The Cheese Trap

How Breaking a Surprising Addiction Will Help You Lose Weight, Gain Energy, and Get Healthy


By Neal D Barnard, MD, MD, FACC

Foreword by Marilu Henner

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New York Times bestselling author Dr. Neal Barnard reveals the shocking truth about cheese-the dangerous addiction that is harming your health-and presents a radical program to lose weight and feel great.

We’ve been told that dairy does a body good, but the truth is that cheese can be dangerous. Loaded with calories, fat, and cholesterol, cheese can make you gain weight and leads to a host of health problems like high blood pressure and arthritis. Worse, it contains mild opiates that make it additive, triggering the same brain receptors as heroin and morphine.

In The Cheese Trap, Dr. Neal Barnard presents a comprehensive program to help readers break free of their cheese addiction so they can lose weight, boost energy, and improve their overall health. This easy-to-follow diet features a treasury of healthy recipes that will tame even the toughest cravings-from pizza, to lasagna, to ice cream and cheesecake.


A Note to the Reader

I hope this book provides you with new insights on food and health and more than a few interesting facts to share. Before we begin, let me mention two important points:

See your health care provider. Health problems can be serious business. If you are making a diet change—and I hope you are—it is a good idea to talk with your doctor along the way. This is not because changing your diet is dangerous. Quite the opposite. It is a really good idea. But people who are taking medications—for diabetes or high blood pressure, for example—very often need to adjust their medications when they improve their diets. Sometimes, they are able to discontinue their drugs altogether. Do not do this on your own. Work with your health care provider to reduce or discontinue your medicines if and when the time is right.

Also, talk with your doctor before you jump into a new exercise routine. If you have been sedentary, have any serious health problems, have a great deal of weight to lose, or are over forty, have your provider check whether you are ready for exercise, and how rapidly to begin.

Get complete nutrition. The way of eating presented in this book is likely to improve your nutrition overall, in addition to the specific health benefits it may bring. Even so, you will want to ensure that you get complete nutrition. Please read the details in Chapter 9. In particular, be sure to take a daily multiple vitamin or other reliable source of vitamin B12, such as fortified cereals or fortified soy milk. Vitamin B12 is essential for healthy nerves and healthy blood.


Hidden in Plain Sight

Does this sound familiar? You'd like to lose a few pounds, but you're having trouble, and it's hard to figure out why. Your eating habits are really not too bad. Maybe you're not exercising quite as much as you'd like, but you're not entirely sedentary either. And still, it's a challenge to lose weight.

Or maybe you have a health condition that is just not getting better: high cholesterol, high blood pressure, diabetes, sore joints, headaches, or less-than-healthy-looking skin. What could be causing the problem?

The answer could be hiding in plain sight.

Imagine losing weight easily, week by week, month by month, without counting calories—and without adding one minute of exercise. Imagine your friends asking how you succeeded at trimming away all those pounds. Imagine them telling you how great you look. Imagine your cholesterol improving, your blood pressure getting better, and your health rebounding day by day.

If you're looking to revamp your eating habits to lose weight or improve your health, the place to start is not with sugar, carbs, or processed foods. The place to start is with cheese.

You love cheese. But I'm sorry to tell you, it does not love you back. And the sooner you recognize it, the sooner you'll conquer your weight or health problems.

"No way!" you might be thinking. "That's impossible!"

Think again. Cheese packs a surprising number of calories—more than enough to explain the weight that you have gained over the years. And what cheese makers did not tell you is that cheese harbors mild opiates that might be just strong enough to keep you hooked. That "fattening-addictive" combination is what makes cheese a serious problem for your weight.

And it gets worse. Because cheese comes from a cow—often a pregnant cow—you are getting a dose of estrogens—female sex hormones—that you never bargained for. And cheese makers add enough salt to make cheese one of the highest-sodium foods. It is high in saturated fat and cholesterol, too. Loaded with calories, high in sodium, packing more cholesterol than steak, and sprinkled with hormones—if cheese were any worse, it would be Vaseline.

"What!?" you are now asking. "Cheese? There's no way it could be that fattening. And to call it addictive is ridiculous! And besides, I love cheese."

Hold that thought.

First of all, you don't need to give up that taste—you just need healthier ways to get it, and I'll show them to you. But, yes, cheese is more fattening—by far—than bread, potatoes, or even pure sugar. Here's why: Most of the calories—about 70 percent—in typical cheeses come from fat, and every last fat gram packs 9 calories.

