Cheese substitute: coconut oil, little protein and one small cholesterol trial

Nobody has pooled trials of plant-based cheese, so the strongest number near this page is borrowed from soy milk. A meta-analysis of 17 randomized trials in 504 adults found that drinking soy milk instead of cow's milk, a median of 17 fl oz (500 ml) a day for at least 3 weeks, lowered LDL cholesterol by 7.3 mg/dL (95% CI 3.5 to 11; metric: 0.19 mmol/L, 0.09 to 0.29). It says nothing direct about a slice of vegan cheddar. The only trial of a cheese substitute itself is one small study from 1993, and its product was a mozzarella-style cheese made with linoleate-rich vegetable oil, which is a different food from today's coconut-oil vegan cheese. In 26 adults with moderately high cholesterol, 100 g a day of it for 2 months lowered LDL by 15 mg/dL (95% CI 7.7 to 27; metric: 0.38 mmol/L, 0.2 to 0.70) against skim-milk mozzarella. HDL cholesterol, triglycerides and weight did not change, and 26 people are too few to rule out small shifts.

The numbers, per 3.5 oz (100 g)

How much is actually in it

• In a label survey of 245 plant-based cheese alternatives sold in the US, only 3% had 5 g or more protein per serving, and 19%, 14% and 1% were fortified with calcium, vitamin B12 and vitamin D. — 245 non-dairy cheese alternatives, 35 brands, US retail, Nov 2021 to Jan 2022 (n = 245) Evidence C source
  3% with >=5 g protein per serving; calcium fortified 19%, B12 14%, vitamin D 1%
• Almost 60% of 245 US plant-based cheese alternatives were high in saturated fat, mostly those made with coconut oil. Cashew-only products had the most protein and the least sodium and saturated fat. — 245 non-dairy cheese alternatives; coconut oil base 106, cashew and coconut 61, cashew 35 (n = 245) Evidence C source
  About 60% high in saturated fat; 15% low in sodium
• Among brands that added calcium to plant-based cheese, 58% used tricalcium phosphate, and 17% each used calcium citrate or calcium sulfate. — 12 of 35 US brands with calcium fortification (n = 12) Evidence C source
  Tricalcium phosphate 58%; calcium citrate 17%; calcium sulfate 17%

What a real portion looks like

• Labeled serving sizes of US plant-based cheese alternatives ranged from 14 to 40 g, most often 28 to 30 g for blocks and shreds and 20 g for slices. — 245 non-dairy cheese alternatives, US retail labels (n = 245) Evidence C source
  Serving 0.49-1.4 oz (14-40 g); blocks and shreds 28-30 g; slices 20 g

What cooking and storage change

• A systematic review of 85 sensory studies found that without casein, plant-based cheese tends to be brittle or gummy and melts poorly, and 60% of those studies had methodological problems. — 85 sensory studies of plant-based cheese (n = 85 studies) Evidence C source
  51 of 85 studies (60%) with methodological issues

What it does to your health

• In a 4-month crossover RCT in 26 adults with high cholesterol, 100 g a day of a vegetable-oil mozzarella cheese product lowered LDL cholesterol by 11 mg/dL (0.28 mmol/L) from baseline and by 15 mg/dL (0.38 mmol/L) versus skim-milk mozzarella. — 26 healthy adults (17 men, 9 women) with moderate hypercholesterolemia; 100 g cheese daily, 2 months per arm (n = 26) Evidence B source
  LDL-C -11 mg/dL (-0.28 mmol/L) vs baseline (95% CI -0.14 to -0.42); -15 mg/dL (-0.38 mmol/L) vs skim-milk mozzarella (95% CI -0.2 to -0.70)
• In the same 26-adult crossover RCT, 2 months on the vegetable-oil cheese product left HDL cholesterol, triglycerides, apolipoproteins and body weight unchanged. — 26 adults with moderate hypercholesterolemia, 4-month crossover, 100 g cheese daily (n = 26) Evidence B source
  No change in HDL-C, triglycerides, apo A-I, apo B-100 or weight

