Cheese sauce: what melting and storing do to the cheese

Nobody has run a trial on cheese sauce as a food, so the useful evidence comes from cheese. By a meta-analysis of 7 randomized trials, about 4.8 oz (135 g) of hard or semi-hard cheese a day for at least 14 days lowered LDL cholesterol by 7.3 mg/dL (95% CI 4.6 to 10; metric: 0.19 mmol/L, 0.12 to 0.27) compared with about 1.8 oz (52 g) of butter. Every trial carried some risk of bias. Melting may change that picture. In a 6-week trial in 162 overweight adults aged 50 and over, 4.2 oz (120 g) of cheddar a day eaten melted raised total cholesterol by 7.7 mg/dL (0.20 mmol/L) and triglycerides by 15 mg/dL (0.17 mmol/L) more than the same cheese unmelted. That trial used melted cheddar, not a flour and milk sauce, and comes from one research group.

The numbers, per 3.5 oz (100 g)

As people eat it, per 3.5 oz (100 g)

How much is actually in it

• Homemade cheese sauce with whole milk has 197 calories, 14.6 g fat and 212 mg sodium per 3.5 oz (100 g), while a packet mix made up with whole milk has 108 calories, 5.7 g fat and 450 mg sodium. — — Evidence E source
  Homemade: 197 calories, 14.6 g fat, 9.12 g sat fat, 246 mg Ca, 212 mg Na; packet: 108 calories, 5.7 g fat, 166 mg Ca, 450 mg Na (per 100 g)
• Dry cheese sauce packet mix carries 2700 mg sodium per 3.5 oz (100 g), and homemade sauce with skim milk still has 172 calories and 11.6 g fat per 3.5 oz (100 g). — — Evidence E source
  Dry mix: 486 calories, 28.4 g fat, 2700 mg Na; skimmed-milk homemade: 172 calories, 11.6 g fat, 215 mg Na (per 100 g)

What a real portion looks like

• A US serving of cheese sauce is 1 tablespoon (16 g) or a 28 g dipping cup, which carries about 46 calories and 184 mg sodium. — — Evidence E source
  Per 100 g: 163 calories, 656 mg Na, 3.08 g sat fat, 71 mg Ca; per 28 g: 45.6 calories, 183.7 mg Na, 0.9 g sat fat

What your body absorbs

• In a crossover RCT in 43 healthy adults, fat from soft cream cheese reached the blood faster than fat from cheddar, with triglycerides up 44% vs 16% at 2 hours, while the 8-hour total was the same. — 43 healthy adults, single meals with 33 g fat from cheddar, cream cheese or butter (n = 43) Evidence B source
  TG at 2 h +44% cream cheese vs +24% butter vs +16% cheddar; 8-h iAUC no difference (P = 0.9)
• Vitamin D added to process cheese was absorbed better than from water, equally in younger and older adults, but 600 IU a day from cheese for 2 months did not raise blood vitamin D in 100 older adults. — 100 adults aged 60 or older for 2 months (RCT); 8 adults in an acute crossover feeding (n = 100) Evidence B source
  No rise in serum 25-OHD with 600 IU/day D3 cheese; D2 absorbed more efficiently from cheese than water

What cooking and storage change

• In a 6-week RCT in 162 overweight adults aged 50 and over, eating 4.2 oz (120 g) cheddar a day melted rather than unmelted raised total cholesterol by 7.7 mg/dL (0.20 mmol/L) and triglycerides by 15 mg/dL (0.17 mmol/L) more. — 162 overweight adults aged 50 or older in Ireland, 120 g full-fat cheddar daily for 6 weeks (n = 162) Evidence B source
  Melted vs unmelted: total cholesterol +7.7 mg/dL (0.20 mmol/L), triglycerides +15 mg/dL (0.17 mmol/L); no difference in LDL, HDL, weight, glucose
• An opened can of commercial cheese sauce caused a type A botulism outbreak: 8 of 52 deli patrons fell ill and 1 died, and inoculated sauce became toxic after 8 days at room temperature. — 52 patrons of a delicatessen in Georgia, USA, 1993 (n = 52) Evidence C source
  8 cases (15%), 5 hospitalized, 1 death
• In a 2018 English restaurant outbreak of Clostridium perfringens food poisoning, leeks in cheese sauce was the only food linked to illness (adjusted OR 51.1), after lapses in hot holding and reuse of leftover sauce. — 40 restaurant diners in a case-control study (28 cases), West Midlands, England (n = 40) Evidence C source
  AOR 51.1 (95% CI 4.13-2492.1)