Compare that to sugar: It turns out that pure sugar has only 4 calories per gram. And to turn sugar into fat, your body has to completely rearrange the sugar molecules; that process burns off another quarter of its calories, or thereabouts.

That's not to say that sugar is health food. But cheese fat has more than twice the calories found in the most concentrated sugar, and its calories are easily stored on your belly, around your thighs, under your chin, and everywhere else. You can see them and feel them, and they show up on the scale.

And what about that addictive effect? Not only does cheese have the saltiness and mouthfeel that some people crave, but as cheese is digested, it releases special chemicals, called casomorphins. In the brain, these chemicals attach to the same opiate receptors that heroin or morphine attach to. Don't get me wrong—casomorphins are nowhere near as mind-numbing as illegal narcotics. But, like heroin and morphine, casomorphins are indeed opiates that affect the brain.

Think of it this way: Coffee contains caffeine, a mild stimulant. While caffeine is not as powerful as, say, amphetamines, it is still strong enough to keep you hooked, as any coffee drinker will tell you. Casomorphins have subtle brain effects, too. And evidence shows that they can keep you hooked, too.

Some foods are fattening. Others are addictive. Cheese is both—fattening and addictive. And that's the problem.

Does it matter? It sure does. Look at the numbers: An average American eats more than 33 pounds of cheese every year. Now imagine if just one and a half of those 33 pounds showed up on the scale each year (which, in fact, happens to be the amount of weight the average American gains each year). Over a decade, that adds up to 15 unwanted pounds, and 30 pounds every two decades. Sound familiar? That's more than enough to explain the weight epidemic in the U.S.

All the Taste, None of the Regrets

A surprising number of health problems are linked to cheese and other dairy products. If your cholesterol is high, could it be because cheese is a huge source of cholesterol-boosting saturated fat, as well as cholesterol itself? If your blood pressure is up, could it be because cheese is also loaded with blood pressure–raising sodium, plus enough fat that it makes your heart push harder to pump your blood? If you have diabetes, could it be that the "bad fat"—saturated fat—that predominates in cheese is causing the insulin resistance that is the hallmark of this condition?

If you have rheumatoid arthritis or any other autoimmune condition, could it be that dairy proteins—which are highly concentrated in cheese—are triggering your symptoms? And what about the hormone effects of cheese? In this book, we will cover all of these and much more.

Filled with fat, crammed with cholesterol, and steeped in sodium, cheese is a seriously unhealthy product. Its addictive properties keep you hooked, even while it works its mischief on your waistline and damages your health.

But here's the good news. I will show you how to slim down and dramatically improve your health by gaining control over this gooey yellow monster. Yes, there are ways to get the taste of cheese, with none of the regrets.

I'll show you how to make the best lasagna, the most delicious pizza, a perfect sandwich topping, a mac and cheese that will delight any twelve-year-old, and many, many other wonderfully tasty foods. You'll know exactly which foods to choose when you're dining out, whether you are at a Michelin-starred restaurant or a fast-food spot. As you savor these delicious foods, you'll almost feel your waistline trimming, your cholesterol and blood pressure coming down, and your health improving.

Most importantly, you will look at foods very differently. Some give you a health boost, while others get in your way, and now you'll know exactly which are which, and you'll take that power into your day-to-day life.

Real People, Real Results

In this book, you will meet people whose lives have been transformed. Patricia suffered with stubborn weight problems, diabetes, and worsening heart disease until she discovered that a simple diet change could trim away 95 pounds and make her feel great. Marc had a similar experience. His extra weight melted away, as did diabetes, hypertension, cholesterol problems, and erectile dysfunction. He got his life back.

Katherine, an aerospace engineer, was at the point of needing a hysterectomy to treat endometriosis, a hormone-related condition that causes intractable abdominal pain and can threaten fertility. Breaking a love affair with cheese and other unhealthful foods cured her pain, trimmed her waistline, and let her live again.

Lauren, an attorney, suffered with crushing migraines. Once she discovered that her headaches were triggered by dairy proteins, she had more power than a prescription could deliver. Migraines? Gone!

Ann suffered from respiratory problems and a chronically out-of-sorts digestive tract. She was the daughter of a milk processor, so dairy products were the last thing she imagined would have been the cause of her problems. But when a doctor suggested going dairy-free, her problems disappeared.

