High-fat cheese and cream consumption links to lower dementia risk over 25 years

By Vijay Kumar MalesuReviewed by Susha Cheriyedath, M.Sc.Dec 23 2025

A long-running Swedish study suggests that not all dairy is equal for brain health, with high-fat cheese and cream showing unexpected associations with lower dementia risk.

Study: High- and Low-Fat Dairy Consumption and Long-Term Risk of Dementia. Image Credit: New Africa / Shutterstock

In a recent study published in the journal Neurology, researchers evaluated whether consumption of high-fat and low-fat dairy products is differentially associated with long-term risk of all-cause dementia.

Dementia Burden and Dietary Uncertainty

Dementia is a growing global public health challenge, with new cases developing every few seconds worldwide and prevalence projected to triple by 2050 as populations age. In the absence of curative treatments, prevention strategies have focused on modifiable lifestyle factors, including diet.

Dietary studies examining dairy intake and dementia risk have produced conflicting results. Dairy products differ substantially in fat content, processing methods, and food composition, all of which may influence cognitive health. Emerging evidence from population studies suggests that not all dairy foods are associated with dementia risk in the same way. However, existing evidence remains observational, and causal relationships have not been established.

Malmö Diet and Cancer Cohort Design

This prospective cohort analysis used data from the Malmö Diet and Cancer (MDC) study, which enrolled adults aged 45 to 73 years in Malmö, Sweden, between 1991 and 1996.

Dietary intake was assessed at baseline using a validated method that combined a 7-day food diary, a semi-quantitative FFQ, and an in-depth dietary interview. Dairy products were classified into four categories - milk, fermented milk products, cheese, and cream - and further subdivided by fat content. Intake was quantified in grams per day for each category.

Dementia Outcomes and Statistical Analysis

Participants were followed from baseline until dementia diagnosis, death, emigration, or the end of follow-up in December 2020, with a median follow-up of approximately 25 years.

The primary outcome was all-cause dementia, with secondary outcomes including Alzheimer’s disease (AD) and vascular dementia (VaD). Dementia diagnoses were identified using the Swedish National Patient Register and ICD codes. Analyses of dementia subtypes were restricted to clinically validated cases through 2014 to enhance diagnostic certainty.

Associations between dairy intake and dementia risk were estimated using Cox proportional hazards models, reporting hazard ratios (HR) and 95% confidence intervals. Models were adjusted for demographic factors, lifestyle behaviors, BMI, cardiovascular risk factors, overall diet quality, and other dairy products. Effect modification by apolipoprotein E epsilon 4 (APOE ε4) genotype was also examined.

Participant Characteristics and Overall Dementia Risk

The analysis included 27,670 participants with a mean baseline age of 58 years; 61% were women. Over follow-up, 3,208 cases of all-cause dementia were identified.

Participants with the highest intake of full-fat cheese and cream tended to have lower BMI, higher educational attainment, and fewer cardiometabolic conditions at baseline, indicating differences in underlying health and lifestyle profiles across intake groups.

After multivariable adjustment, individuals consuming the highest amounts of high-fat cheese (≥50 g/day) had a 13% lower risk of all-cause dementia compared with those consuming the lowest amounts (≤15 g/day; HR 0.87, 95% CI 0.78–0.97). Similarly, participants consuming ≥20 g/day of high-fat cream had a 16% lower risk of dementia compared with non-consumers (HR 0.84, 95% CI 0.72–0.98). Dose–response analyses suggested largely linear inverse associations.

Dementia Subtypes, Genetics, and Substitution Models

When dementia subtypes were analyzed, high-fat cheese intake showed the strongest inverse association with VaD. High-fat cream intake was inversely associated with both AD and VaD when modeled continuously.

Low-fat dairy products, including low-fat cheese, low-fat cream, milk, fermented dairy products, and butter, were not significantly associated with the risk of all-cause dementia. However, high butter intake (≥40 g/day) was associated with an increased risk of AD in subtype analyses.

Genetic analyses showed that the inverse association between high-fat cheese intake and AD was observed only among individuals without the APOE ε4 allele. No significant interactions were found for age, sex, education level, or overall diet quality.

Substitution analyses suggested that replacing high-fat cheese or cream with processed meat or high-fat red meat was associated with a higher dementia risk. These models represent statistical dietary comparisons rather than real-world substitutions and may reflect broader dietary patterns rather than isolated effects of dairy fat. Sensitivity analyses generally supported the main findings, although associations were weaker among participants reporting stable diets over time.

Interpretation and Public Health Implications

In this large, long-term Swedish cohort, higher consumption of high-fat cheese and cream was associated with a lower risk of all-cause dementia, particularly VaD, while low-fat dairy products showed no clear associations.

These findings challenge the assumption that dairy fat content alone determines cognitive health effects. However, because the study was observational, causal inference is limited. The authors emphasize that the results should be interpreted cautiously and do not justify changes to dietary guidelines without confirmation from randomized or mechanistic studies.