The Doctor’s Surgery. The fatty guide to avoiding dementia.

By Theodore Dalrymple

Full-fat cheese and cream might protect your brain

When I was young, parents were encouraged to feed their children eggs and dairy products, such as cheese, cream and butter. After the penury of the war years, luxury was thought to be good for the little ones’ health.

Then came a reaction. People – by which I mean, of course, members of the middle class – were increasingly badgered or terrorised by epidemiologists into eschewing dairy products because they led straight to heart attack and stroke, as sin once led to damnation.

Fat was deemed to be deadly. So, ever alert to fashion, the food industry began to produce fat-free substitutes of varying degrees of unpalatability.

Even very fatty foods were marked with labels declaring them to be 40-per-cent fat-free – which meant, presumably, that the other 60 per cent was fat. The public is often not very good at sums.

The elixir of life became the so-called Mediterranean diet, full of olive oil and sun-dried tomatoes. Keats’s Ode to a Nightingale could now be read as medical advice:

‘O, for a draught of vintage! that hath been

Cool’d a long age in the deep-delved earth,

Tasting of Flora and the country green,

Dance, and Provençal song, and sunburnt mirth!

O for a beaker full of the warm South,

Full of the true, the blushful Hippocrene…’

The Flora to which Keats referred, ahead of his time, was obviously the well-known spread – call it not margarine – of that name.

Now it stood to reason that if animal fat clogged up arteries, it would lead in the end to cognitive decline. Indeed, about a fifth of people with dementia have the vascular type, which causes small, undetected strokes. Hence, avoiding animal fat should reduce the risk of dementia, the fear of developing which haunts us all.

But a recent study in Sweden of people of average age 58, followed up for 25 years, found that the consumption of full-fat cheese and cream protected against the development of dementia, by a factor of about a sixth. This is not the first time there has been such a finding: studies in the Netherlands and Britain had results compatible with the Swedish ones. Consuming low-fat cream or cheese conferred no benefit, by comparison with consuming no cream or cheese at all.

I doubt, somehow, that the news will percolate quickly into popular consciousness, because self-denial is believed to be more virtuous and health-giving (increasingly the same thing) than self-indulgence. If Marie Lloyd were to be reincarnated, she would now sing, ‘A little of what you fancy does you harm.’

Look at all those shelves in the supermarket with their low-fat products, almost in accusatory fashion, as if you deserve what you get if you choose the full-fat versions, not the ‘healthy option’.

All research has to come with caveats. The whirligig of time brings in its revenges, especially in epidemiology; what was good for you today will be regarded as near to poison tomorrow, and vice versa. Full-fat cheese may yet turn out to be very bad for you.

I have seen several reversals of recommendations in my lifetime, especially about diet.

There was one rather curious omission from this study. Although we learn that 11.59 per cent of the 27,670 people at the outcome of the study developed dementia in the 25 years of follow-up, there is no mention of death – surely another undesirable outcome of some importance.

Do full-fat cheese-eaters live longer or shorter lives than those who eat no cheese, or only low-fat cheese?

Given that the prevalence of dementia rises with age, if full-fat cheese eaters die earlier, their rate of dementia will naturally be lower.

Notwithstanding this caveat, the onus is surely on the low-fattists, if I may be allowed a neologism, to prove their case.

First published in the Oldie