, Swiss 187 mg | Adds to daily sodium; see Safety. 21 18 20 19 13 | Human data |
| Calcium | mineral | Curd USDA per 100 g: Parmesan 1,184 mg, Swiss 890 mg, cheddar 710 mg, Gouda 700 mg | Amount in the food; absorption was not studied in the sources read. 21 18 20 19 | Human data |
| Biogenic amines (tyramine, histamine, cadaverine, putrescine) | amines | Formed during ripening In 125 Polish ripened cheeses: tyramine found in 28.0% (5.62 to 646 mg/kg); histamine above 100 mg/kg in 11.2% | Tyramine matters with MAOI antidepressants; histamine matters for people who react to it. 4 8 15 | Lab |
| Bioactive peptides and organic acids | fermentation products | Formed during ripening Not read. | A 2026 review says they may influence digestion, immunity and heart risk; the benefits are not shown for aged cheese. 1 | Review |
Mechanisms, receptors and pathways
| Target or pathway | Gene or receptor | What was found | Level |
|---|---|---|---|
| Tyramine and monoamine oxidase | Monoamine oxidase (the enzyme MAOI drugs block) | MedlinePlus ties high-tyramine foods, including aged cheese, to a serious reaction in people taking tranylcypromine. A 2025 survey found tyramine mainly in cheeses containing Enterococcus faecium and E. faecalis. 15 4 | Human data |
| Why cheese affects cholesterol differently from butter | Not applicable | The 2015 authors say calcium, specific types of saturated fat or the food structure might explain it. Not tested. 10 | Authors interpretation |
| Ripening conditions and amines | Not applicable | A 2026 systematic review says pH, ripening temperature and time, salt, moisture, fat, packaging and added cultures changed amine build-up in cheese studies; the best culture pair gave up to 80% lower total amines. 8 | Lab |
Absorption, metabolism and elimination
- Absorption
- Not found for cheese nutrients in the sources read.
- Distribution
- Not found.
- Metabolism
- Not found.
- Elimination
- Not found.
- Bioavailability
- Not established.
Isolated compounds versus whole extracts
The cholesterol and death results are for natural cheese eaten as food. The inflammation trial used a mix of milk, skyr and cheddar. Processed cheese slices, spreads and powders were not read, and fermented foods are not automatically probiotics. No supplement is covered.
Nutritional composition
Nutrition from USDA FoodData Central (SR Legacy, April 2018), read 2026-10-26 from the saved copy in the project. Cheddar (FDC 173414) per 100 g: 403 kcal, 22.87 g protein, 33.31 g fat (18.867 g saturated), 3.37 g carbohydrate, 0.48 g total sugars, 0 g fibre, 710 mg calcium, 455 mg phosphorus, 653 mg sodium, 76 mg potassium, 3.64 mg zinc, 28.5 mcg selenium, 1.1 mcg vitamin B12, 0.428 mg riboflavin, 337 mcg vitamin A (RAE), 99 mg cholesterol. One USDA portion of 1 oz (28.35 g, about one slice, the 100 g values multiplied by 0.2835) is about 114 kcal, 6.5 g protein, 9.4 g fat, 5.3 g saturated fat, 185 mg sodium, 201 mg calcium and 0.31 mcg B12. Parmesan, hard (170848) per 100 g: 392 kcal, 35.75 g protein, 14.85 g saturated fat, 1,175 mg sodium, 1,184 mg calcium. Swiss (171251): 393 kcal, 26.96 g protein, 18.227 g saturated fat, 187 mg sodium, 890 mg calcium, 0.987 g total trans fat. Gouda (171241): 356 kcal, 24.94 g protein, 17.614 g saturated fat, 819 mg sodium, 700 mg calcium, 2.22 g total sugars. The USDA vitamin D values for these cheeses look unusually high and were left out. Values change with the milk, age and maker; check the label. Natural cheese only; processed cheese was not read.
1 high certainty3 low certainty3 not enough evidence
What was looked at
The 7 benefits and uses checked for Aged Cheese, each with how strong the evidence is. Tap one to open it.
- Protein, calcium and other nutrients (nutrient content)High certainty
- Blood cholesterol compared with butterLow certainty
- Death from any cause (observational)Low certainty
- Heart disease and type 2 diabetes (dairy as a whole)Not enough evidence
- Inflammation markers on a high-dairy diet (cheese was one of three foods)Not enough evidence
- Gut health and probiotic effectNot enough evidence
- Easier on lactose intolerance than other dairyLow certainty
Lab markers tracked in the studies
LDL cholesterolHDL cholesterolTriglyceridesInterleukin-6 (IL-6)Tumor necrosis factor-alpha (TNF-alpha)Interleukin-4 (IL-4)
What is Aged Cheese good for?
The main studied uses and how strong the human evidence is for each. Most results are for cheese as part of the diet, and some are for dairy as a whole.
Benefits, one by one
Each card is a research question, not a promise. Tap a goal to filter. Open a card to see the studies, doses and limits.
Protein, calcium and other nutrients (nutrient content)
High certaintyCheddar has about 22.9 g of protein, 710 mg of calcium and 1.1 mcg of vitamin B12 per 100 g, by USDA data. One ounce (28.35 g, about one slice) has about 6.5 g of protein, 201 mg of calcium and 0.31 mcg of B12. Parmesan has more calcium (1,184 mg per 100 g), Swiss 890 mg and Gouda 700 mg.
4 studiesCheddar, hard Parmesan, Swiss and Gouda from USDA SR Legacy. Processe…
Studies, doses and limits
What the trials found
No trial was read showing that eating cheese corrects low calcium, protein or B12. The values are food-table facts and vary with the milk, the age and the maker.
Results
Aged cheese is a concentrated source of protein, calcium, phosphorus, zinc, selenium and B12 on paper. It is also concentrated in saturated fat and sodium (see Safety).
Effect sizes as reported
USDA per 100 g: cheddar 710 mg calcium, 22.87 g protein; Parmesan 1,184 mg calcium, 35.75 g protein; Swiss 890 mg calcium, 26.96 g protein; Gouda 700 mg calcium, 24.94 g protein.
Why this rating
High that the food contains these nutrients (USDA data). Not tested as a treatment for any shortfall.
Form and dose studied
Cheddar, hard Parmesan, Swiss and Gouda from USDA SR Legacy. Processed cheese slices, spreads and powders were not read.
Who was studied
General adult diet.
Limits
Nutrient facts, not trials. Values differ between brands and ages of cheese.
Why researchers looked
People eat cheese as a source of protein and calcium.
Traditional use
Cheese is eaten as a food in many cuisines. Long use as food is not proof that it treats any condition.
Proposed mechanism Nutrient database
These are nutrient amounts in the food, taken from USDA tables.
A proposed mechanism does not show that the effect happens in people.
See the Safety tab for milk allergy, sodium, saturated fat, tyramine and pregnancy.