What it does to your health

• In a 6-week RCT in 164 overweight adults aged 50 and over, dairy fat eaten inside cheddar gave lower LDL cholesterol (115 vs 133 mg/dL (2.97 vs 3.43 mmol/L)) than the same fat, casein and calcium eaten separately. — 164 overweight adults aged 50 or older, about 40 g dairy fat daily for 6 weeks (n = 164) Evidence B source
  Post-intervention TC 5.23 vs 5.57 mmol/L; LDL 115 vs 133 mg/dL (2.97 vs 3.43 mmol/L) (cheese matrix vs butter + caseinate + calcium)
• A meta-analysis of 7 RCTs found that about 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) compared with about 1.8 oz (52 g) of butter. — adults in 7 RCTs, at least 14 days, 135 g/day hard or semi-hard cheese vs about 52 g/day butter (n = 7 RCTs) Evidence A source
  TC -0.24 mmol/L (95% CI -0.34 to -0.15); LDL-C -0.19 (95% CI -0.27 to -0.12); HDL-C -0.04

Who this works differently for

• Among 146 adults with celiac disease in England, food questionnaires revealed unintended gluten intake through starch-thickened sauces such as cheese sauce. — 146 adult biopsy-diagnosed celiac patients in England (n = 146) Evidence C source
  Qualitative: gluten exposure via cheese sauce, custard, ketchup, breakfast cereals

The bottom line

What goes in the pan decides the numbers. Per 100 g, UK tables give homemade cheese sauce with whole milk 197 calories, 14.6 g fat and 212 mg sodium. A packet mix made up with whole milk has 108 calories, 5.7 g fat and 450 mg sodium, and the dry powder itself holds 2700 mg sodium before milk dilutes it. Switching to skim milk at home still leaves 172 calories and 11.6 g fat. The US survey counts a serving as a 16 g tablespoon or a 28 g dipping cup, which carries about 46 calories and 184 mg sodium. Cheese texture shifts timing more than totals. In 43 healthy adults, blood fats rose 44 percent two hours after cream cheese against 16 percent after cheddar, and the 8-hour totals were the same. In 164 overweight adults over 50, LDL was lower when about 40 g of dairy fat a day came inside cheddar (115 mg/dL (2.97 mmol/L)) than when the same fat, protein and calcium were eaten separately (3.43). Vitamin D added to process cheese was absorbed well, but 600 IU a day from fortified cheese for 2 months did not raise blood vitamin D in 100 older adults. The real hazards are storage and gluten. An opened can of commercial cheese sauce kept at a deli caused botulism in 8 of 52 customers, and one died. In the lab, sauce seeded with spores turned toxic after 8 days at 72 °F (22 °C), so the risk came from an opened can kept at room temperature. In an English restaurant outbreak, leeks in cheese sauce was the only food linked to illness after lapses in hot holding and reuse of the previous day's sauce (odds ratio 51.1, 95% CI 4.13 to 2492.1, with no food samples). Adults with celiac disease in England took in gluten unintentionally through starch-thickened sauces such as cheese sauce, by their own food questionnaires. We found no study of cheese sauce in pregnancy, in children, or with medicines.