Safety, limits and interactions

• Many plant-based cheeses are made from cashews, and cashew is among the most commonly reported tree nut allergies in the USA. Challenge-confirmed tree nut allergy affects under 2% of people. — 36 population prevalence studies of tree nut allergy in children and adults, 1996-2014 (n = 36 studies) Evidence C source
  Challenge-confirmed tree nut allergy prevalence below 2%; probable 0.05-4.9%
• Laboratory data suggest heating does not remove cashew allergens: seed storage proteins in cashew and other tree nuts stayed stable under thermal processing. — 32 studies, mostly in vitro, on processed tree nuts (n = 32 studies) Evidence D source
  Heat stability of nsLTPs and seed storage proteins; roasting reduced only PR-10 allergenicity in hazelnut and almond

What people believe that the data does not support

• The idea that plant-based cheese matches dairy cheese nutritionally does not hold on average: median protein and calcium in 245 US products were zero, versus about 5 to 8 g protein per serving in dairy cheese. — 245 non-dairy cheese alternatives, US, 2021-2022 (n = 245) Evidence C source
  Median protein 0 g and median calcium 0 per serving; dairy cheese about 5-8 g protein and 10-20% DV calcium per serving

Who this works differently for

• Among children with cow's milk allergy, those not using special formula or plant-based dairy alternatives had lower protein intake per kg than those who did. — 57 children: 27 with IgE-mediated cow's milk allergy, 30 healthy controls; 24-h recalls (n = 57) Evidence C source
  Lower protein (g/kg) and branched-chain amino acid intake without formula or plant-based alternatives

What is still unknown

• No trial synthesis exists for plant-based cheese. The closest, a meta-analysis of 17 RCTs in 504 adults, found soy milk instead of cow's milk lowered LDL cholesterol by 7.3 mg/dL (0.19 mmol/L). — 17 RCTs, 504 adults, median 17 fl oz (500 mL) soymilk daily for at least 3 weeks (n = 504) Evidence A source
  LDL-C -7.3 mg/dL (95% CI -11 to -3.5; metric: -0.19 mmol/L, -0.29 to -0.09); non-HDL-C -10 mg/dL (-17 to -3.9; metric: -0.26 mmol/L, -0.43 to -0.10)

The bottom line

What is on the shelf today looks different from that trial product. A survey of the labels of 245 plant-based cheeses sold in the United States in 2021 and 2022 found that only 3 percent carried 5 g or more of protein per serving, and the median product listed zero protein and zero calcium. Almost 60 percent were high in saturated fat, mostly those built on coconut oil. Products made from cashews alone more often had the most protein and the least sodium and saturated fat. Only 19 percent added calcium, 14 percent vitamin B12 and 1 percent vitamin D. All of these are label figures from one market, not laboratory analysis. A labeled serving runs from 14 to 40 g, usually 28 to 30 g for blocks and shreds and 20 g for slices. If you choose a substitute to cut saturated fat, read the label, since the coconut-oil products were the ones most often high in it. Melting is where the substitute gives itself away. A review of 85 sensory studies says that without casein, plant-based cheese tends to turn brittle or gummy, and it judged 60 percent of those studies to have methodological problems. The caution that matters is tree nut allergy, because many of these cheeses are made from cashews. Across 36 prevalence studies, challenge-confirmed tree nut allergy affected under 2 percent of people, and cashew is among the most commonly reported tree nut allergies in the United States. Laboratory studies, mostly in vitro, found that storage proteins in cashew and other tree nuts stay stable through heating, so melting a cashew cheese should not be expected to remove the allergen. In one small study of 57 children, allergic children who used neither special formula nor plant-based dairy alternatives ate less protein per kilogram than allergic children who did. That study counted formula and plant alternatives together and did not look at cheese substitutes, and the median product on the US shelf listed zero protein, so a vegan cheese is not a protein source for a child who cannot have milk. We found no study on pregnancy or on drug interactions.