You will also meet some people in the cheese industry who have devoted countless hours and millions of dollars to keeping you hooked on cheese—people who have signed surprising financial arrangements with restaurant chains to, in so many words, trigger cheese cravings. And you will meet innovators, like Michael Schwarz, Miyoko Schinner, and Tal Ronnen, who have devised delightful savory cheeses from healthful, entirely plant-based ingredients, with none of the moo or goo of dairy cheeses. You'll meet restaurateurs like Nanci Alexander, whose gourmet restaurant replaced all the cheese with truly exquisite ingredients that keep customers coming back for more. They are revolutionizing the world of food.

Let me also introduce myself. I grew up in Fargo, North Dakota, and went to medical school at the George Washington University in Washington, DC, and am on the faculty there today. In 1985, I founded the Physicians Committee for Responsible Medicine to bring a new emphasis on prevention and nutrition into medical practice and to improve how research is conducted.

Over the years, the Physicians Committee has completed many research studies to elucidate how foods affect body weight, cholesterol, blood pressure, diabetes, and chronic pain. Some of our studies have been very influential. In 2003, the National Institutes of Health funded us to test a new dietary approach to type 2 diabetes that turned out to be the most powerful program of its kind ever developed. Many people are using it to improve their diabetes and sometimes even make it go away.

We worked with GEICO—the insurance company—to see how a nutrition program might work in the workplace, finding that simple diet changes can revolutionize the health of employees. In 2015, the U.S. government cited our research work as strong evidence for recommending plant-based diets in the Dietary Guidelines for Americans.

In the course of our studies, I have noticed an odd phenomenon. A surprising number of people whose health dramatically improved from dietary changes reported that, despite all their health improvements, they still found themselves having a hankering for cheese. Not ice cream, not yogurt, not chocolate milk, but specifically cheese. Even when cheese had been a huge contributor to their health problems, their cravings made it hard to tear themselves away.

After hearing this over and over, I began to study cheese's effects on our health and to investigate why it has such a surprisingly strong attraction. This book shares what I've found. I hope you find it enlightening, fun, encouraging, and powerful. And I hope you will share the power of what you are about to learn with everyone you know. I wish you the very best of health.


The Ultimate Processed Food

Fugu is the world's second-strangest food. Fugu is the Japanese word for the meat of the puffer fish, that small creature who, when threatened, turns himself into a spike-covered balloon. Puffer fish have more than spikes; they also harbor deadly tetrodotoxin. One bite contains enough poison to paralyze your diaphragm and arrest your breathing.

The possibility of death by suffocation has not stopped adventurous diners from wanting to taste it. And Japanese chefs have been willing to dedicate three or more years of their lives to learning the fine art of separating the poisonous and nonpoisonous puffer fish parts in order to be legally allowed to serve it.

You really have to wonder, how did this start? What courageous adventurers were willing to experiment, Russian roulette–style, with various puffer fish organs until they got it right?

Well, the puffer fish has nothing on Camembert. Cheese is easily the world's strangest food, and the most improbable. Mother Nature never imagined anything like this.

First of all, one of our human forebears had to want to take milk from another species. It apparently took two and a half million years of human existence before that idea popped into someone's head. Then he or she had to figure out how to make an animal stand still long enough to extract her milk. That, too, was a challenge, when you consider the size of the animals involved and the fact that very few would be lactating at the appropriate time. And since animals produce milk only for a limited period of time after giving birth, our prehistoric food pioneer would have had to sort out how to keep milk flowing.

Then he or she had to mix the milk with bacteria to ferment it, and then combine it with enzymes hidden in the lining of the fourth stomach of a calf.

Finally, people had to like the gooey result—which was not a foregone conclusion, given that the smell of cheese is the smell of bacterial decomposition. In fact, the brevibacteria used to produce Muenster, Limburger, and several other common cheeses are the very germs responsible for the stench of unwashed human feet.

What are the odds? Makes fugu sound easy.

Indeed, cheese was not exactly an overnight sensation. There was not a single cheese factory in the U.S. until 1851, and it was not until 1935 that the average American ate even 5 pounds of it per year. But eventually it found its way into our hearts.

Into our coronary arteries, to be more precise. And into our thighs and hips, and spilling onto our medical charts. The health problems cheese causes are more subtle and protracted than puffer fish poisoning, but they are extremely common. So much so that most people assume they are just part of life.

In this chapter, we'll take a look at this odd, familiar, smelly, and loved product; how cheese makers turn a pail of milk into a block of cheese; and how a product of bacterial decomposition becomes hard to resist. In later chapters, we will see what happens when you swallow it.

