Cheese and ricotta: gentler on LDL than butter, and ricotta is barely tested

Hard cheese raises LDL cholesterol less than butter with a similar fat load. A meta-analysis of 5 randomized trials in healthy adults found that about 5.1 oz (145 g) of hard cheese a day, roughly seven 21 g slices, left LDL 6.5 percent lower than butter did (-8.5 mg/dL (95% CI -11 to -5.4; metric: -0.22 mmol/l, -0.29 to -0.14)), and HDL came out 3.9 percent lower too. At English cheddar's 723 mg per 3.5 oz (100 g), that amount of cheese carries about 1,050 mg of sodium. An updated meta-analysis of 7 trials of at least 14 days put the gap at 0.19 mmol/L (95% CI -0.27 to -0.12) for 4.8 oz (135 g) of cheese against about 1.8 oz (52 g) of butter, with some risk of bias in every trial. Butter is the comparison, so these trials say nothing about cheese against a low-fat diet. Ricotta has almost no trials. The one study we found is observational: among 802 adults in Palermo, more weekly ricotta went with higher LDL, from a food questionnaire where confounding is possible.

How much is actually in it

• Per 100 g, ricotta has about a third of cheddar's energy and fat and a seventh of its sodium, but also about a third of its calcium and protein. — CoFID 2021 foods Cheese, Ricotta (12-176) and Cheese, Cheddar, English (12-346) (n = 2 records) Evidence E source
  Ricotta vs cheddar per 3.5 oz (100 g): 144 vs 416 calories; fat 11.0 vs 34.9 g; protein 9.4 vs 25.4 g; calcium 240 vs 739 mg; sodium 100 vs 723 mg; lactose 2.0 vs 0.1 g
• USDA measures whole-milk ricotta at 0.78 mcg vitamin B12 per 3.5 oz (100 g) across 7 samples ranging 0.65 to 0.97, while the UK table gives only 0.3 mcg. — USDA Foundation Foods Cheese, ricotta, whole milk (FDC 746766) vs CoFID 12-176 (n = 7 samples) Evidence E source
  B12 0.78 mcg (samples 0.65-0.97); riboflavin 0.327 mg (samples 0.27-0.42); saturated fat 6.97 g; CoFID B12 0.3 mcg, riboflavin 0.19 mg
• Across 41 USDA samples, cheddar sodium ran from 575 to 743 mg per 3.5 oz (100 g), a 26% spread. — USDA Foundation Foods Cheese, cheddar, 41 samples (n = 41 samples) Evidence E source
  Sodium 654 mg (range 575-743, median 650); calcium 707 mg (range 641-761)

What a real portion looks like

• US survey portions differ by an order of magnitude: an unspecified serving of ricotta is 123 g, while a slice of cheddar is 21 g. — FNDDS foods Cheese, Ricotta (14201500) and Cheese, Cheddar (14104100) Evidence E source
  Ricotta 1 cup 246 g, quantity not specified 123 g; cheddar 1 slice 21 g, 1 cubic inch 17 g, 1 cup shredded 113 g

What your body absorbs

• The cheese matrix changes how fat is absorbed: in 18 men, a casein gel raised blood triglycerides by 21 mg/dL (0.24 mmol/L) more than cheddar with the same fat and protein. — Normal-weight men aged 18 to 40, 4 test meals, 8-hour postprandial (n = 18) Evidence B source
  Postprandial TG +0.24 ± 6.2 mg/dL (0.07 mmol/L) after casein gel vs cheese; free fatty acids lower for cheese in the first 2 hours
• Protein from cheddar is absorbed more slowly than from milk: in 24 young adults, branched-chain amino acids from cheese peaked at about 120 minutes with a lower insulin response. — 12 men and 12 women, about 27 years, 20 g protein from cheese or milk (n = 24) Evidence B source
  BCAA appearance slower and more sustained, peaking about 120 min; insulin not changed by cheese vs spike after milk