Sources

1. chsb-daily-r3-03 · cross-sectional label survey
   Only 3% of these cheese alternatives had 5 g or more of protein, while 19%, 14%, and 1% were fortified with calcium, vitamin B12, and vitamin D, respectively.
   Nutrients, 2022 · checked 2026-09-30
2. chsb-daily-r3-04 · cross-sectional label survey
   Almost 60% had high levels of saturated fat, while 15% had low sodium levels. The products based on cashews alone more commonly had the highest protein levels and the lowest sodium and saturated fat levels. Those containing coconut oil more commonly had higher saturated fat and sodium levels and were most frequently fortified with vitamin B12.
   Nutrients, 2022 · checked 2026-09-30
3. chsb-daily-r3-06 · cross-sectional label survey
   Seven of the twelve brands that had calcium fortification (58%) used tricalcium phosphate, two brands (17%) used calcium citrate, two brands (17%) used calcium sulfate
   Nutrients, 2022 · checked 2026-09-30
4. chsb-daily-r3-05 · cross-sectional label survey
   One serving size of cheese varied from 14 to 40 g depending upon the format of the cheese. The most common serving sizes for block cheeses and shreds were 28 and 30 g, while slices typically were 20 g.
   Nutrients, 2022 · checked 2026-09-30
5. chsb-daily-r3-10 · systematic review
   The absence of casein in plant-based cheese often results in brittle or gummy textures, whereas plant-based fats and proteins often lead to phase separation and weak cohesion, thereby affecting sensory quality.
   Crit Rev Food Sci Nutr, 2026 · checked 2026-09-30
6. chsb-daily-r3-01 · randomized crossover trial
   Modified-fat cheese substitution resulted in a decreased low-density lipoprotein cholesterol level when compared with levels at both baseline (-0.28 mmol/L; 95% Cl, -0.14 to -0.42 mmol/L) and during consumption of the skim-milk mozzarella cheese (-0.38 mmol/L; 95% Cl, -0.2 to -0.70 mmol/L).
   Ann Intern Med, 1993 · checked 2026-09-30
7. chsb-daily-r3-02 · randomized crossover trial
   No differences in weight or in the amount or type of calories consumed were found during the study. ... High-density lipoprotein cholesterol, plasma triglyceride, and apolipoprotein A-l and B-100 levels were unaltered.
   Ann Intern Med, 1993 · checked 2026-09-30
8. chsb-daily-r3-08 · systematic review
   Challenge-confirmed IgE-mediated tree nut allergy prevalence was less than 2 % (although only seven studies used this gold standard) while probable tree nut allergy prevalence ranged from 0.05 to 4.9 %. ... Prevalence of individual tree nut allergies varied significantly by region with hazelnut the most common tree nut allergy in Europe, walnut and cashew in the USA and Brazil nut, almond and walnut most commonly reported in the UK.
   Curr Allergy Asthma Rep, 2015 · checked 2026-09-30
9. chsb-daily-r3-09 · systematic review of in vitro and clinical studies
   The majority of the in vitro studies investigating the allergenicity of nonspecific lipid transfer proteins (nsLTPs) and seed storage proteins in hazelnut, almond, cashew nut, Brazil nut, walnut, pecan nut and pistachio nut show heat stability towards different thermal processing methods.
   Allergy, 2013 · checked 2026-09-30
10. chsb-daily-r3-07 · cross-sectional label survey
    However, the median values for the protein and calcium content of the non-dairy cheeses in our study were found to be zero (Table 1).
    Nutrients, 2022 · checked 2026-09-30
11. chsb-daily-r3-11 · cross-sectional study
    However, the Children with cow's milk allergy do not consume special infant formula or plant-based dairy alternatives group had a lower protein (g/kg) and branched-chain amino acid (mg/kg) intake than the Children with cow's milk allergy consume special infant formula or plant-based dairy alternatives group.
    Rev Assoc Med Bras (1992), 2022 · checked 2026-09-30
12. chsb-daily-r3-12 · meta-analysis of RCTs
    The substitution of soymilk for cow's milk resulted in moderate reductions in non-HDL-C (mean difference, - 0.26 mmol/L [95% confidence interval, - 0.43 to - 0.10]), systolic blood pressure (- 8.00 mmHg [- 14.89 to - 1.11]), and diastolic blood pressure (- 4.74 mmHg [- 9.17 to - 0.31]); small important reductions in LDL-C (- 0.19 mmol/L [- 0.29 to - 0.09])
    BMC Med, 2024 · checked 2026-09-30