Making Cheese

Cheese making is not without some theoretical advantages. Anyone who drinks milk knows that it does not stay fresh very long; turning it into cheese preserves it. Along the way, cheese concentrates milk's fat, protein, and calories. It also makes it a lot more portable.

Cheese also eliminates lactose, the milk sugar that is indigestible for many people. Nursing babies can digest lactose and use it for energy. But after the age of weaning, the enzymes that digest lactose start to disappear and, without them, milk causes cramps and diarrhea. Although many people—especially whites—carry a genetic mutation that makes those enzymes persist longer, the majority of adults are lactose-intolerant. But when milk is turned into cheese, that indigestible lactose is mostly removed.

To see how cheese is made, let's take a trip to the tiny town of Theresa, Wisconsin, northwest of Milwaukee. A little factory on Henni Street has been cranking out cheese since 1900. In 1905, John Widmer arrived in the U.S. from Switzerland, learned the cheese-making craft, and eventually took over the factory. It has stayed in the Widmer family ever since.

As you arrive in Theresa, you realize that you saw surprisingly few cows along the country roads. Obviously, the number-one cheese-producing state would need lots and lots of cows, but the fields were empty, for the most part. Where they are is something we'll touch on in Chapter 7.

Nonetheless, a huge milk shipment arrives at the Widmer's Cheese Cellars factory early each morning and is poured into two large vats, each about twenty feet long and three feet deep. It takes more than a gallon of milk to make a pound of Cheddar.

Because milk comes from a living, breathing animal, its chemical makeup varies from batch to batch, and that affects the taste or texture of the cheese. So cheese producers can head off problems by standardizing the milk—adding cream, skim milk, or skim milk powder, as the case may be, to keep the fat and protein content uniform from batch to batch.

They can also adjust the color. Cheese's orange color comes, in part, from traces of beta-carotene in milk—the same beta-carotene that gives an orange color to carrots and sweet potatoes. It is too dilute to be seen in milk, but it becomes visible as milk fat is concentrated in the cheese-making process. Widmer's and other cheese makers can legally intensify the color with annatto, a tree extract from Latin America and the Caribbean.

Goats, sheep, and water buffalos do not secrete beta-carotene into their milk as cows do, so their cheese is white. To make cow's milk mozzarella look white, some manufacturers add titanium dioxide or peroxides. Dunkin' Donuts used the same trick to make its powdered sugar extra white—until consumer complaints led to its removal.

Bring on the Bugs

With the vats now filled like milky wading pools, the next step is to add bacterial cultures. The bacteria ferment the milk sugar, lactose, to produce lactic acid, which contributes to the flavor of cheese.

What kind of bacteria? For a mild product, cheese makers use strains that produce lactic acid and not much else. For other varieties, they add cultures that produce various flavors and perhaps bubbles (to make holes). And they might eventually add molds and yeast, adding scents and tastes of their own.

Some bacteria are particularly stinky. Take brevibacteria, for example. This bacterial genus is ubiquitous. They are all over your skin and down your socks. If you haven't washed your feet in a while, it's those overgrowing brevibacteria that make people open the windows.

Brevibacteria are used to produce Muenster, Limburger, and several other cheeses, as we saw earlier. If these cheeses smell like unwashed feet, it's because you're smelling precisely the same thing.

Some cheese cultures include Staphylococcus epidermidis, one of the bacterial species responsible for human B.O. If you're hungry for details, the bacteria produce isovaleric acid (3-methylbutanoic acid), which imparts a characteristic odor to the human armpit and to some strong cheeses.

One of the compounds often produced during cheese making—butyric acid—is also produced when your stomach acid digests food, which is why, to many people, Parmesan has a faint odor of vomit.

As the cheese-making process proceeds, milk fats and proteins break down into a wide variety of chemical products, one of which is skatole. If you notice a slight off-odor (let's face it, cheese does not smell like roses), that is because skatole is also responsible for part of the odor of human feces (it is produced from tryptophan in the human intestine). The U.S. military has also used skatole for its nonlethal "stinkbomb" "malodorant weaponry" designed to temporarily incapacitate the enemy. But you can get it without a military contract. It is in ordinary cheese.

The human nose is exquisitely sensitive to bacterial decomposition, alerting us to food that has gone bad as well as to fecal contamination and other unclean things. But it is precisely the scents of decomposing food, unwashed feet, B.O., and human waste that end up in cheese.