What it does to your health

• A meta-analysis of 5 RCTs found that eating about 5.1 oz (145 g) of hard cheese a day lowered LDL cholesterol by 6.5% compared with butter of a similar fat profile. — Healthy adults in 5 randomized trials comparing hard cheese with butter (n = 5 RCTs) Evidence A source
  LDL-C -8.5 mg/dL (95% CI -11 to -5.4; metric: -0.22 mmol/l, -0.29 to -0.14), -6.5%; HDL-C -1.9 mg/dL (-0.05 mmol/l) (-3.9%); triglycerides no effect
• An updated meta-analysis of 7 RCTs found that 4.8 oz (135 g) of cheese a day for at least 14 days lowered LDL cholesterol by 7.3 mg/dL (0.19 mmol/L) against about 1.8 oz (52 g) of butter. — Adults in 7 randomized trials, at least 14 days, hard or semi-hard cheese (n = 7 RCTs) Evidence A source
  LDL-C WMD -7.3 mg/dL (95% CI -10 to -4.6; metric: -0.19 mmol/L, -0.27 to -0.12); total cholesterol -9.3 mg/dL (-0.24 mmol/L); HDL-C -1.5 mg/dL (-0.04 mmol/L)
• In a 3-week crossover RCT of 14 young men, LDL cholesterol was lower after a hard cheese diet than after butter with the same dairy fat. — 14 healthy young men, three 3-week periods, 20% of energy from dairy fat (n = 14) Evidence B source
  Fasting LDL-C higher after butter than cheese (p = 0.037); total cholesterol borderline (p = 0.054)
• Observational data from 802 adults in Palermo linked more weekly ricotta portions with higher LDL cholesterol, while milk intake went with lower LDL. — 802 healthy adults of the ABCD_2 cohort, Palermo, Sicily (n = 802) Evidence C source
  LDL-C positively associated with ricotta intake (p < 0.001), inversely with milk (p < 0.005) in multivariate models

Safety, limits and interactions

• In 2026 a Listeria outbreak traced to soft ricotta (requeson) from one Maryland dairy sickened 15 people in 4 states, hospitalizing 14 and killing 1. — US multistate outbreak, Clover Hill Dairy requeson/soft ricotta, declared over August 2026 (n = 15) Evidence E source
  15 cases, 14 hospitalizations, 1 death, 4 states
• FDA says pregnant women, older people and people with weakened immune systems should not eat unpasteurized milk products, including cheese made from unpasteurized milk, or any queso fresco-type cheeses. — pregnant women, the elderly, people with weakened immune systems Evidence E source
  Advised not to eat unpasteurized milk products or any queso fresco-type cheeses (high Listeria risk)
• The FDA label for transdermal selegiline (EMSAM) at 9 mg/24 h or more lists aged cheeses as foods to avoid and ricotta as acceptable. — Adults using EMSAM (selegiline transdermal system) at 9 mg/24 h or 12 mg/24 h (n = -) Evidence E source
  Aged cheeses: avoid; ricotta: acceptable (label Table 5, dairy)

What people believe that the data does not support

• The EU refused to let sellers claim that milk and cheese promote dental health in children, and none of its 12 cheese claims is authorized. — EU register of nutrition and health claims, snapshot 2026-09-21 Evidence E source
  Claim POL-HC-6306 non-authorized; 12 of 12 cheese-related claims non-authorized

Who this works differently for

• In pooled RCT data on 197 middle-aged adults eating 4.2 oz (120 g) cheese daily for 6 weeks, there was no formal sex difference, but within women whole cheese lowered total and LDL cholesterol while its deconstructed parts raised them. — 197 middle-aged adults (41.6% male), 6 weeks, about 40 g dairy fat a day (n = 197) Evidence B source
  Cheese lowered total and LDL cholesterol vs deconstructed cheese; no sex x treatment interaction, but within women deconstructed cheese raised LDL