Blood cholesterol compared with butter
Low certaintyIn a pooled analysis of 5 trials, hard cheese (about 145 g a day) lowered LDL ('bad') cholesterol by 6.5% and HDL ('good') cholesterol by 3.9% compared with butter. Triglycerides did not change. Compared with tofu or fat-modified cheese, cheese raised total or LDL cholesterol.
2 studiesHard cheese versus butter; the trials used a weighted mean of 145 g a…
Studies, doses and limits
What the trials found
The 2015 review found 12 trials in healthy adults and pooled 5 that compared hard cheese with butter. It is a comparison with another fatty food, not with no cheese.
Results
Hard cheese raised LDL less than butter did. That does not show cheese lowers cholesterol.
Effect sizes as reported
LDL -0.22 mmol/L (-6.5%, 95% CI -0.29 to -0.14); HDL -0.05 mmol/L (-3.9%, -0.09 to -0.02); triglycerides no effect.
Why this rating
Low: a handful of short trials, large amounts of cheese, blood markers only, and a butter comparison. No GRADE rating was given in the abstract, so this is our reading.
Form and dose studied
Hard cheese versus butter; the trials used a weighted mean of 145 g a day, a large amount.
Who was studied
Healthy adults.
Limits
Blood markers, not heart attacks. Compared with tofu or fat-modified cheese, cheese raised cholesterol.
Why researchers looked
Cheese is high in saturated fat, so researchers asked whether it raises cholesterol as much as butter.
Traditional use
Cheese is eaten as a food in many cuisines. Long use as food is not proof that it treats any condition.
Proposed mechanism Authors interpretation
Not settled. The authors say calcium, specific types of saturated fat or the structure of cheese might explain it, and call for more research.
A proposed mechanism does not show that the effect happens in people.
See Safety for what the American Heart Association says about saturated fat.
Death from any cause (observational)
Low certaintyIn 9 follow-up studies with 21,365 deaths, people who ate the most cheese were not more or less likely to die in the follow-up period than people who ate the least. The authors conclude long-term cheese eating was not linked to higher risk of death.
1 studiesCheese as usually eaten; types were not separated in the abstract.
Studies, doses and limits
What the trials found
The 2017 analysis pooled 9 prospective cohort studies. Highest versus lowest intake was not significantly linked to death, and there was no dose-response link.
Results
No clear link either way.
Effect sizes as reported
Summary RR 1.02 (95% CI 0.97 to 1.06); per 43 g a day RR 1.03 (0.99 to 1.07).
Why this rating
Low: observational, so it shows a link and not a cause, and food questionnaires are imperfect. The result is a null one.
Form and dose studied
Cheese as usually eaten; types were not separated in the abstract.
Who was studied
Adults followed over time in several countries.
Limits
Searched PubMed only through May 2016.
Why researchers looked
Death from any cause is a net measure of whether a food looks harmful or helpful over many years.
Traditional use
Cheese is eaten as a food in many cuisines. Long use as food is not proof that it treats any condition.
Proposed mechanism Observational
Not applicable. Observational analysis.
A proposed mechanism does not show that the effect happens in people.
A neutral finding for death does not remove the sodium, saturated fat or tyramine cautions.
Heart disease and type 2 diabetes (dairy as a whole)
Not enough evidenceA review of follow-up studies found neutral or beneficial links between dairy overall and heart and diabetes outcomes. Its abstract reports results for total dairy, milk and yogurt, not for cheese on its own.
1 studiesTotal dairy, milk and yogurt.
Studies, doses and limits
What the trials found
Total dairy and low-fat dairy were linked to 3 to 4% lower diabetes risk; yogurt to lower diabetes risk; total dairy and milk were not linked to coronary heart disease; milk was linked to lower stroke risk.
Results
No result for cheese alone could be read.
Effect sizes as reported
Yogurt and diabetes RR 0.86 (95% CI 0.83 to 0.90) at 80 g a day; milk 8% lower stroke risk per 200 g a day.
Why this rating
Insufficient for aged cheese: the abstract gives no cheese-specific number. One author has received grants from dairy industry bodies.
Form and dose studied
Total dairy, milk and yogurt.
Who was studied
Adults in cohort studies.
Limits
Not about cheese; observational.
Why researchers looked
Dairy foods contain both helpful and harmful nutrients for the heart and blood sugar.
Traditional use
Cheese is eaten as a food in many cuisines. Long use as food is not proof that it treats any condition.
Proposed mechanism Observational
Not applicable. Observational analysis.
A proposed mechanism does not show that the effect happens in people.
None specific.
Inflammation markers on a high-dairy diet (cheese was one of three foods)
Not enough evidenceIn a 6-week crossover trial of 30 adults with overweight or obesity, a high-dairy diet (3 servings a day of milk, skyr and full-fat cheddar) did not change the main inflammation marker IL-6 or body weight. TNF-alpha fell and IL-4 rose. In men, some markers were higher on the dairy diet.
1 studiesLow-fat milk, skyr and full-fat cheddar.
Studies, doses and limits
What the trials found
30 adults completed both diets in random order. The main outcome (IL-6) did not change. TNF-alpha and IL-4 changed in the expected direction; metabolic, vascular, weight and fat measures did not.
Results
A small, mixed change in two blood markers from a mix of three dairy foods.
Effect sizes as reported
TNF-alpha p=0.042 (fell); IL-4 p=0.026 (rose); IL-6 no change.
Why this rating
Insufficient for cheese: one small trial, markers only, cheese mixed with milk and skyr, and authors with ties to Dairy Farmers of Canada.
Form and dose studied
Low-fat milk, skyr and full-fat cheddar.
Who was studied
Adults with overweight or obesity and heart and metabolic risk factors.
Limits
Small; short; cheese effect cannot be separated; in men IL-6, TNF-alpha, triglycerides and diastolic blood pressure were higher on the dairy diet.
Why researchers looked
Dairy contains compounds thought to affect inflammation.
Traditional use
Cheese is eaten as a food in many cuisines. Long use as food is not proof that it treats any condition.
Proposed mechanism Authors interpretation
Not shown. The authors suggest dairy has bioactive components; the trial did not test why.
A proposed mechanism does not show that the effect happens in people.
See Safety for sodium and saturated fat.
Gut health and probiotic effect
Not enough evidenceAged cheese is a fermented food, but a fermented food is not automatically a probiotic. No trial was found showing aged cheese itself improves gut health.
2 studiesNot applicable.
Studies, doses and limits
What the trials found
The ISAPP expert panel defines fermented foods and separates them from probiotics. No cheese trial on gut outcomes was read.
Results
No evidence of a gut benefit was found for aged cheese in the sources read.
Why this rating
Insufficient: expert statements and a review of possibilities, with no cheese trial.
Limits
Several ISAPP panel members have industry ties (dairy, probiotics).
Why researchers looked
Cheese is made with microbes, so people ask whether it helps the gut like a probiotic.
Traditional use
Cheese is eaten as a food in many cuisines. Long use as food is not proof that it treats any condition.