Sources

1. chss-r4-09 · food composition data
   CoFID 17-775 Cheese sauce, made with whole milk, homemade | Energy (kcal) | 197 per 100 g ; Fat (g) | 14.6 ; Satd FA /100g fd (g) | 9.12 ; Calcium (mg) | 246 ; Sodium (mg) | 212 || CoFID 17-781 Cheese sauce, packet mix, made up with whole milk, homemade | Energy (kcal) | 108 per 100 g ; Fat (g) | 5.7 ; Calcium (mg) | 166 ; Sodium (mg) | 450
   CoFID 2021, Public Health England, codes 17-775 and 17-781 (OGL v3.0) · checked 2026-09-29
2. chss-r4-10 · food composition data
   CoFID 12-593 Sauce, cheese, packet mix, dry | Energy (kcal) | 486 per 100 g ; Fat (g) | 28.4 ; Sodium (mg) | 2700 || CoFID 17-773 Cheese sauce, made with skimmed milk, homemade | Energy (kcal) | 172 per 100 g ; Fat (g) | 11.6 ; Sodium (mg) | 215
   CoFID 2021, Public Health England, codes 12-593 and 17-773 (OGL v3.0) · checked 2026-09-29
3. chss-r4-11 · food portion data
   FNDDS 14650100 Cheese sauce (fdc 2705808) | 1 tablespoon | 16 g ; 1 dipping-size container | 28 g ; Energy 163 KCAL per 100 g ; Sodium, Na 656 MG per 100 g ; Fatty acids, total saturated 3.08 G per 100 g ; Calcium, Ca 71 MG per 100 g
   FNDDS 2021-2023, USDA, code 14650100 · checked 2026-09-29
4. chss-r4-04 · randomized crossover trial
   No difference in the triglyceride iAUC0-8 h (P-meal = 0.9) was observed between the 3 meals. However, at 2 h, the triglyceride response caused by the cream cheese (change from baseline: +44%) was significantly greater than that induced by butter (change from baseline: +24%; P = 0.002) and cheddar cheese (change from baseline: +16%; P = 0.0004).
   Am J Clin Nutr, 2017 · checked 2026-09-29
5. chss-r4-05 · randomized controlled trial
   Peak serum vitamin D and area under the curve were similar between younger (23 to 50 yr) and older (72 to 84 yr) adults, and vitamin D2 was absorbed more efficiently from cheese than from water. ... Among older individuals, consuming 600 IU of vitamin D3 daily from cheese for 2 mo was insufficient to increase serum 25-OHD during limited sunlight exposure.
   J Dairy Sci, 2005 · checked 2026-09-29
6. chss-r4-01 · randomized controlled trial
   Melted cheese, compared to unmelted cheese, increased total cholesterol (0.23 ± 0.79 mmol L-1vs. 0.02 ± 0.67 mmol L-1, P = 0.008) and triglyceride concentrations (0.17 ± 0.39 mmol L-1vs. 0.00 ± 0.42 mmol L-1, P = 0.016). Melted cheese increased total cholesterol concentrations by 0.20 ± 0.15 mmol L-1 and triglyceride concentrations by 0.17 ± 0.08 mmol L-1 compared to unmelted cheese.
   Food Funct, 2024 · checked 2026-09-29
7. chss-r4-06 · outbreak investigation
   8 of 52 patrons (15%) met the case definition for botulism. ... An open can of cheese sauce contained type A botulinum toxin and yielded C botulinum on culture. Cheese sauce experimentally inoculated with C botulinum spores became toxic after 8 days at a temperature of 22 degrees C (room temperature).
   Ann Intern Med, 1996 · checked 2026-09-29
8. chss-r4-07 · case-control outbreak study
   Multivariable analysis found that leeks in cheese sauce was the only item associated with illness (aOR 51.1; 95% CI 4.13-2492.1). Environmental investigations identified significant lapses in food safety, including lapses in temperature control during cooking and hot holding, likely cross-contamination between raw and cooked foods and the reuse of leftover cheese sauce for the next day's service.
   Epidemiol Infect, 2020 · checked 2026-09-29
9. chss-r4-02 · randomized controlled trial
   However, a stepwise-matrix effect was observed between the groups for total cholesterol (TC) (P = 0.033) and LDL cholesterol (P = 0.026), with significantly lower postintervention TC (mean ± SD) (5.23 ± 0.88 mmol/L) and LDL cholesterol (2.97 ± 0.67 mmol/L) when all of the fat was contained within the cheese matrix (Group A), compared with Group C when it was not (TC: 5.57 ± 0.86 mmol/L; LDL cholesterol: 3.43 ± 0.78 mmol/L).
   Am J Clin Nutr, 2018 · checked 2026-09-29
10. chss-r4-03 · 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 2026-09-29
11. chss-r4-08 · cohort survey
    The FFQ revealed further examples of gluten ingestion, presumably unintentional, particularly through the consumption of breakfast cereals and starch-based sauces such as cheese sauce, custard and ketchup.
    J Hum Nutr Diet, 2011 · checked 2026-09-29