March 2022 Issue
Probiotics: Probiotics in Cheese
By Densie Webb, PhD, RD
Today’s Dietitian
Vol. 24, No. 3, P. 14
While some varieties of cheese offer potentially beneficial bacteria, clients likely need guidance on identifying them.
Knowledge about the potential health benefits of consuming probiotics regularly has expanded over the last few decades, with research offering some promising results. Arguably, yogurt with live and active cultures has received the lion’s share of this limelight in research and among both health care professionals and consumers. However, certain varieties of cheese can contain probiotics at levels comparable to—and sometimes greater than—yogurt.
The World Health Organization defines probiotics as “live microorganisms which, when administered in adequate numbers, confer a health benefit on the host.” Probiotic bacteria, specifically bifidobacteria and lactobacilli, are normal inhabitants of the human colon. These bacteria benefit health by improving the balance of intestinal microflora and improving mucosal defenses against pathogens. Additional health benefits may include enhanced immune response, reduction of serum cholesterol, vitamin synthesis, anticarcinogenic activity, and antibacterial activity.1 Anything that boosts the levels of these bacteria potentially can decrease risk of some diseases.
While research on probiotics in cheese has been limited, RDs can help guide clients toward those with possible benefit.
What Cheeses Contain Probiotics?
Probiotics are found in cheeses that have been aged, but not heated (pasteurized) afterward. This includes both soft and hard cheeses, such as Swiss, Provolone, Gouda, cheddar, Edam, Gruyère, and some cottage cheese (although most cottage cheese in the United States goes through a heat process, so clients should check package labels for the presence of live and active cultures that may have been added).2 Other cheeses that may contain probiotics include feta, caciocavallo, Emmental, and Parmesan.
While yogurt has been studied extensively to examine the effect of its regular consumption on health parameters, the microbial makeup of cheese mainly has been researched for its contributions to taste and texture. That’s because the levels and types of bacteria affect acidification and flavor development of cheese. As such, human clinical studies that examine the health benefits of probiotic-containing cheese are sparse.
In bacteria-ripened cheese, such as cheddar, both the starter microbes and those naturally present during ripening (ie, nonstarter bacteria) depend on the production conditions and the nutrients available during the manufacture and ripening processes. Starter lactic acid bacteria found in cheddar cheese, for example, are stressed during manufacture and the aging process, which alters their ability to survive and interact with other bacterial populations. The starter bacteria are reduced quickly in the initial phases of ripening, likely due to the utilization of most of the lactose present, which explains why many hard, aged cheeses are low in lactose. As the cheese ripens, nonstarter bacteria slowly increase to become the dominant microbes in cheese.3 In the example of cheddar cheese, nonstarter bacteria generally are derived from milk handling, cheese manufacturing equipment, and human contact during manufacture.4
One study found that probiotic bacteria can survive throughout the cheesemaking and aging process, indicating that consumption via hard cheeses is possible, but generalizations are difficult; estimates of bacterial viability vary across different foods and environments and by how the bacteria are measured.5
Furthermore, the abilities of certain microorganisms to persist in the final product and potentially colonize the intestine are poorly understood. One pilot study showed that dairy-associated bacteria can be transferred to the intestine and colonized via consumption of fresh Parmesan cheese when consumed daily and can be enhanced by cow’s milk consumption.6
Choosing Cheese
Cheese is potentially a good vehicle for delivery of probiotic microorganisms into the intestine due to its specific chemical and physical characteristics compared with fermented milks (ie, due to its lower acidity, greater fat content, higher nutrient availability, lower oxygen content, and denser texture). However, according to Boston-based Erin Coffield, RDN, LDN, vice president of health and wellness communications for the National Dairy Council, “very few cheeses have probiotics at a level needed to confer a benefit.”
And, she says, it’s important to note that just because a food is fermented doesn’t mean it will contain live cultures in levels required to provide health benefits. To offer health benefits, probiotics must remain viable in food products above a certain threshold—a minimum concentration of 106 colony-forming units (CFUs) per milliliter or gram and that a total of 108 to 109 CFUs of probiotic microorganisms should be consumed daily for a probiotic effect. However, few food products, including cheese, specify on the label the levels of probiotics they provide.1,7
Most probiotic foods already on the market, such as fermented milk and yogurt, are fresh products generally consumed within days or weeks of manufacture. In contrast, hard cheeses, such as cheddar, have long ripening times of up to two years, but previous studies have shown that probiotic bacteria survive well in both cheddar and Gouda cheeses.8 There also are cheeses that have probiotics added after processing, such as Babybel Plus Probiotic.