Proposed mechanism Review of possibilities
A 2026 review says fermented dairy may produce peptides and organic acids that could affect digestion, immunity and heart risk, but results are hard to turn into consistent benefits. These are possibilities.
A proposed mechanism does not show that the effect happens in people.
None specific.
Easier on lactose intolerance than other dairy
Low certaintyNIDDK suggests people with lactose intolerance try yogurt and hard cheeses like cheddar or Swiss, which are lower in lactose than other milk products. USDA lists 0.0 to 2.2 g of total sugars per 100 g in the four cheeses (total sugars, not lactose alone).
5 studiesHard cheeses such as cheddar and Swiss.
Studies, doses and limits
What the trials found
This is agency guidance, and no trial of aged cheese in lactose-intolerant people was read.
Results
Often easier to tolerate than milk, but not lactose-free.
Effect sizes as reported
Total sugars per 100 g (USDA): cheddar 0.48 g, Parmesan 0.11 g, Swiss 0.0 g, Gouda 2.22 g.
Why this rating
Low: agency advice and food-table data, no trial read.
Form and dose studied
Hard cheeses such as cheddar and Swiss.
Who was studied
People with lactose intolerance.
Limits
Total sugars is not a lactose measure.
Why researchers looked
Many people avoid dairy because of lactose.
Traditional use
Cheese is eaten as a food in many cuisines. Long use as food is not proof that it treats any condition.
Proposed mechanism Authoritative guidance
Hard cheese is lower in lactose than other milk products, per NIDDK. Lactose is not the same as milk allergy.
A proposed mechanism does not show that the effect happens in people.
A milk allergy is different: aged cheese is not safe for cow's milk allergy.
Connections to the rest of health
How Aged Cheese connects to the rest of our health knowledge graph. Every link says what kind of connection it is. A safety link (for example to the liver) is a warning, not a benefit. A study that merely mentions a topic never creates a benefit link.
Explore every connection: goals, body systems, organs, symptoms, genes
A. Wellness goals
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Preventive Wellness | High certainty | Protein, calcium and other nutrients (nutrient content): Cheddar has about 22.9 g of protein, 710 mg of calcium and 1.1 mcg of vitamin B12 per 100 g, by USDA data. One ounce (28.35 g, about one slice) has about 6.5 g of protein, 201 mg of calcium and 0.31 mcg of B12. Parmesan has more calcium (1,184 mg per 100 g), Swiss 890 mg and Gouda 700 mg. | 21 18 20 19 | |
| Cholesterol Balance | Low certainty | Blood cholesterol compared with butter: In a pooled analysis of 5 trials, hard cheese (about 145 g a day) lowered LDL ('bad') cholesterol by 6.5% and HDL ('good') cholesterol by 3.9% compared with butter. Triglycerides did not change. Compared with tofu or fat-modified cheese, cheese raised total or LDL cholesterol. | 10 6 | |
| Heart Health | Low certainty | Blood cholesterol compared with butter: In a pooled analysis of 5 trials, hard cheese (about 145 g a day) lowered LDL ('bad') cholesterol by 6.5% and HDL ('good') cholesterol by 3.9% compared with butter. Triglycerides did not change. Compared with tofu or fat-modified cheese, cheese raised total or LDL cholesterol. | 10 6 | |
| Healthy Aging | Low certainty | Death from any cause (observational): In 9 follow-up studies with 21,365 deaths, people who ate the most cheese were not more or less likely to die in the follow-up period than people who ate the least. The authors conclude long-term cheese eating was not linked to higher risk of death. | 9 | |
| Heart Health | Not enough evidence | Heart disease and type 2 diabetes (dairy as a whole): A review of follow-up studies found neutral or beneficial links between dairy overall and heart and diabetes outcomes. Its abstract reports results for total dairy, milk and yogurt, not for cheese on its own. | 7 | |
| Blood Sugar Support | Not enough evidence | Heart disease and type 2 diabetes (dairy as a whole): A review of follow-up studies found neutral or beneficial links between dairy overall and heart and diabetes outcomes. Its abstract reports results for total dairy, milk and yogurt, not for cheese on its own. | 7 | |
| Healthy Weight | Not enough evidence | Inflammation markers on a high-dairy diet (cheese was one of three foods): In a 6-week crossover trial of 30 adults with overweight or obesity, a high-dairy diet (3 servings a day of milk, skyr and full-fat cheddar) did not change the main inflammation marker IL-6 or body weight. TNF-alpha fell and IL-4 rose. In men, some markers were higher on the dairy diet. | 5 | |
| Inflammation Balance | Not enough evidence | Inflammation markers on a high-dairy diet (cheese was one of three foods): In a 6-week crossover trial of 30 adults with overweight or obesity, a high-dairy diet (3 servings a day of milk, skyr and full-fat cheddar) did not change the main inflammation marker IL-6 or body weight. TNF-alpha fell and IL-4 rose. In men, some markers were higher on the dairy diet. | 5 | |
| Gut Health | Not enough evidence | Gut health and probiotic effect: Aged cheese is a fermented food, but a fermented food is not automatically a probiotic. No trial was found showing aged cheese itself improves gut health. | 3 1 | |
| Digestive Comfort | Low certainty | Easier on lactose intolerance than other dairy: NIDDK suggests people with lactose intolerance try yogurt and hard cheeses like cheddar or Swiss, which are lower in lactose than other milk products. USDA lists 0.0 to 2.2 g of total sugars per 100 g in the four cheeses (total sugars, not lactose alone). | 17 21 18 20 19 |
B. Body systems
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Musculoskeletal System | Biological association | High certainty | Studied for: Protein, calcium and other nutrients (nutrient content) | 21 18 20 19 |
| Cardiovascular System | Biological association | Low certainty | Studied for: Blood cholesterol compared with butter Studied for: Death from any cause (observational) | 10 6 9 7 5 |
| Endocrine System | Biological association | Not enough evidence | Studied for: Heart disease and type 2 diabetes (dairy as a whole) | 7 |
| Immune System | Biological association | Not enough evidence | Studied for: Inflammation markers on a high-dairy diet (cheese was one of three foods) | 5 |
| Digestive System | Biological association | Not enough evidence | Studied for: Gut health and probiotic effect Studied for: Easier on lactose intolerance than other dairy | 3 1 17 21 18 20 19 |
E. Health conditions
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Cow's milk allergy | Adverse effect or risk | Documented risk | Cow's milk is among the foods that cause most food allergies. Preparation or compound: Milk proteins in cheese |
14 |
| Listeriosis | Adverse effect or risk | Documented risk | The NHS and CDC advise avoiding raw-milk and soft ripened cheeses unless cooked in pregnancy. Preparation or compound: Raw-milk and soft ripened cheese |
16 11 |
| High cholesterol | Preliminary | Hard cheese raised LDL less than butter in 5 trials; not a treatment. Preparation or compound: Hard cheese |
10 |
I. Biomarkers