The bottom line

Per 100 g in the UK table, ricotta has 144 calories, 11.0 g fat and 100 mg sodium, against 416 calories, 34.9 g fat and 723 mg sodium in English cheddar. It also carries less of what cheese is eaten for, 9.4 g protein and 240 mg calcium against 25.4 g and 739 mg. Compare by serving too, since a US survey serving of ricotta is 123 g and a slice of cheddar is 21 g. Cheddar sodium ran from 575 to 743 mg per 3.5 oz (100 g) across 41 USDA samples. USDA measured 0.78 mcg vitamin B12 in whole-milk ricotta across 7 samples, while the UK record gives 0.3 mcg and may describe a whey ricotta. How the cheese is built changes digestion in short meal tests. In 18 men, a casein gel with the same fat and protein as cheddar raised blood triglycerides 21 mg/dL (0.24 mmol/L) more than the cheese over one 8-hour test. In 24 young adults, amino acids from cheddar entered the blood slowly and peaked at about 120 minutes. In pooled data on 197 middle-aged adults eating 4.2 oz (120 g) a day for 6 weeks, whole cheese lowered LDL compared with the same parts eaten separately. Women seemed to respond more clearly, but the formal test for a sex difference was not significant. The EU refused the claim that milk and cheese promote dental health in children. Refusal means the evidence was judged insufficient at assessment. The safety fact on record is Listeria. In 2026 an outbreak traced to soft ricotta (requeson) from one Maryland dairy sickened 15 people in 4 states, hospitalizing 14 and killing 1, and CDC notes that pasteurized soft cheese can be contaminated after pasteurization. We hold no card yet on who is most at risk from Listeria in these cheeses or which to choose, and that gap is not reassurance. We have not yet gathered evidence on tyramine in aged hard cheese such as mature cheddar with MAO-inhibitor drugs. If you are pregnant, or take a medicine that comes with food warnings, which cheeses fit is a question for the person treating you.

