Adults who consumed higher amounts of high-fat cheese over decades had a lower risk of developing dementia compared with those with minimal intake, according to a recent study published in Neurology.
In a Swedish prospective cohort followed for up to 25 years, participants consuming at least 50 g/d of high-fat cheese and those consuming at least 20 g/d of high-fat cream had lower risks of all-cause dementia, while no significant associations were observed for low-fat dairy products or most other dairy foods. High-fat cheese intake was also associated with lower vascular dementia risk and with lower Alzheimer disease risk among apolipoprotein E ε4 noncarriers.
These findings were based on data from the Malmö Diet and Cancer cohort, which included 27,670 community-dwelling adults aged 45 to 73 years at baseline who completed dietary assessments between 1991 and 1996. Dietary intake was evaluated using a validated diet history method integrating a 7-day food diary, a semiquantitative food frequency questionnaire, and a structured dietary interview. Low- and high-fat dairy categories were defined using preset fat percentage cutoffs of 2.5% for milk and fermented milk, 20% for cheese, and 30% for cream, consistent with the fat content specified in the food frequency questionnaire. Intake was calculated in grams per day and grouped according to the cohort distribution.
Participants were followed from baseline until dementia diagnosis, death, emigration, or December 31, 2020. Dementia outcomes were identified through linkage with the Swedish National Patient Register, with diagnoses through 2014 validated by trained physicians using clinical symptoms, cognitive assessments, brain imaging findings, and cerebrospinal fluid biomarker measurements when available. The primary outcome was all-cause dementia, with Alzheimer disease and vascular dementia evaluated as secondary outcomes. Cox proportional hazards regression models were used to estimate hazard ratios and 95% confidence intervals, with adjustment for age, sex, total energy intake, season, educational level, lifestyle factors, cardiometabolic conditions, overall diet quality, and mutual intake of other dairy products.
During follow-up, 3,208 incident cases of all-cause dementia were identified. In fully adjusted models, high-fat cheese and high-fat cream demonstrated linear inverse dose-response associations with all-cause dementia, whereas low-fat cheese, low-fat cream, high-fat milk, fermented milk, and butter were not associated with risk.
The researchers acknowledged several limitations. The observational design limits causal inference, and residual or unmeasured confounding remains possible. Diet was assessed only at baseline, and dietary changes over time may have led to exposure misclassification. Measurement reproducibility was lower for cream than for cheese. Baseline cognitive status was not assessed. In addition, dementia subtype diagnoses after 2014 were not validated, and the findings may not be generalizable beyond a Swedish population.
The researchers stated, “we found that higher intake of high-fat cheese and high-fat cream, but not other dairy products, was associated with a lower risk of all-cause dementia.”
Sebastian Palmqvist, one of the authors, reported institutional research funding from Avid and Ki Elements through the Alzheimer’s Drug Discovery Foundation and has received consulting or speaker fees from several pharmaceutical companies in the past 2 years, Oskar Hansson, another one of the authors, reported employment with Lund University and Eli Lilly, and the remaining researchers reported no relevant disclosures.
Source: Neurology