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| LDL cholesterol | Biological association | Low certainty | Measured in trials: lower than with butter. A lab change is not the same as a health benefit. | 10 |
| HDL cholesterol | Biological association | Low certainty | Measured in trials: lower than with butter. A lab change is not the same as a health benefit. | 10 |
| Triglycerides | Biological association | Low certainty | Measured in trials: no significant change. A lab change is not the same as a health benefit. | 10 |
| Interleukin-6 (IL-6) | Biological association | Not enough evidence | Measured in trials: no significant change. A lab change is not the same as a health benefit. | 5 |
| Tumor necrosis factor-alpha (TNF-alpha) | Biological association | Not enough evidence | Measured in trials: lowered. A lab change is not the same as a health benefit. | 5 |
| Interleukin-4 (IL-4) | Biological association | Not enough evidence | Measured in trials: raised. A lab change is not the same as a health benefit. | 5 |
K. Biological pathways
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Calcium | Preliminary mechanism | Human | Cheese is a calcium source on paper; Parmesan has the most of the four cheeses read. | 21 18 20 19 |
| Tyramine | Preliminary mechanism | Human | Formed during ripening; matters with MAOI antidepressants. | 15 4 |
| LDL cholesterol | Preliminary mechanism | Human | Hard cheese raised LDL less than butter in 5 trials. | 10 |
L. Active compounds
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Protein | Biological association | Human | Milk protein is also the source of the milk allergen. Preparation or compound: Curd |
21 18 20 19 |
| Saturated fat | Biological association | Human | The AHA advisory links replacing saturated fat with unsaturated fat to lower cardiovascular disease; it is about saturated fat overall. Preparation or compound: Milk fat |
21 18 20 19 6 |
| Sodium | Biological association | Human | Adds to daily sodium; see Safety. Preparation or compound: Added salt |
21 18 20 19 13 |
| Calcium | Biological association | Human | Amount in the food; absorption was not studied in the sources read. Preparation or compound: Curd |
21 18 20 19 |
| Biogenic amines (tyramine, histamine, cadaverine, putrescine) | Biological association | Lab | Tyramine matters with MAOI antidepressants; histamine matters for people who react to it. Preparation or compound: Formed during ripening |
4 8 15 |
| Bioactive peptides and organic acids | Biological association | Review | A 2026 review says they may influence digestion, immunity and heart risk; the benefits are not shown for aged cheese. Preparation or compound: Formed during ripening |
1 |
Each connection is stored with the ingredient, the connected record, the kind of connection, the evidence status, the supporting studies, the preparation or compound involved, and a review date (last reviewed October 26, 2026).
Evidence at a glance: what changed in 2 lab markers
Tap a number to show only those markers. Counts are markers, not people.
The evidence
The research centre for Aged Cheese. Every record here was checked against PubMed or the publisher's page; we never list a study we have not verified.
Evidence by outcome
Bars show how many studies we found for each outcome, not how well it works. People are added up across trials only (reviews are not added, to avoid double counting).
How we rate evidence
High certainty
Several well-run trials or reviews agree; further research is unlikely to change the picture much.
Moderate certainty
Good trials point the same way, but some doubt remains.
Low certainty
Small, short or inconsistent trials. The finding could change with better research.
Very low certainty
Very little or very weak human data. Treat as a possibility only.
Mixed findings
Trials or reviews disagree with each other.
Not enough evidence
Not enough human research to say either way.
Evidence against
Good research found no benefit, or found harm.
We take the reviewers' own risk-of-bias and GRADE statements where they exist, and otherwise judge from study size, design, consistency, directness and whether a product matches what is sold. Many publications do not make evidence high. Method note: We started from our existing aged-cheese summary, re-checked nutrition against saved USDA FoodData Central data, read the health agency pages (NHS, MedlinePlus, NIDDK, WHO, FDA, and the CDC through a reader tool) and re-read PubMed abstracts for reviews, trials and lab analyses. Only abstracts were read for studies. Items we could not verify are flagged in the research gaps.
Study library: every study we checked 22
| Study | Design | People | Product, dose, length | Result |
|---|---|---|---|---|
| Arslan 2026 Functional fermented dairy products: a review of mechanisms, health potential, and technological challenges. Front Nutr · PMID 42221754 · DOI |
Narrative review mixed |
Review of fermented dairy products (yoghurt, kefir, cheese) | Fermented dairy products Fermented dairy products See results |
The review says fermented dairy may influence gut function, immune regulation, metabolic health and heart risk through bioactive compounds, but translating this into consistent benefits is hard because strains, products, processing and amounts vary. It names biogenic amines, sodium, allergenicity and antimicrobial resistance as safety points. It calls for better human studies. No numbers (Not applicable) Methods, limits and fundingOutcomes: Possible health mechanisms and safety issues Limitations: A review of possibilities across several dairy foods, not proof for aged cheese. Funding and conflicts: The authors declare no commercial conflicts. Read: abstract |
| Hyseni 2025 The role of fermented foods in managing food allergies in children and adults: a systematic review. Front Nutr · PMID 41561179 · DOI |
Systematic review |
10 human studies, from 558 records | Fermented foods including fermented soy, baked goods, oat drinks and dairy (yogurt, cheese) Fermented foods in general See results · vs Various |
Some studies reported lower allergenicity, linked mainly to breakdown of gluten or soy proteins. In one case fermented food made the allergic response worse. Most studies had important weaknesses. The authors conclude the evidence is too limited to draw solid conclusions. No numbers in the abstract (Not applicable) Methods, limits and fundingOutcomes: Food allergy outcomes and allergenicity Limitations: Only 10 studies, mixed foods, high risk of bias. The abstract does not give a cheese-specific result. Funding and conflicts: One author is employed by a company (VetAgro Sup); no other conflicts declared. Registered at OSF. Read: abstract |
| Marco 2021 The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on fermented foods. Nat Rev Gastroenterol Hepatol · PMID 33398112 · DOI |
Consensus statement n/a |
Expert panel convened in September 2019 | Fermented foods in general Fermented foods in general See results |