Sources

1. crc-r7-08 · CoFID 2021, dataset
   Cheese, Ricotta [12-176]: Energy 144 kcal; Fat 11.0 g; Protein 9.4 g; Satd FA 6.90 g; Calcium 240 mg; Sodium 100 mg; Lactose 2.0 g per 100 g. Cheese, Cheddar, English [12-346]: Energy 416 kcal; Fat 34.9 g; Protein 25.4 g; Satd FA 21.68 g; Calcium 739 mg; Sodium 723 mg; Lactose 0.1 g per 100 g
   CoFID 2021, Public Health England, codes 12-176 and 12-346 (OGL v3.0) · checked 2026-09-28
2. crc-r7-09 · USDA FoodData Central Foundation, dataset
   Cheese, ricotta, whole milk (FDC 746766, foundation): vitamin B12 0.78 ug = 32% DV, Foundation samples 0.65-0.97 n=7; riboflavin 0.327 mg, samples 0.27-0.42 n=7; saturated fat 6.97 g; CoFID 12-176 B12 0.3 ug, riboflavin 0.19 mg
   USDA FoodData Central, Foundation Foods, FDC 746766 · checked 2026-09-28
3. crc-r7-10 · USDA FoodData Central Foundation, dataset
   Cheese, cheddar: Sodium, Na 654.0 MG range 575.0-743.0 (median 650.0), samples 41, spread 26%; Calcium, Ca 707.0 MG range 641.0-761.0 (median 708.0), samples 41, spread 17%
   USDA FoodData Central, Foundation Foods, release 2026-04-30, Cheese, cheddar · checked 2026-09-28
4. crc-r7-11 · FNDDS, dataset
   Cheese, Ricotta, FNDDS 14201500: 1 cup = 246 g; Quantity not specified = 123 g. Cheese, Cheddar, FNDDS 14104100: 1 slice = 21 g; 1 cubic inch = 17 g; 1 cup, shredded = 113 g
   USDA FNDDS, codes 14201500 and 14104100 (FDC 2705750, 2705709) · checked 2026-09-28
5. crc-r7-05 · RCT
   Postprandial triglycerides (TGs) (primary outcome) increased by (mean ± SEM) 0.24 ± 0.07 and 0.19 ± 0.07 mmol/L after MCI Gel compared with Cheese and Hom. Cheese, respectively (both P ≤ 0.05).
   Am J Clin Nutr, 2021 · checked 2026-09-28
6. crc-r7-06 · RCT
   We found that cheese ingestion had a slower yet more sustained branched-chain amino acid circulation appearance over the postprandial period peaking at ~120 min.
   Nutrients, 2021 · checked 2026-09-28
7. crc-r7-01 · Meta-analysis of RCTs
   Compared with butter intake, cheese intake (weighted mean difference: 145.0 g/d) reduced low-density lipoprotein cholesterol (LDL-C) by 6.5% (-0.22 mmol/l; 95%CI: -0.29 to -0.14) and high-density lipoprotein cholesterol (HDL-C) by 3.9% (-0.05 mmol/l; 95%CI: -0.09 to -0.02) but had no effect on triglycerides.
   Nutr Rev, 2015 · checked 2026-09-28
8. crc-r7-02 · Meta-analysis of RCTs
   Pooled analyses of 7 RCTs showed a reduction in fasting total cholesterol, LDL-C and HDL-C concentrations after ≥14 d mean daily intake of 135 g cheese (weighted mean difference [WMD]: -0.24 mmol/L; 95% confidence interval (CI): -0.34, -0.15; I2 = 59.8%, WMD: -0.19 mmol/L; 95% CI: -0.27, -0.12; I2 = 42.8%, and WMD: -0.04 mmol/L; 95% CI: -0.08, -0.00; I2 = 58.6%, respectively) relative to ∼52 g/d butter.
   Adv Nutr, 2023 · checked 2026-09-28
9. crc-r7-03 · RCT
   Fasting LDL cholesterol concentration was significantly higher after butter than cheese diet (p = 0.037), with a borderline significant difference in total cholesterol (p = 0.054) after the experimental periods of three weeks.
   J Am Coll Nutr, 2004 · checked 2026-09-28
10. crc-r7-07 · Cohort
    However, multivariate analyses showed an inverse association between serum LDL-C and milk intake as well as a positive association between ricotta cheese intake and LDL-C concentrations.
    Nutrients, 2021 · checked 2026-09-28
11. crc-r7-13 · Outbreak notice
    Cases: 15 ... Hospitalizations: 14 ... Deaths: 1 ... States: 4
    CDC, Listeria Outbreak Linked to Requeson/Soft Ricotta Cheese, 2026 · checked 2026-09-28
12. sf-lsc-r3-ricotta-1 · agency advice
    Pregnant women, the elderly, and those with weakened immune systems should not eat certain foods, including unpasteurized milk and unpasteurized milk products, any queso fresco-type cheeses, raw and smoked fish, raw sprouts, and certain other raw foods, which carry a high risk for L. monocytogenes.
    Listeria (Listeriosis), US Food and Drug Administration, Preventing Foodborne Illness at Home · checked 2026-10-08
13. sf-tymaoi-17 · agency advice
    Aged cheeses ... Processed cheeses, mozzarella, ricotta cheese, cottage cheese, and yogurt
    EMSAM (selegiline transdermal system), FDA-approved label, sections 2.3 and 7.2 (Table 5) · checked 2026-10-08
14. crc-r7-12 · Regulatory decision
    POL-HC-6306 Dairy products (milk and cheese) Dairy foods (milk and cheese) promote dental health in children. -/- Non-authorised
    EU Register on nutrition and health claims, claim POL-HC-6306, snapshot 2026-09-21 · checked 2026-09-28
15. crc-r7-04 · RCT
    No sex × treatment interactions were observed although, within-sex analysis found men and women to respond differently. Within males, cholesterol concentrations decreased in response to dairy fat. Within the female group cheese lowered total and LDL cholesterol concentrations, whereas deconstructed cheese was found to increase the same lipid markers.
    Atherosclerosis, 2025 · checked 2026-09-28