- Brain health is intimately intertwined with our diet.
- The association between the consumption of dairy products and the risk of dementia is widely debated.
- In a large observational study conducted over 25 years in Sweden, researchers found that individuals who consumed a high intake of high-fat cheese and cream may have a lower risk of dementia.
More than 6 million Americans are currently afflicted by dementia, and this number is expected to double by 2060 [1]. Dietary interventions have the potential to mitigate the risk, as brain health is dependent on our diet; however, there is ongoing debate about dietary recommendations, especially regarding dairy.
Some studies have shown that following the MIND diet (Mediterranean-DASH Diet Intervention for Neurodegenerative Delay), or eating leafy vegetables, berries, whole grains, nuts, and olive oil and limiting red meats and dairy helps reduce cognitive decline [2, 3]. Similarly, a study conducted in a Japanese cohort found that a high intake of cheese is associated with an increased dementia risk [4], while two studies in Finland and the UK showed the opposite [5, 6].
In a new observational study conducted over the course of 25 years in Sweden, researchers found that a high intake of high-fat cheese (≥50 g/d) or high-fat cream (≥20 g/d) is associated with a lower risk of dementia [7].
“This does not mean that cheese or cream prevents dementia,” says Emily Sonestedt, an associate professor at Lund University in Sweden and the senior author on the paper. “But it does suggest that these foods, when eaten in reasonable amounts as part of a normal diet, do not appear harmful for brain health and may be part of a pattern linked to lower [dementia] risk.”
The study had almost 28,000 participants from the Malmö Diet and Cancer study in Malmö, Sweden [8]. Participants’ ages ranged from 45-73 years, and there were no cases of dementia at baseline. The researchers identified cases of dementia using the Swedish National Patient Register. Participants filled out a 7-day food diary and completed a food frequency questionnaire upon recruitment. There was a median follow-up of almost 25 years, but the researchers only reassessed the participants’ diets once after 5 years [7].
The frequency at which the researchers issued the questionnaires is not “out of the realm for a large observational study” says Bryan Neth, an assistant professor of neurology and medical oncology at Mayo Clinic who was not involved in this study.
Most large observational studies are based on self-reported questionnaires; however, according to Neth, there are limitations to how we interpret the results because researchers cannot control participants’ diets and must rely on accurate reporting.
Over 3,200 cases of dementia were observed, and the study’s analysis revealed a linear, inverse association between high-fat cheese intake and dementia. In other words, participants who consumed a high amount (≥50 g/d) of high-fat cheese (at least 20% fat) had a 13% lower risk of dementia than those who ate less than 15 grams per day. Similarly, participants who regularly ate high-fat cream (≥20 g/d) had a 16-18% lower risk of dementia than individuals who consumed no high-fat cream [7].
Of note, individuals with the highest intake of high-fat cheese or high-fat cream were also more likely to have a lower body mass index, higher education levels, and a lower prevalence of diabetes, hypertension, cardiovascular disease, and stroke [7], which all decrease the risk of dementia and Alzheimer’s [9].
There was no association between eating low-fat cheese, low-fat cream, high-fat milk, fermented milk, or butter with dementia risk [7].
“The study seems to be well-done from an observational standpoint,” says Neth. “It was a large cohort with a well-characterized population, and they followed them for over 25 years, which is impressive.”
The study was conducted entirely in a Swedish population.
“We would like to see these findings replicated in other large populations,” says Sonestedt, “Especially in countries where different types of cheese and dairy products are consumed.”
“Results are going to vary depending on the population,” says Neth. “In this very specific Swedish population, they’re probably not eating a lot of the ultra-processed foods that our traditional, American diet has. A lot of Europe eats more of a whole foods-based diet with fruits, vegetables, nuts, berries.”
The study did not investigate the underlying mechanism, but Sonestedt notes that our brains rely heavily on fats for building cell membranes and conducting cell signaling. Indeed, studies have shown that supplementing foods with phospholipids, or fats, found in milk may support neurogenesis and improve cognitive function in older populations.
In addition, Sonestedt points out that cheese is not just fat—it includes proteins, minerals, vitamins, and bioactive compounds that can influence inflammation, metabolism, and vascular health, which are closely linked to brain health. She hypothesizes that together, these components may have an effect on our blood vessels and could one day explain the associations she and her colleagues observed between high-fat cheese and the lower dementia risk [7].
“What our findings suggest,” says Sonestedt, “is that judging foods solely by fat content can be misleading. The overall diet, lifestyle, and long-term vascular health matter far more.”
References
- Rajan KB, Weuve J, Barnes LL, McAninch EA, Wilson RS, Evans DA. Population estimate of people with clinical Alzheimer’s disease and mild cognitive impairment in the United States (2020-2060). Alzheimers Dement. 2021 Dec;17(12):1966-75.
- Morris MC, Tangney CC, Wang Y, Sacks FM, Barnes LL, Bennett DA, et al. MIND diet slows cognitive decline with aging. Alzheimer’s & Dementia. 2015;11(9):1015-22.
- Morris MC, Tangney CC, Wang Y, Sacks FM, Bennett DA, Aggarwal NT. MIND diet associated with reduced incidence of Alzheimer’s disease. Alzheimer’s & Dementia. 2015;11(9):1007-14.
- Lu Y, Sugawara Y, Tsuji I. Association between dairy intake and risk of incident dementia: The Ohsaki cohort 2006 study. Eur J Nutr. 2023 Oct;62(7):2751-61.
- Dobreva I, Marston L, Mukadam N. Which components of the Mediterranean diet are associated with dementia? A UK Biobank cohort study. Geroscience. 2022 Oct;44(5):2541-54.
- Ylilauri MPT, Hantunen S, Lönnroos E, Salonen JT, Tuomainen TP, Virtanen JK. Associations of dairy, meat, and fish intakes with risk of incident dementia and with cognitive performance: The Kuopio Ischaemic Heart Disease Risk Factor study (KIHD). Eur J Nutr. 2022 Aug;61(5):2531-42.
- Du Y, Borne Y, Samuelsson J, Glans I, Hu X, Nagga K, et al. High- and low-fat dairy consumption and long-term risk of dementia: Evidence from a 25-year prospective cohort study. Neurology. 2026 Jan 27;106(2):e214343.
- Berglund G, Elmstähl S, Janzon L, Larsson SA. The Malmö Diet and Cancer study. Design and feasibility. J Intern Med. 1993 Jan;233(1):45-51.
- Aiello AE, Momkus J, Stebbins RC, Zhang YS, Martin CL, Yang YC, et al. Risk factors for Alzheimer’s disease and cognitive function before middle age in a U.S. Representative population-based study. The Lancet Regional Health – Americas. 2025;45.
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