For decades, the nutrition conversation around dairy has focused on what to avoid. Saturated fat raises cholesterol. Cholesterol clogs arteries. Clogged arteries damage the brain. The logical conclusion seemed clear: if you want to protect your cognitive function, full-fat cheese and cream should be limited. Low-fat dairy, if any dairy at all, was the safer choice.
A study published in December 2025 in Neurology, the journal of the American Academy of Neurology, challenges this assumption in ways that have sparked both excitement and controversy. Researchers at Lund University in Sweden tracked 27,670 adults for approximately 25 years and found that those who consumed more full-fat cheese and cream developed dementia at lower rates than those who avoided these foods. The findings don’t prove that cheese prevents cognitive decline, and they come with important limitations, but they do suggest the relationship between dairy fat and brain health is more nuanced than previously believed.
The Study Design and Key Findings
The research team, led by Dr. Emily Sonestedt at Lund University, analyzed data from a large Swedish cohort study. Participants averaged 58 years old at baseline and provided detailed dietary information through one-week food consumption records, frequency questionnaires, and interviews about food preparation methods. Over the 25-year follow-up period, 3,208 participants developed dementia, providing a substantial sample for analysis.
The numbers for high-fat cheese are particularly striking. People who consumed 50 grams or more of high-fat cheese (greater than 20% fat content) daily had a 13% lower risk of all-cause dementia compared to those eating less than 15 grams daily. For vascular dementia specifically, the reduction was even larger: 29% lower risk among higher cheese consumers. When researchers looked at the raw numbers, 10% of high cheese consumers developed dementia compared to 13% of low consumers.
High-fat cream showed similar patterns. Participants consuming at least 20 grams per day of high-fat cream (greater than 30% fat content) had about a 16% lower risk of all-cause dementia compared to non-consumers. The association held for both Alzheimer’s disease and vascular dementia subtypes.
Perhaps equally important is what the study didn’t find. Low-fat cheese, low-fat cream, milk (both high-fat and low-fat), fermented milk products, and butter showed no significant association with dementia risk in either direction. The protective association appeared specific to high-fat cheese and cream, not dairy consumption in general.
Why This Matters for Nutrition Science
The findings conflict with decades of dietary guidance that treated all saturated fat as uniformly harmful. The saturated fat in full-fat dairy has been a primary target of heart-healthy diet recommendations. Yet this study, along with a growing body of research on dairy and cognitive outcomes, suggests the relationship between dairy fat and health may depend heavily on context, specifically the food matrix in which that fat is consumed. This adds to other recent discoveries about unexpected factors in dementia prevention, including research on vaccines and neurodegeneration.
The concept of food matrix effects has gained traction in nutrition science over the past decade. Rather than viewing foods as simply collections of isolated nutrients, researchers increasingly recognize that how nutrients are packaged matters. The calcium, protein, probiotics, and fat in cheese exist in a complex matrix that affects their absorption, metabolism, and physiological effects. Cheese matrix effects may explain why studies consistently fail to link cheese consumption with increased cardiovascular disease, despite its saturated fat content.
Several mechanisms have been proposed to explain potential brain-protective effects of dairy fat. Dairy contains phospholipids and sphingolipids, types of fats that differ structurally from the triglycerides that make up most dietary fat. These specialized lipids play important roles in brain cell membranes and myelin sheaths, connecting to our understanding of how the gut-brain axis influences cognitive function. Cheese is also one of the richest dietary sources of vitamin K2, which has been linked to reduced arterial calcification and improved cognitive outcomes in some studies.
The fermentation process that creates cheese may also be relevant. During aging, cheese develops bioactive peptides and other compounds not present in milk. Some of these compounds have demonstrated anti-inflammatory and neuroprotective effects in laboratory studies. The specific bacterial cultures used in cheese making influence which compounds are produced, potentially explaining why different cheese types might have different health effects.
The Limitations You Need to Know
Before celebrating with a cheese board, it’s essential to understand what this study can and cannot tell us. This is observational research, meaning it identifies associations but cannot prove that cheese caused the lower dementia rates. The possibility of confounding, where some third factor explains both cheese consumption and dementia risk, cannot be eliminated.
