 You may have heard the expression, knowledge is power. Well, today we're going to give you more power to control your diet and lifestyle by giving you the facts. Welcome to the Nutrition Facts Podcast, I'm your host, Dr. Michael Greger. Today, we take a critical look at one of the foods people have trouble cutting down on. We start with the simple question, is cheese really bad for you? In a series of videos I did about saturated fat, I talked about a major campaign launched by the global dairy industry to neutralize the negative image of milk fat among regulators and health professionals as related to heart disease. That campaign continues to this day, with a publication of a meta-analysis demonstrating neutral, meaning non-harmful associations between dairy products and cardiovascular disease and death. OK, well, first of all, how do we know the dairy industry had anything to do with this study? Well, it was published in a journal that forces authors to disclose financial conflicts of interest. Let's see what they divulged. Dairy, dairy, dairy, dairy, dairy, the fourth largest dairy company in the world, dairy, dairy, milk, beer, soda, McDonald's, dairy, dairy, dairy, dairy. Oh, and the study itself was explicitly funded by dairy, dairy, dairy. OK then. The other big new one was this, suggesting that a little bit of cheese every day isn't just neutral, but actually good for you. And they make it clear that they have no conflicts of interest. They're just employees of the Yili Innovation Center and the Yili R&D Center. You know, China's largest dairy producer, making it one of the world's largest dairy companies? OK, but how can cheese consumption be associated with better health outcomes? Well, most of these studies were from Europe, where cheese consumption is associated with a higher socio-economic status. See, in Europe they're not eating cheese whiz and velvita. Cheese is generally an expensive product, and so who eats cheese? Those with higher paying jobs, higher socio-economic strata, higher education levels, all of which are associated with better health outcomes, which may have nothing to do with their cheese consumption. Higher socio-economic groups also consume more fruits and vegetables and more candies. So I bet you could do a population study and show candy consumption is associated with better health. Shh, don't tell the National Confectioners Association. Too late! Did you know that candy consumers have lower levels of inflammation? A 14% decreased risk of elevated blood pressure brought to you by the candy industry and the USDA, our government which props up the sugar industry to the tune of a billion dollars a year. It's like when our tax dollars are used to buy up surplus cheese. Paul Shapiro wrote a great editorial. Imagine the headline, government buys 20 million in surplus Pepsi, or hard-earned tax dollars buying up millions of unwanted colicans, all as a favor to the flailing soda industry, which just kept producing drinks no one wanted. As outrageous as such a government handout to the soda industry would be, that's exactly what the USDA is doing for the dairy industry. Michelle Simon did a great report on how her government colludes with the industry to promote dairy junk foods. The federal government administers check-off programs to promote milk and dairy. McDonald's is a six-dedicated dairy check-off program employees at its corporate headquarters to try to squeeze in more cheese. That's how we got double-stake quesadillas. That's how we got three cheese stuffed crust pizza complete with a summer of cheese. These funds are being used to promote foods that contribute to the very diseases our federal government is allegedly trying to prevent. Does it make sense to tell Americans to avoid foods, high in salt, sugar, and saturated fat, while engaging in the promotion of those same foods? Look, the meat and dairy industries can do what they like with their own money, but the public power of taxation should be used for the public good, not to support the dairy and candy industries. In our next story, we compare dairy to other foods for heart attack and stroke risk. When industry-funded studies suggest their products have neutral health effects or even beneficial, one question you always have to ask is compared to what? Is cheese healthy? Compared to what? And if you're sitting down to make a sandwich, cheese is probably healthy, compared to bologna, but compared to peanut butter? No way. What's the point? Well, will it made a former chair of nutrition at Harvard? To conclude that dairy foods are neutral, it could be misleading, as it could be misinterpreted to mean that increasing consumption of dairy foods would have no effects on cardiovascular disease or mortality. Lost is that the health effects of increasing or decreasing consumption of dairy foods would depend, importantly, on the specific foods that are substituted for dairy foods. Like what do you got to put on your salad? Cheese would be healthy compared to bacon, but not compared to nuts. See, consumption of nuts or plant protein has been found to be protectively associated with the risk of coronary heart disease and type 2 diabetes in contrast and take up red meat, for example, has been associated with increased risk. Thus, it's reasonable to assume that the lack of association with dairy foods could put them somewhere in the middle of a spectrum of healthfulness, but certainly not an optimal source of energy or protein. More broadly, the available evidence supports policies that limit dairy production and encourages production of healthier sources of proteins and fats. He wasn't just speculating. This was based on three famous Harvard studies involving hundreds of thousands of men and women exceeding 5 million person years of follow-up. This was really the first large-scale prospective study to examine dairy fat intake compared to other types of fat in relation to heart attack and stroke risk. Also replacing like 100 calories of fat worth of cheese with 100 calories of fat worth of peanut butter on a daily