The panel defined fermented foods and drinks as foods made through desired microbial growth and enzymatic conversions of food components. It clarified the difference between fermented foods and probiotics, and discussed safety, risks and health benefits. No numbers (Not applicable) Methods, limits and fundingOutcomes: Definition of fermented foods; difference from probiotics; safety and health Limitations: Expert consensus about fermented foods as a group, not a cheese trial. The abstract does not rate the evidence for cheese. Funding and conflicts: Several panel members report consulting, speaking or research funding from food, dairy and probiotic companies (for example Danone, Yakult and the Icelandic Milk and Skyr Corporation); ISAPP is itself a probiotics body. Read: abstract |
| Pawul-Gruba 2025 Prevalence of Biogenic Amines and Their Relation to the Bacterial Content in Ripened Cheeses on the Retail Market in Poland. Foods · PMID 40724300 · DOI |
Laboratory analysis n/a |
125 125 ripened cheese samples from Polish shops |
Ripened cheeses (retail) Cheese as food See results |
Tyramine was found in 28.0% of samples (5.62 to 646 mg/kg), mostly in cheeses with Enterococcus faecium and E. faecalis. Histamine was above 100 mg/kg in 11.2% of the cheeses (the only amine with a legal limit in the EU rules cited). Cadaverine and putrescine were found in 28.0% and 20.8%. The authors say ripened cheeses may contain significant amounts of biogenic amines and may pose a potential health hazard. Tyramine in 28.0% of samples; histamine over 100 mg/kg in 11.2% (Not applicable) Methods, limits and fundingOutcomes: Eight biogenic amines, including tyramine and histamine Limitations: A shop survey in one country. It measured the cheese, not symptoms in people. The abstract does not name cheese types. Funding and conflicts: The authors declare no conflicts of interest. Read: abstract |
| Prowting 2026 Inflammatory Cytokine Responses to 6 Wks of Increased Dairy Intake in Individuals with Overweight and Obesity-A Randomized Crossover Trial. J Nutr · PMID 41176279 · DOI |
Randomised crossover trial |
30 30 adults (18 women, 12 men) with overweight or obesity and heart and metabolic risk factors |
Mixed dairy diet: low-fat milk, Skyr yogurt and full-fat cheddar cheese (cheese was one of three foods) Full-fat cheddar cheese as part of a dairy mix 3 servings a day for 6 weeks See results · vs Habitual low-dairy diet (1 serving a day or less), 6 weeks, washout of at least 4 weeks |
There was no change in IL-6, the main outcome. TNF-alpha fell and IL-4 rose on the high-dairy diet compared with the low-dairy diet. There were no changes in metabolic, vascular, body weight or fat measures. In men, some measures (IL-6, TNF-alpha, triglycerides, diastolic blood pressure) were higher on the high-dairy diet. Registered NCT04902417. TNF-alpha p=0.042; IL-4 p=0.026; IL-6 no change (Not given in the abstract) Methods, limits and fundingOutcomes: IL-6 (main outcome), TNF-alpha, IL-4, weight, fat, blood pressure Limitations: Small trial. Cheese was one of three dairy foods, so the effect of cheese alone is unknown. Markers, not illness. Funding and conflicts: Industry link: several authors report financial support from Dairy Farmers of Canada, and one reports supplies from Lactalis Canada. Read: abstract |
| Sacks 2017 Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association. Circulation · PMID 28620111 · DOI |
Expert advisory |
Review of trials and cohort studies of dietary fat | Saturated fat swapped for unsaturated fat (not cheese specifically) Dietary fat See results · vs Replacement of saturated fat by polyunsaturated vegetable oil; or by refined carbohydrate |
Trials that lowered saturated fat and replaced it with polyunsaturated vegetable oil reduced cardiovascular disease by about 30%, similar to a statin. Replacing saturated fat with refined carbohydrates and sugars did not lower it. The authors conclude strongly that lowering saturated fat and replacing it with unsaturated fats, especially polyunsaturated, will lower cardiovascular disease. About 30% lower cardiovascular disease in the polyunsaturated-oil trials (Not applicable) Methods, limits and fundingOutcomes: Cardiovascular disease Limitations: It is about saturated fat as a whole, not about cheese. The abstract does not discuss dairy foods. Funding and conflicts: The American Heart Association states its writing group members disclose conflicts. Read: abstract |
| Soedamah-Muthu 2018 Dairy Consumption and Cardiometabolic Diseases: Systematic Review and Updated Meta-Analyses of Prospective Cohort Studies. Curr Nutr Rep · PMID 30406514 · DOI |
Systematic review meta analysis |
Prospective cohort studies of dairy and type 2 diabetes, coronary heart disease and stroke | Dairy foods eaten as food (total dairy, low-fat dairy, milk, yogurt) Cheese as food Observational; per 200 g a day for total dairy · vs Lower intake |
Total dairy and low-fat dairy were linked to a 3 to 4% lower risk of diabetes. Yogurt was linked to lower diabetes risk (RR 0.86 at 80 g a day). Total dairy and milk were not linked to coronary heart disease. Milk (200 g a day) was linked to 8% lower stroke risk. The authors call the overall links neutral or beneficial. The abstract does not report results for cheese alone. Yogurt and diabetes RR 0.86; milk and stroke 8% lower (Yogurt 0.83 to 0.90) Methods, limits and fundingOutcomes: Type 2 diabetes, coronary heart disease, stroke Limitations: Observational. The abstract gives no cheese-specific result, so it cannot be used for aged cheese on its own. Funding and conflicts: One author reports unrestricted grants for earlier work from the Dutch Dairy Association, Global Dairy Platform, the Dairy Research Institute and Dairy Australia. Read: abstract |
| Tashi 2026 Microorganisms and Physicochemical Factors Controlling Biogenic Amines During Cheese Ripening: A Systematic Review. J Food Prot · PMID 41494586 · DOI |
Systematic review n/a |
14 studies (2010 to 2024) of biogenic amines in ripening cheese | Ripening cheese, with and without added probiotic strains Ripening cheese See results |
Tyramine and histamine were the amines most often reported at high levels. Added cultures reduced total amines by up to 80% in the best case. Salt, moisture, fat and packaging also affected amine build-up. The authors say the studies were too different to compare well. Up to 80% lower total amines with the best culture pair (Not applicable) Methods, limits and fundingOutcomes: Biogenic amine levels during ripening Limitations: Studies differed in strains, cheese types and methods. Mostly lab or production studies. Funding and conflicts: The authors declare no competing interests. Read: abstract |
| Tong 2017 Cheese Consumption and Risk of All-Cause Mortality: A Meta-Analysis of Prospective Studies. Nutrients · PMID 28098767 · DOI |
Systematic review meta analysis |
9 prospective cohort studies, 21,365 deaths | Cheese eaten as food (usual intake) Cheese as food Observational; highest versus lowest intake · vs Lowest cheese intake |
Highest versus lowest cheese intake was not significantly linked to death from any cause. There was no dose-response link. The authors conclude that long-term cheese intake was not associated with an increased risk. Summary RR 1.02; per 43 g a day RR 1.03 (0.97 to 1.06; 0.99 to 1.07) Methods, limits and fundingOutcomes: Death from any cause Limitations: Observational, so it shows a link and not a cause. The search used PubMed only, through May 2016. Cheese types were not separated in the abstract. Funding and conflicts: The authors declare no conflict of interest. Read: abstract |