Raw Milk Cheese
Chemical and microbiological analyses show that raw milk cheeses tend to be more complex and flavorful than their pasteurized counterparts. Pasteurization kills off much of the natural milk flora responsible for flavor development.9 However, current FDA rules state that any cheese produced in the United States must be either made from pasteurized milk or held for 60 days, with the idea that harmful bacteria will die out in that time.10 Catherine Donnelly, PhD, a food scientist at the University of Vermont and author of Ending the War on Artisan Cheese, says that, if handled properly with the right safety protocols in place, cheese made with raw milk is safe. “You’re using bacterial cultures to lower the pH to the point where, in certain cheeses, pathogens can’t grow. You’re using heat treatment of curds in many of the different cheese families. So that gives an equivalent level of safety if the product were made from pasteurized milk.”11
What About Processed Cheese?
Processed cheese is a food product made from cheese and unfermented dairy ingredients mixed with emulsifiers. Additional ingredients, such as vegetable oils, salt, food coloring, or sugar may be included. As a result, many flavors, colors, and textures of processed cheese exist. Because they’re made from unfermented dairy ingredients, pasteurized process cheese, pasteurized process cheese food, and pasteurized process cheese spread contain no probiotics.
Bottom Line
When counseling clients and patients about food sources of probiotics, let them know that probiotics can be found in some cheeses as well as yogurt, but remind them that not all fermented foods provide probiotics. Clients should check labels on any food from which they hope to receive a probiotic benefit for an explicit statement that the product contains “live and active cultures”—especially on yogurt and cottage cheese labels. Many soft and hard cheeses, including Swiss, Provolone, Gouda, cheddar, Edam, Gruyère, feta, caciocavallo, Emmental, and Parmesan are likely to provide at least some probiotics, but note that statements about “live and active cultures” are unlikely to be found on aged cheeses.
— Densie Webb, PhD, RD, is a freelance writer, editor, and industry consultant based in Austin, Texas.
References
1. Karimi R, Mortazavian AM, Da Cruz AG. Viability of probiotic microorganisms in cheese during production and storage: a review. Dairy Sci Technol. 2011;91:283-308.
2. Is cheese a healthy source of probiotics? Harvard Health Publishing website. https://www.health.harvard.edu/staying-healthy/is-cheese-a-healthy-source-of-probiotics. Published February 1, 2021. Accessed December 24, 2021.
3. Stefanovic E. Kilcawley KN, Roces C, Rea MC, O’Sullivan M, et al. Evaluation of the potential of Lactobacillus paracasei adjuncts for flavor compounds development and diversification in short-aged Cheddar cheese. Front Microbiol. 2018;9:1506.
4. Leeuwendaal N, Stanton C, O’Toole PW, Beresford TP. The potential of non-starter lactic acid bacteria from Cheddar cheese to colonise the gut. J Funct Foods. 2021;83:104425.
5. Ganesan B, Weimer BC, Pinzon J, et al. Probiotic bacteria survive in Cheddar cheese and modify populations of other lactic acid bacteria. J Appl Microbiol. 2014;116(6):1642-1656.
6. Milani C, Duranti S, Napoli S, et al. Colonization of the human gut by bovine bacteria present in Parmesan cheese. Nat Commun. 2019;10(1):1286.
7. Kechagia M, Basoulis D, Konstantopoulou S, et al. Health benefits of probiotics: a review. ISRN Nutr. 2013;2013:481651.
8. Stanton C, Gardiner G, Lynch PB, Collins JK, Fitzgerald G, Ross RP. Probiotic cheese. Int Dairy J. 1998;8(5-6):491-496.
9. Wolf C. Artisan cheese in the new decade. Forbes website. https://www.forbes.com/sites/clarkwolf/2020/01/06/artisan-cheese-in-the-new-decade/?sh=54981f0e3615. Published January 6, 2020. Accessed December 22, 2021.
10. Part 133 - cheeses and related cheese products. Code of Federal Regulations website. https://www.ecfr.gov/current/title-21/chapter-I/subchapter-B/part-133. Updated January 13, 2022.
11. Saxena J. Why are Americans afraid of eating raw milk cheese? Eater website. https://www.eater.com/2019/11/12/20955111/catherine-donnelly-interview-why-americans-are-afraid-of-raw-milk-cheese. Published November 21, 2019. Accessed December 17, 2021.