basis might reduce risk up to 24%, where a substitution with other animal fats might make things worse. Here's how it breaks down for heart disease. Swapping dairy fat for like vegetable oil would be associated with a decrease in disease risk, where swapping dairy for meat increases risk. Dairy fat calories may be as bad or worse as straight sugar. The lowest risk would entail swapping to a whole-plant food like whole grains. Yeah, dairy products are a major contributor to the saturated fat in the diet and have thus been targeted as one of the main dietary causes of, you know, the number one killer of men and women. But the dairy industry likes to argue there are other things in dairy products like fermentation byproducts and cheese that could counteract these saturated fat effects. All part of an explicit campaign by the dairy industry to neutralize the negative image of milk fat among regulators and health professionals. If global dairy platform looks familiar, they were one of the funders of the milk and dairy's neutral study, trotting out their dairy fat is counteracted notion, to which the American Heart Association responds that no information from controlled studies supports the assertion that fermentation has beneficial nutrients to cheese that somehow counteract the harmful effects of the saturated fat. We need to cut down on dairy, meat, coconut oil, no matter what their respective industries say. In fact, that's the reason the American Heart Association felt they needed to release this special presidential advisory in 2017. They wanted to set the record straight on why well-conducted scientific research overwhelmingly supports limiting saturated fat in the diet. Finally today, we look at how the meat and dairy industries design studies showing their products have neutral or even beneficial effects on cholesterol and inflammation. Bored about this interventional study, a randomized crossover trial which compared a high-fat cheese diet to a high-fat meat diet to a low-fat diet, a high-cheese diet cheese, which is loaded with saturated fat, a high-meat diet meat, which is loaded with saturated fat, versus carb, a low-fat diet, and people ended up with the same cholesterol levels. Let's see how they did it. Half the study was paid for in part by the dairy industry, and the other half paid for by dairy, dairy, dairy, and dairy. If you're the dairy industry and you're trying to design a study to show that a high-cheese diet doesn't raise cholesterol, how would you go about doing that? The beef industry was in the same pickle as the cheese industry. Beef has saturated fat, which raises cholesterol, which raises the risk of dying from our number one killer. What's an industry to do? So they designed a study where they added beef and cholesterol went down. How is that possible? They did this by cutting out so much dairy, pork, poultry, fish, and eggs that their overall saturated fat intake was cut in half. They cut saturated fat levels in half, and the cholesterol levels went down. Well, duh! They could have swapped in Twinkies and said snack cakes lower your cholesterol or frosting or anything. OK, so now that you know the trick, let's go back to this study. How are you going to get a high-fat cheese diet and a high-fat meat diet to have anywhere near the same saturated fat level as a diet with neither? Unless—wait, don't tell me what— they added coconut oil or something to the other diet? They added so much coconut oil and cookies to the so-called low-fat diet that they were able to sufficiently raise the level of saturated fat to cause a similar rise in cholesterol. That's how you can make a cheese or meat-rich diet look like it doesn't raise cholesterol. That reminds me of the desperation evident in this study that compared the effects of dairy cheddar cheese to a non-dairy cheddar cheese called DEA. Milk consumption has plummeted in recent years as people have discovered plant-based alternatives like soy milk and almond milk, and now there's plant-based cheese alternatives? What's the National Dairy Council to do? How are you going to design a study that shows it's healthier to eat cheese? Design a study where cheese causes less inflammation than the vegan alternative. I ain't got their work cut out for them. DEA is no health food by any stretch, but definitely three times less saturated fat than cow cheese. So I give up. How could you possibly show more inflammation from DEA? Well, there is one fat that may cause more inflammation than milk-fat palm oil. In fact, it may raise cholesterol levels as much as trans-fat-laden partially hydrogenated oil. Yeah, but what do you tell me? They like slip the DEA group some extra palm oil on the side? Yes! Can you believe it? They compared cheese to DEA plus palm oil. So much extra palm oil that the vegan alternative meal ended up having the same amount of saturated fat as the cheese meal. That's like improving tofu is worse than beef by doing a study where they compared a beef burger to a tofu patty stuffed with lard. Oh wait, the meat industry already did that. But at least they had the decency to concede that replacing of meat by tofu in the habitual diet would probably not usually be accompanied by the addition of lard. We would love it if you could share with us your stories about reinventing your health through evidence-based nutrition. Go to nutritionfacts.org slash testimonials. We may share it on our social media to help inspire others. To see any graphs, charts, graphics, images, or studies mentioned here, please go to the Nutrition Facts Podcast landing page. There you'll find all the detailed information you need plus links to all the sources we cite for each of these topics. For a timely text on the pathogens that cause pandemics, you can order the e-book, audiobook, or hard copy of my last book, How to Survive a Pandemic. For recipes, check out my second to last book, My How Not to Diet Cookbook. It's beautifully designed with more than 100 recipes for delicious and nutritious meals. 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