| de Goede 2015 Effect of cheese consumption on blood lipids: a systematic review and meta-analysis of randomized controlled trials. Nutr Rev · PMID 26011901 · DOI |
Systematic review meta analysis |
12 randomised trials in healthy adults; the pooled analysis used 5 trials of hard cheese versus butter | Hard cheese eaten as food Cheese as food Weighted mean 145 g a day See results · vs Butter (similar polyunsaturated to saturated fat ratio); also tofu and fat-modified cheese in other trials |
Compared with butter, hard cheese lowered LDL cholesterol by 6.5% and HDL cholesterol by 3.9% and had no effect on triglycerides. Compared with tofu or fat-modified cheese, cheese raised total or LDL cholesterol. There was not enough data to compare cheese with other foods. LDL -0.22 mmol/L (-6.5%); HDL -0.05 mmol/L (-3.9%); triglycerides no effect (LDL -0.29 to -0.14; HDL -0.09 to -0.02 (mmol/L)) Methods, limits and fundingOutcomes: LDL and HDL cholesterol, triglycerides Limitations: Blood markers only, not heart attacks. Large amounts of cheese. The comparison is with butter, not with no cheese. The authors say the reason (calcium, types of saturated fat or the cheese structure) needs more research. Funding and conflicts: Funding is not stated in the abstract. Read: abstract |
| s-cdc-listeria CDC: Preventing Listeria infection · Source |
Health agency n/a |
Methods, limits and fundingRead: full-text | ||
| s-cdc-raw-milk CDC: Raw milk · Source |
Health agency n/a |
Methods, limits and fundingRead: full-text | ||
| s-fda-sodium US FDA: Sodium reduction in the food supply · Source |
Health agency n/a |
Methods, limits and fundingRead: full-text | ||
| s-medlineplus-foodallergy MedlinePlus: Food allergy · Source |
Health agency n/a |
Methods, limits and fundingRead: full-text | ||
| s-medlineplus-tranylcypromine MedlinePlus: Tranylcypromine (drug information) · Source |
Health agency n/a |
Methods, limits and fundingRead: full-text | ||
| s-nhs-foods-to-avoid NHS: Foods to avoid in pregnancy · Source |
Health agency n/a |
Methods, limits and fundingRead: full-text | ||
| s-niddk-lactose NIDDK: Eating, diet, and nutrition for lactose intolerance · Source |
Health agency n/a |
Methods, limits and fundingRead: full-text | ||
| s-usda-fdc-170848 USDA FoodData Central: Cheese, parmesan, hard (FDC 170848, SR Legacy, April 2018) · Source |
Reference database n/a |
Methods, limits and fundingRead: full-text | ||
| s-usda-fdc-171241 USDA FoodData Central: Cheese, gouda (FDC 171241, SR Legacy, April 2018) · Source |
Reference database n/a |
Methods, limits and fundingRead: full-text | ||
| s-usda-fdc-171251 USDA FoodData Central: Cheese, swiss (FDC 171251, SR Legacy, April 2018) · Source |
Reference database n/a |
Methods, limits and fundingRead: full-text | ||
| s-usda-fdc-173414 USDA FoodData Central: Cheese, cheddar (FDC 173414, SR Legacy, April 2018) · Source |
Reference database n/a |
Methods, limits and fundingRead: full-text | ||
| s-who-healthy-diet WHO: Healthy diet fact sheet · Source |
Health agency n/a |
Methods, limits and fundingRead: full-text |
What we do not know yet
- No trial of aged cheese eaten in ordinary amounts against no cheese was found; the cholesterol trials compare cheese with butter and used large amounts.
- The long-term results are observational and cannot show cause.
- No cheese-specific advice for breastfeeding, babies or young children was read.
- How often histamine or tyramine in cheese causes symptoms, and any safe amount, was not found.
- Storage times, mould, contamination, kidney-disease advice and processed cheese were not researched.
- The CDC pages were read through a reader tool because direct download was blocked.
How new research is added
New studies are found by a saved PubMed search and placed in a review queue before the page changes.
Lab markers
What changed in blood or saliva tests during trials. A changed number is not the same as feeling or being healthier, and we give no "normal ranges".
Metabolic 3
LDL cholesterol
Lower than with butter in trials
The 'bad' cholesterol carried in the blood. Higher levels are linked to more heart disease.
Low certaintyResults and what it means
Why it was measured
It is the usual blood marker used in diet trials for heart risk.
Statistical vs. clinical meaning
A smaller rise than butter, not a fall compared with no cheese. Compared with tofu or fat-modified cheese, cheese raised total or LDL cholesterol.
Safety implication
Cheese still has a lot of saturated fat; see Safety.
| Study | Result | People | Product |
|---|---|---|---|
| 10 | LDL -0.22 mmol/L (95% CI -0.29 to -0.14), a 6.5% difference, with hard cheese versus butter | Healthy adults in 5 trials | Hard cheese, weighted mean 145 g a day, versus butter |
HDL cholesterol
Lower than with butter in trials
The 'good' cholesterol carried in the blood.
Low certaintyResults and what it means
Why it was measured
It is measured alongside LDL in diet trials.
Statistical vs. clinical meaning
HDL was slightly lower with cheese than with butter. The clinical meaning was not stated.
Safety implication
None specific.
| Study | Result | People | Product |
|---|---|---|---|
| 10 | HDL -0.05 mmol/L (95% CI -0.09 to -0.02), a 3.9% difference, with hard cheese versus butter | Healthy adults in 5 trials | Hard cheese versus butter |
Triglycerides
No significant change in trials
Fats carried in the blood.
Low certaintyResults and what it means
Inflammatory 2
Interleukin-6 (IL-6)
No significant change in trials
A blood signal linked to inflammation.
Not enough evidenceResults and what it means
Why it was measured
It was the main outcome of the dairy trial.
Statistical vs. clinical meaning
The main outcome did not move.
Safety implication
In men IL-6 was higher on the dairy diet.
| Study | Result | People | Product |
|---|---|---|---|
| 5 | No change in IL-6 between the high-dairy and low-dairy diets | 30 adults with overweight or obesity | 3 servings a day of milk, skyr and full-fat cheddar for 6 weeks |
Tumor necrosis factor-alpha (TNF-alpha)
Lowered in trials
A blood signal linked to inflammation.
Not enough evidenceResults and what it means
Why it was measured
A secondary outcome of the dairy trial.
Statistical vs. clinical meaning
A small change in one marker, not in illness; cheese cannot be separated from milk and skyr.
Safety implication
In men TNF-alpha was higher on the dairy diet.
| Study | Result | People | Product |
|---|---|---|---|
| 5 | TNF-alpha fell on the high-dairy diet (p=0.042) | 30 adults with overweight or obesity | Mixed dairy with cheddar, 6 weeks |
Other 1
Interleukin-4 (IL-4)
Raised in trials
A blood signal of the immune system.
Not enough evidenceResults and what it means
Why it was measured
A secondary outcome of the dairy trial.
Statistical vs. clinical meaning
The meaning of the change was not established.
Safety implication
None specific.
| Study | Result | People | Product |
|---|---|---|---|
| 5 | IL-4 rose on the high-dairy diet (p=0.026) | 30 adults with overweight or obesity | Mixed dairy with cheddar, 6 weeks |
Safety
What studies and official sources say about side effects, medicines and who should check first. Each point shows what kind of evidence it comes from.
