Study analysis · The American journal of clinical nutrition · 2018

Cheese lowers cholesterol more than butter—even when they have the same fat content.

Eating cheese with the same amount of fat as butter makes your cholesterol lower, because cheese is structured differently.

Reading level
Moderate certainty
Level 1b · Individual RCT

Overview

What the study found

The study in plain English — the bottom line, every takeaway we extracted, and what to do with them.

In simple terms

This study gave different people different ways to eat the same amount of dairy fat—some ate cheese, others ate butter with powder—and found that cheese made cholesterol levels go down a bit more. It doesn't prove cheese is healthier overall, just that how you eat the fat matters in this one case.

What’s the bottom line?

Scientists gave people the same amount of dairy fat—but in different forms—to see if how it’s packaged matters for cholesterol.

How strong is this study?

The study did a good job by randomly giving people different foods so no one could cheat the results. But we don't know if people knew what they were eating, which could have changed how they acted or reported things. That’s why we can’t be 100% sure, but it’s still one of the best kinds of studies we have.

Reporting

0 / 100

  • COI disclosureconflicts of interest not disclosed
  • Data availabilitydata not shared
  • Code availabilitycode not shared
Methodology

70 / 100

  • Randomization+20/20
  • Blindingblinding unclear
  • Control group+15/15
  • Sample size (n=164)+11.2/20
  • Follow-up+10/10
Publication

100 / 100

Statistical

77 / 100

  • P-values+15/15
  • Effect size+20/20
  • Confidence intervalsno confidence intervals
  • Pre-registration+15/15

Each component is scored out of 100 and then capped by the study design — a case series cannot reach the ceiling a randomised trial can, however well it is reported.

Where it sits

RCT reviews

Max 100

Randomized Trials

Max 90

Reviews of Cohort Studies

Max 85

Cohort Studies

Max 72

Reviews of Case-Control Studies

Max 63

Case-Control Studies

Max 58

Cross-Sectional & Case Series

Max 50

Expert Opinion

Max 5
StrongerWeaker
Randomized Trials
Level 1b
64

64 / 100

Probability of being correct

Participants are randomly assigned to treatment or control groups, minimizing bias. The gold standard for testing whether an intervention causes an effect.

This design can establish causation. Randomization was confirmed, but blinding was unknown, which introduces potential performance or detection bias. However, the study design still allows for causal inference as randomization controls for confounding, even without confirmed blinding.

No Conflicts

No conflicts of interest identified

Not Disclosed

No conflicts of interest identified; the study was funded by a government agency with no involvement in study execution, analysis, or interpretation.

Undisclosed — Suspicious

Funders

Enterprise Ireland

Conflict Details

multiple authors
Funding

Enterprise Ireland: Received grant funding (TC-2013-001) for the study

Independent Analysis Safeguards

  • The sponsors had no influence on the execution of the study, the analysis, or the interpretation of data.

No author affiliations with industry or financial conflicts of interest were disclosed. The funding source is a government agency, and explicit safeguards for independent analysis were stated.

Key takeaways

  1. 01

    People who ate 40g of dairy fat in full-fat cheese had lower cholesterol (5.23 mmol/L total, 2.97 mmol/L LDL) than those who ate the same fat in butter plus supplements (5.57 and 3.43 mmol/L).

  2. 02

    The difference is small but statistically significant—cheese lowered LDL by about 0.46 mmol/L more than butter+supplements, which could matter for heart health over time.

Surprising findings

  • Adding calcium and casein supplements to butter did NOT lower cholesterol like cheese did.For decades, scientists thought cheese’s benefits came from calcium or casein—this study proves those nutrients alone don’t explain the effect.
  • The cholesterol-lowering effect was only seen with full-fat cheese—not reduced-fat cheese plus butter.People assume removing fat from cheese makes it healthier, but this shows the full matrix—including fat—is essential for the benefit.

Practical takeaways

Swap butter on toast or in cooking with full-fat cheese (about 1.5 oz or 40g daily) to potentially lower LDL cholesterol.

This effect was only seen in overweight adults over 50; results may not apply to younger or leaner people. Also, cheese is calorie-dense—don’t add it on top of your current diet.

high confidence

Why this study matters

Cheese vs. Butter: Same Fat, Different Results

In a 6-week trial with 164 overweight adults over 50, those who ate 40g of dairy fat in full-fat cheese had significantly lower total cholesterol (5.23 mmol/L) and LDL cholesterol (2.97 mmol/L) than those who ate the same fat in butter plus calcium caseinate and supplements (TC: 5.57 mmol/L; LDL: 3.43 mmol/L). The difference was statistically significant (p=0.033 and p=0.026).

This flips the script on the idea that all saturated fats are equal—what matters isn’t just how much fat you eat, but how it’s packaged in food.

The Cheese Matrix Mystery

Reduced-fat cheese plus butter didn’t lower cholesterol like full-fat cheese did—even though both had the same total fat and added calcium/casein. This proves the intact physical structure of cheese (the 'matrix') is key, not just its nutrients.

You can’t replicate cheese’s benefit by adding calcium pills to butter. The food’s physical form matters more than its ingredient list.

No Weight Gain, No Blood Sugar Spike

Despite consuming 40g of dairy fat daily for six weeks, none of the groups gained weight or saw changes in glucose or insulin levels. This suggests short-term high-fat dairy intake doesn’t harm metabolic health in overweight older adults.

This challenges the fear that full-fat dairy automatically leads to weight gain or diabetes—especially relevant for low-carb and keto audiences.

Want the whole report?

Detailed mode opens the full scientific breakdown — every score component, the methodology, conflicts of interest, the evidence analysis behind each claim, and the raw study data.

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