People who eat more full-fat cheese may differ from those who avoid it in many ways beyond diet. In Sweden, where the study was conducted, cheese consumption correlates with certain demographic, socioeconomic, and lifestyle factors. Those who consume traditional Swedish cheese may also engage in other behaviors that protect cognitive function. They might exercise more, drink less alcohol, have more social connections, or have better access to healthcare. The researchers controlled for many known confounding factors, but unmeasured confounders may remain.
The dietary assessment method presents another limitation. Researchers collected food consumption data at baseline, approximately 25 years before dementia diagnoses. Dietary habits almost certainly changed during this quarter-century period. Someone who ate substantial cheese in their late 50s may have modified their diet dramatically in subsequent decades. The single assessment point provides only a snapshot, not a continuous record of lifetime dietary patterns.
Geographic specificity also limits generalizability. Swedish food culture differs substantially from other regions. The way Swedes prepare and consume cheese, often as cold slices rather than melted or cooked, may affect bioavailability of nutrients. The specific cheese varieties popular in Sweden differ from those consumed in other countries. Results from this Swedish cohort may not translate directly to populations with different dietary patterns.
The researchers themselves emphasize caution. As one team member noted, this is “not a green light to dramatically increase intake.” The study shows an association, not a treatment effect. Until randomized controlled trials specifically test whether increasing cheese consumption reduces dementia risk, the findings should inform but not dictate dietary choices.
What This Means for Your Brain Health
Given the study’s limitations, what practical conclusions can you draw? The research supports including moderate amounts of full-fat dairy in an overall brain-healthy diet rather than avoiding dairy fat on principle. If you currently enjoy cheese and cream as part of a balanced diet, this study suggests no reason to eliminate them for cognitive health reasons.
Quality likely matters more than quantity. The cheese varieties linked to health benefits in various studies tend to be traditionally made, fermented, and aged, not heavily processed cheese products. Artisanal and aged cheeses like cheddar, gouda, brie, and parmesan differ substantially from processed cheese singles or cheese-flavored products. The benefits, if real, probably stem from compounds produced during traditional cheese making.
The APOE e4 connection deserves attention for those aware of their genetic risk. The study found that among carriers of the APOE e4 gene variant, the strongest genetic risk factor for Alzheimer’s disease, the protective association between cheese and dementia was weakened or absent. For non-carriers, the relationship was stronger. This genetic interaction suggests that dairy fat’s effects on brain health may depend partly on individual genetic makeup.
Dietary context remains paramount. No single food, including cheese, determines brain health outcomes. The populations with lowest dementia rates worldwide, including in Mediterranean and Scandinavian regions, consume dairy as part of diverse dietary patterns rich in vegetables, fish, whole grains, and olive oil. They also tend to be physically active, socially engaged, and mentally stimulated. Cheese is one element in a complex lifestyle pattern, not a standalone intervention.
The Bottom Line
The Swedish study adds to growing evidence that full-fat dairy, and particularly traditionally made cheese, may not deserve its reputation as a cognitive health villain. Among nearly 28,000 adults followed for 25 years, those consuming more high-fat cheese and cream developed dementia at lower rates than those who avoided these foods. The association was specific to high-fat dairy products, with low-fat versions showing no relationship either way.
These findings don’t prove that cheese protects the brain. They do suggest that the decades-long focus on reducing all saturated fat may have been overly simplistic. Food is more than the sum of its nutrients, and the complex matrix of compounds in traditionally made cheese may produce effects quite different from isolated saturated fat.
For most people, moderate consumption of high-quality, traditionally made cheese as part of an overall healthy diet appears compatible with, and possibly supportive of, long-term cognitive health. The emphasis should remain on overall dietary patterns, physical activity, sleep, social connection, and cognitive engagement, the interventions with the strongest evidence for brain protection.
Practical Takeaways:
- Don’t fear full-fat cheese as part of a balanced diet; evidence of harm is weaker than previously assumed
- Choose traditionally made, aged cheeses over heavily processed cheese products
- Target 30-50 grams daily (1-2 oz) of high-fat cheese if desired, consistent with Mediterranean diet patterns
- Remember that APOE e4 carriers may not see the same associations; consider genetic testing if you’re optimizing for cognitive longevity
- Focus on overall lifestyle factors, diet diversity, exercise, sleep, and social connection, not any single food
Sources: Neurology (Sonestedt et al., December 2025, DOI: 10.1212/WNL.0000000000214343), American Academy of Neurology press release, Lund University research, Science Media Centre expert commentary, food matrix research from nutrition journals.