Main points to know 5
- MAOI antidepressants and tyramine. MedlinePlus says that during treatment with the MAOI tranylcypromine, a serious reaction may occur with foods high in tyramine, and names cheese that has been aged among them. Your doctor or dietitian tells you which foods to avoid completely and which you may eat in small amounts. A 2025 shop survey found tyramine in 28% of ripened cheeses, up to 646 mg/kg. If you take an MAOI, ask your prescriber or pharmacist before eating aged cheese. Authoritative guidance 15 4
- Milk allergy. Cow's milk is among the foods that cause most food allergies (MedlinePlus). Cheese is a milk food, so aged cheese is not safe for someone with a cow's milk allergy. A 2025 review found the evidence that fermentation lowers allergenicity is limited, with weak studies. Do not treat aged cheese as safe for milk allergy. For trouble breathing or swelling of the face, lips or throat, call 911 or your local emergency number. Authoritative guidance 14 2
- Pregnancy, raw milk and Listeria in soft cheeses. The NHS lists hard cheeses such as cheddar and Parmesan as safe in pregnancy, pasteurised or not, but says mould-ripened soft cheeses (brie, camembert) and soft blue cheeses must be thoroughly cooked, and unpasteurised milk products avoided, because of listeria. The CDC says any cheese made with raw milk should be avoided, and lists hard cheeses made with pasteurized milk, such as cheddar or Parmesan, as safer choices. Advice differs by country, so ask your own midwife or doctor. Listeria is rare but can be serious in pregnancy, newborns, adults 65 and older and people with weakened immune systems. Authoritative guidance 16 11 12
- Salt and saturated fat. Cheese is concentrated in both. Cheddar has 653 mg of sodium and 18.9 g of saturated fat per 100 g (185 mg and 5.3 g in one ounce). Parmesan has 1,175 mg of sodium per 100 g, Swiss only 187 mg. The American Heart Association advisory strongly concludes that swapping saturated fat for unsaturated fat lowers cardiovascular disease; it is about saturated fat as a whole, not cheese alone. WHO says to keep saturated fat to no more than 10% of energy and salt under 5 g a day. People with high blood pressure, kidney disease or high LDL should ask their clinician about cheese. Authoritative guidance 6 22 13 21 18 20 19
- Histamine and other amines in ripened cheese. A 2025 survey of 125 ripened cheeses in Polish shops found histamine above 100 mg/kg in 11.2%. A 2026 review says tyramine and histamine are the amines most often reported at high levels, and that levels depend on ripening conditions, salt, moisture and added cultures. Levels vary between batches. No source read gave a safe amount for people who react to histamine or described how often cheese causes symptoms. Laboratory analysis 4 8
Side effects 5
| Effect | How often | Severity and recovery | Evidence |
|---|---|---|---|
| Raised LDL cholesterol compared with unsaturated fat sources The advisory is about saturated fat overall. | Cheese raised total or LDL cholesterol compared with tofu or fat-modified cheese in trials; it raised LDL less than butter | mild to moderate (a blood marker) Not described. | Randomised trials 10 6 |
| High sodium intake Differs widely between cheeses. | US average is about 3,400 mg a day against a 2,300 mg a day limit (FDA); cheese adds sodium (185 mg in one ounce of cheddar) | mild to moderate Not described. | Reference data 13 21 22 |
| Allergic reactions to cow's milk protein, from hives to anaphylaxis A milk allergy is an immune reaction, different from lactose intolerance. | Not stated in the sources read | can be severe (anaphylaxis) Not described. | Authoritative guidance 14 |
| Listeria infection from raw-milk or soft ripened cheeses The advice targets soft and raw-milk cheeses; hard pasteurised cheeses are listed as safer. | The CDC calls Listeria infection rare; it is more serious in higher-risk groups | can be severe (miscarriage or stillbirth is named by the NHS) Not described. | Authoritative guidance 16 11 |
| Reactions to histamine or tyramine in ripened cheese (the symptoms were not described in the sources read) This is the content of cheese, not a count of people who got ill. | Histamine over 100 mg/kg in 11.2% of 125 ripened cheeses; tyramine found in 28.0% | Not described. Not described. | Laboratory analysis 4 8 |
Liver
No liver injury from eating cheese was found in the sources read. A liver-safety source (such as LiverTox) was not searched for cheese.
How often. No frequency was found.
Monitoring. No agency monitoring advice was found.
This is a safety connection. It is not evidence that Aged Cheese supports liver health.
Medicines and supplements 3
| With | Why it matters | Importance | Evidence | What to do |
|---|---|---|---|---|
| MAOI antidepressants (monoamine oxidase inhibitors, such as tranylcypromine) prescription | Aged cheese contains tyramine formed during ripening; an MAOI blocks the enzyme that breaks tyramine down. | MedlinePlus says a serious reaction may occur with high-tyramine foods, and names cheese that has been aged, smoked, improperly stored or spoiled. A 2025 survey found tyramine up to 646 mg/kg in ripened cheeses. | Authoritative guidance Moderate certainty 15 4 | Ask your prescriber or pharmacist before eating aged cheese on an MAOI. |
| Medicines for blood pressure, kidney disease or cholesterol prescription | Sodium and saturated fat in cheese could work against the aim of these medicines. | No source read named a cheese-specific interaction with these medicines. This is a general caution, not a documented interaction. | Theoretical Not enough evidence 13 6 | Tell your clinician if cheese is a large part of your diet. |
| Other medicines and supplements other | Apart from MAOIs, no source read described a cheese-specific interaction. | None found Not enough evidence | Ask a pharmacist if you have a question about a particular medicine. |
Who should check first 7
| Situation | Advice | Evidence |
|---|---|---|
| Cow's milk allergy | Avoid aged cheese and read labels. Ask an allergist about your own case. For trouble breathing or swelling of the face, lips or throat, call 911 or your local emergency number. | Authoritative guidance 14 2 |
| Taking an MAOI antidepressant | Ask your prescriber or pharmacist about aged cheese before eating it. | Authoritative guidance 15 |
| Pregnancy | The NHS lists hard cheeses such as cheddar and Parmesan as safe and says soft mould-ripened and soft blue cheeses must be cooked; the CDC says avoid any cheese made with raw milk. Check the label for pasteurized milk and ask your midwife or doctor. | Authoritative guidance 16 11 |
| Breastfeeding | No source read gave cheese-specific advice for breastfeeding. Ask your midwife or doctor. | Gap |
| Weakened immune system, age 65 or over | The CDC lists these groups as higher risk for Listeria and raw milk germs. Avoid raw-milk cheese and ask your clinician about soft cheeses. | Authoritative guidance 11 12 |
| High blood pressure, kidney disease or high LDL cholesterol | Sodium and saturated fat add up with cheese. Ask your clinician or dietitian how it fits your limits; Parmesan is much saltier than Swiss. | Reference data 18 20 6 |
| Lactose intolerance | NIDDK says hard cheeses like cheddar and Swiss are lower in lactose than other dairy and often easier to tolerate. They are not lactose-free. | Authoritative guidance 17 |
Overdose, product quality and regulators
Summary. No toxicity from aged cheese as ordinary food was found in the sources read. The safety points are allergy, tyramine and MAOIs, raw-milk germs, salt and saturated fat.
Animal. Not reviewed.
