By Pharmacist Karen Kier
ONU HealthWise

The phrase “say cheese” for photos appears in newspaper articles starting in the 1940s. In 1943, the Oxford English Dictionary cites the phrase being repeated by Joseph E. Davies, who was the United States ambassador (1936-1938) to the Soviet Union and appointed by President Franklin D. Roosevelt. Prior to “saying cheese” other words such as prunes, whiskey, and cheese with crackers were used by photographers to get you to smile. 

In Japan, they say the word for sunshine, while in Korea they use the word for kimchi.  When you say cheese, it naturally spreads the mouth into a smile and shows your teeth!

Why cheese for health?

On January 7, 2026, the government released the new 2025-2030 Dietary Guidelines for Americans.  This new inverted food pyramid garnered some controversy. The new guidelines emphasize high-fat dairy, red meat, and increased levels of protein. The guidelines also recommend consuming less added sugar, especially for children under 4 years of age, and avoiding highly processed foods. 

Part of the controversy is the science behind these recommendations. Let us look at cheese!

High-fat cheese is defined as a product with more than 25% of its calories from fat.  Some examples of high-fat cheeses include cheddar (~35%), brie, cream cheese, Gouda, blue cheese, and Camembert. Low-fat cheese contains less than 20% fat in the product and good examples are cottage cheese, feta, ricotta, goat cheese, Swiss, and part-skim mozzarella. 

Is there any evidence to support better health with high-fat dairy cheeses?

On January 27, 2026, in the journal Neurology, a study was published evaluating the consumption of cheeses and the risk for dementia. This cohort study was done in Sweden and followed 27,670 participants for 25 years. The researchers recruited participants between 1991 and 1996 and did a comprehensive dietary assessment. Food consumption was measured using food consumption 7-day food diaries, a food frequency questionnaire, and dietary interviews.

The aim of the study was to evaluate if there was a difference between high-fat dairy and low-fat dairy, which included an analysis of cheese intake on the development of dementia. The study evaluated high-fat versus low-fat milk, cream, butter and fermented milk, besides the intake of high-fat versus low-fat cheese. 

The authors defined high-fat cheese as greater than 20% fat.  The researchers used the Swedish National Patient Register to identify participants who had been diagnosed with any form of dementia, including Alzheimer’s disease and vascular dementia. They controlled for a patient’s APOE4 status, which is the strongest genetic risk factor for developing late-onset Alzheimer’s disease. 

Of the 27,670 participants, 3,208 or 11.6% developed dementia over the 25 years the researchers evaluated them.  The individuals who ate more of the high-fat cheeses were less likely to develop dementia. When comparing high-fat cheese consumption to low-fat cheese, the high-fat cheese group had a 13% lower risk of developing dementia.  However, when you compared the high-fat cheese group to those who had no to very low cheese intake, the risk of dementia was even lower at 29%. This lower risk was only found in those individuals who did not carrier the genetic risk of the APOE4 gene. 

The conclusion from the scientists was that high-fat cheese had a protective effect in preventing dementia in individuals without a genetic APOE4 risk. High-fat cream (>30%) had a 16% reduced risk of developing dementia as well. Interestingly, there was no association and no reduced risk of dementia when the researchers evaluated low-fat cream, high-fat or low-fat milk, butter, or high-fat versus low-fat fermented milk. 

Some experts have evaluated the data from this study and highlighted important issues to consider in the results. One expert pointed out that high-fat cheeses such as aged cheddars are more expensive in the grocery store and this could limit purchases. In the study, another critique was the high-fat cheese consumers were younger in age, had lower BMIs, had college degrees, and were predominantly males. In addition, the high-fat cheese group was less likely to have high blood pressure, diabetes, or a history of cancer.  The study did not evaluate high-cheese intake and any relationship to these diseases, so conclusion can’t be drawn for these other disease states. 

One expert made an interesting observation related to the protective effect of high-fat cheese, and it has some biological plausibility. When you eat high-fat foods, they can trigger reward circuits in the brain making you happy and satisfied.  This could stop you from craving other or more food/calories and eating less. Something to think about!

It may not be a bad thing to say “cheese.”  Smile and eat some cheddar!