Systematic reviewindependent cross-checkabstract checked I-DRY-124 standard review
Cheese is linked to neutral or slightly better health outcomes
Cheese consumption and multiple health outcomes: an umbrella review and updated meta-analysis of prospective studies.
Overview
Zhang M et al.. Adv Nutr 2023 · PMID 37328108 · DOI 10.1016/j.advnut.2023.06.007
About 5-8% lower mortality and CVD in high cheese eaters.
Does the study support the specific claim? Partly · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Summarise cheese and health.
- How was the study done?
Umbrella review.
- How many people, animals or samples were studied?
Many cohorts.
- What was actually found?
Neutral to modest benefits.
- How large was the observed effect?
Mortality RR 0.95.
- What do the results mean in everyday life?
Moderate cheese is fine.
- What are the study's limitations?
Observational.
- What does it say about Elawady's specific claim?
Supports allowing cheese, not banning yogurt.
- Do the results apply to Germany and Europe?
Applicable.
- What can explicitly not be concluded from this study?
Cannot prove benefit.
Scientific in-depth review
1. Full reference
- Authors
- Zhang M et al.
- Journal
- Adv Nutr
- Year
- 2023
- Identifier
- PMID 37328108 DOI 10.1016/j.advnut.2023.06.007
- Verification
- verified – PubMed efetch 2026-10-26
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
not stated in abstract
2. Research question
What are the health associations of cheese consumption?
3. Study design and population
- Study design
- Systematic review – Umbrella review with updated and de novo meta-analyses of prospective studies; NutriGrade
- Population
Prospective cohorts
- Country
Multinational
- Period
to 31 Aug 2022
- Sample size
54 articles; 47 outcomes
- Inclusion and exclusion criteria
Meta-analyses/pooled analyses of prospective studies
4. Methods and endpoints
- Exposure / intervention
Cheese
- Comparator
Lowest intake
- Endpoints
47 outcomes
- Statistical methods
Random effects; small-study and excess-significance tests
5. Actual results
- Results
Highest v lowest cheese: all-cause mortality RR 0.95 (0.92-0.99); CV mortality 0.93 (0.88-0.99); incident CVD 0.92 (0.89-0.96); CHD 0.92 (0.86-0.98); stroke 0.93 (0.89-0.98); type 2 diabetes 0.93 (0.88-0.98); total fracture 0.90 (0.86-0.95); dementia 0.81 (0.66-0.99); null for cancer mortality, hypertension and prostate cancer (moderate quality for several).
- Absolute risks
not reported
- Authors' conclusion
Cheese consumption has neutral to moderate benefits for human health.
6. Strengths
- Comprehensive
- Credibility assessment
7. Weaknesses
- Observational
- Possible healthy-user effects
8. Risk of bias
- Orienting tool
- AMSTAR 2
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Abstract only.
9. Assessment of the statistical interpretation
Small relative associations.
10. Relevance to the specific claim
Supports that the allowed aged cheeses are not harmful in moderate amounts; together with yogurt data (I-DRY-107), it shows no basis for treating cheese and yogurt differently.
11. Independent contrary findings
A-DRY-02 (cheese and prostate cancer per 50 g/d).
12. Transferability to Germany and Europe
Western cohorts; Egyptian cheeses are often saltier (not quantified).
13. Overall methodological judgement
Fair support for the allowed side; no support for the forbidden side.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | high |
| Directness | direct |
| Reproducibility | unknown |
| Consistency with the overall evidence | consistent |
| Regional transferability | moderate |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Salt content of Egyptian cheeses.