High dose or long term signals. A 2017 analysis of 9 cohort studies found no significant link between cheese intake and death from any cause.
Overdose response. Not found.
Genotoxicity. Not researched.
Raw milk can carry germs, and ripened cheeses can build up amines. Mould, heavy metals and additives in cheese were not researched.
Raw milk germs. The CDC names Campylobacter, Cryptosporidium, E. coli, Listeria, Brucella and Salmonella as germs raw milk can carry, and says products made from raw milk can expose people to germs. Higher-risk groups are children under 5, adults over 65, pregnant women and people with weakened immune systems. 12
Biogenic amines in ripened cheese. In 125 Polish retail ripened cheeses, histamine was above 100 mg/kg in 11.2% and tyramine was found in 28.0%. 4
| Body | Action | Date |
|---|---|---|
| NHS (UK) (United Kingdom) | Foods to avoid in pregnancy: pasteurised or unpasteurised hard cheeses such as cheddar and parmesan are safe; mould-ripened soft cheeses and soft blue cheeses must be thoroughly cooked; unpasteurised milk products are to be avoided. source | 2026-06-15 |
| CDC (United States) | Preventing Listeria infection: avoid any cheese made with raw (unpasteurized) milk unless heated until steaming hot; hard cheeses made with pasteurized milk such as cheddar or Parmesan are listed as safer. source | 2025-01-31 |
| CDC (United States) | Raw milk: names the germs it can carry and the higher-risk groups. source | 2025-01-31 |
| MedlinePlus (US National Library of Medicine) (United States) | Tranylcypromine: a serious reaction may occur with high-tyramine foods including cheese that has been aged, smoked, improperly stored or spoiled. source | 2017-05-15 |
| MedlinePlus (US National Library of Medicine) (United States) | Food allergy: cow's milk is among the foods that cause most food allergies; anaphylaxis is a medical emergency. source | |
| NIDDK (US National Institutes of Health) (United States) | Lactose intolerance: hard cheeses like cheddar or Swiss are lower in lactose than other milk products. source | 2018-02 |
| WHO (International) | Healthy diet: saturated fat under 10% of energy, trans fat under 1%, salt under 5 g a day for adults. source | 2026-01-26 |
| US FDA (United States) | Sodium reduction: average US intake about 3,400 mg a day; Dietary Guidelines advise 2,300 mg a day or less for ages 14 and over. source | 2024-11-01 |
When to get medical help
- Trouble breathing, wheezing, swelling of the lips, face, tongue or throat, widespread hives, repeated vomiting, dizziness or collapse after eating cheese (possible milk anaphylaxis): use epinephrine if prescribed, then call 911 or your local emergency number
- Signs of dangerously high blood pressure after eating aged cheese while taking an MAOI (such as severe headache or chest pain): seek urgent medical help
- Fever, muscle aches, stiff neck or confusion after eating soft or raw-milk cheese, especially in pregnancy or with a weakened immune system (possible Listeria): contact a doctor urgently
Stop using the product and contact a clinician or emergency service. In the US, Poison Control is 1-800-222-1222.
General information only, not medical advice. Ask a clinician or pharmacist before use, especially with medicines, in pregnancy or with a health condition. See the Natural Remedy Safety guide.
Frequently asked questions
What is aged cheese?
Is aged cheese bad for cholesterol?
Does cheese raise the risk of death?
In 9 follow-up studies, the highest cheese intake was not significantly linked to death from any cause (RR 1.02). That is an association, not proof.
Is aged cheese lactose-free?
Can I eat hard cheese when pregnant?
Why do soft cheeses carry more Listeria advice than hard cheeses?
Can I eat aged cheese if I take an MAOI antidepressant?
Why do some people get headaches or flushing from aged cheese?
Is aged cheese safe with a milk allergy?
How salty is aged cheese?
Is aged cheese a probiotic food?
Does aged cheese reduce inflammation?
One small 6-week trial of milk, skyr and cheddar found two inflammation markers moved and the main one did not. Cheese was one of three foods, and the trial had ties to Dairy Farmers of Canada.
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Editorial transparency
- Written by
- AlternativeMed editorial team. Research compiled with AI assistance, then checked against the sources listed.
- Medical review
- None. This page has not been reviewed by a physician or pharmacist.
- First published
- 2026-10-26
- Last substantive update
- 2026-10-26
- How we research
- We started from our existing aged-cheese summary, re-checked nutrition against saved USDA FoodData Central data, read the health agency pages (NHS, MedlinePlus, NIDDK, WHO, FDA, and the CDC through a reader tool) and re-read PubMed abstracts for reviews, trials and lab analyses. Only abstracts were read for studies. Items we could not verify are flagged in the research gaps.
- How we rate evidence
- See "How we rate evidence" in the Evidence tab.
- Independence
- No product is promoted on this page. No affiliate links are shown. The 6-week dairy trial and one dairy review author have dairy-industry funding or grants, and several ISAPP panel members have food and probiotic industry ties; this is stated where they are used.
Sources 22
Each source was opened and checked. Where we read only the abstract, it says so. The small numbers in the text point here.
- Arslan BN, Döndaş NY, Koçhan S, Bulut SD, et al.. Functional fermented dairy products: a review of mechanisms, health potential, and technological challenges.. Front Nutr. 2026. PMID 42221754. DOI 10.3389/fnut.2026.1779688. (abstract)
- Hyseni B, Papadimitriou K, Issa A, Tonay AN, et al.. The role of fermented foods in managing food allergies in children and adults: a systematic review.. Front Nutr. 2025. PMID 41561179. DOI 10.3389/fnut.2025.1689636. (abstract)
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- . CDC: Preventing Listeria infection. . . (full-text)
- . CDC: Raw milk. . . (full-text)
- . US FDA: Sodium reduction in the food supply. . . (full-text)
- . MedlinePlus: Food allergy. . . (full-text)
- . MedlinePlus: Tranylcypromine (drug information). . . (full-text)
- . NHS: Foods to avoid in pregnancy. . . (full-text)
- . NIDDK: Eating, diet, and nutrition for lactose intolerance. . . (full-text)
- . USDA FoodData Central: Cheese, parmesan, hard (FDC 170848, SR Legacy, April 2018). . . (full-text)
- . USDA FoodData Central: Cheese, gouda (FDC 171241, SR Legacy, April 2018). . . (full-text)
- . USDA FoodData Central: Cheese, swiss (FDC 171251, SR Legacy, April 2018). . . (full-text)
- . USDA FoodData Central: Cheese, cheddar (FDC 173414, SR Legacy, April 2018). . . (full-text)
- . WHO: Healthy diet fact sheet. . . (full-text)
Where to buy
Check the label first. Whatever you buy, look for these:
- Live and active cultures on the label, if that is what you want
- Refrigerated or shelf-stable, since shelf-stable versions may be heat treated
- Added sugar and sodium
- A best-by date
Talk to a pharmacist or doctor before you start any supplement, especially if you take medicines. See the Safety tab for interactions.
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