Calves' Stomachs or Genetic Engineering?

Okay, our milk is standardized, pasteurized, and color-adjusted, and bacteria have been busily fermenting it. Now, it's time to coagulate it, turning fluid milk into solid curd. To do this, cheese makers add rennet—enzymes that break apart milk proteins and fats. Traditionally, rennet was taken from calves' stomachs, and Widmer's still uses this source. The liquefied calf extract looks a bit like tea as it is poured into the mix.

Most cheese makers use genetically engineered rennet. In 1990, the U.S. Food and Drug Administration approved the process in which enzyme-producing genes are inserted into bacteria and fungi, which, in turn, produce rennet. And some cheeses are coagulated without rennet, using plant extracts or—in the case of cream cheese, paneer, and other soft cheeses—citric acid, vinegar, and similar acids.

Rennet causes the curds to form, and the watery whey is then drained off. And that presents a new challenge, especially for large-scale cheese makers. What do you do with all that useless whey? Cheese factories put out tons of it, and it will take quite a landfill to handle that load of cheese factory waste.

As it happens, the dairy industry found a market for whey. Packed in a tub, whey protein is heavily promoted to body builders who can be induced to pay top dollar in hopes that it will pump up their muscles.

Forming and Salting

Time to pour the curds into a form—a round one to produce a wheel, a rectangular one to produce a block. These forms have also produced names for cheese: In Italian it is formaggio, in French fromage.

To make brick cheese—a Wisconsin original invented in 1877—Widmer's cheese makers pile on actual bricks, squeezing out the last bits of water and whey protein. And, yes, they use the same bricks that Granddad used.

Along the way, salt is added to stop bacterial growth and add flavor. As we will see in the next chapter, a surprising amount of salt ends up in every slice of cheese you'll find at the store.

Widmer's cheese blocks then go into the curing room, where warm, humid conditions encourage bacterial growth. Over the next week, the surface will be washed daily with bacteria, then the bricks are wrapped in parchment and foil for sale.

Endless Varieties

There are, of course, countless varieties of cheese that differ from each other based on the animal species they come from, the bacterial cultures used, the aging process, and other factors.

Cottage cheese and cream cheese are coagulated with acid, using little or no rennet. They retain a bit of lactose sugar and are not aged, which is why their flavors are mild.

Ricotta (Italian for "recooked") is made from whey, rather than casein.

Feta is traditionally made from sheep's milk or a combination of sheep's and goat's milk.

Although mozzarella traditionally comes from the milk of water buffalos, as we saw above, in the United States it is made from cow's milk. Thanks to its use on pizza, it has overtaken Cheddar as the number-one cheese in America.

Camembert and Brie, from northern France, are made with bacteria, mold, and yeast that contribute their own smells and flavors—objectionable to some, addictive to others. Only one small Camembert factory remains in the village of Camembert. Fromagerie Durand is happy to show you its cows standing in thick manure and the process of turning their milk into cheese.

Roquefort, Gorgonzola, and Stilton have mold introduced into their interiors. Roquefort is made with sheep's milk, Gorgonzola and Stilton with cow's milk.

Emmental (or Emmentaler), from Switzerland, is famous for its holes ("eyes"), which are the result of bacterial cultures producing carbon dioxide gas.

In medieval times, Edam's red outer color came from turnsole dye, according to Michael Tunick, a U.S. Department of Agriculture cheese scientist. Rags soaked with dye were hung over pans of urine. The urine's ammonia heightened the color of the dye, which was then rubbed onto the cheese. Today, the cheese's color comes from a red wax coating.


  • "If you want to know where medicine will be ten years from now, read Dr. Neal Barnard's writings today."—Dean Ornish, MD, New York Times bestselling author of The Spectrum and Dr. Dean Ornish's Program for Reversing Heart Disease
  • "Our love-affair with cheese is killing us. Learning the truth about cheese may save your life."—Joel Fuhrman, MD, New York Times bestselling author of The End of Heart Disease and The End of Diabetes, among others
  • "The Cheese Trap busts open the myths of cheese as a health food and provides an eye opening, mouth shutting view of the way cheese is produced and does damage."—Joel Kahn MD, Clinical Professor of Medicine, and author of The Whole Heart Solution
  • "Calories, cholesterol, salt and saturated fat-Dr. Barnard analyzes the process and problems of cheese production and consumption in the American population. It's no wonder that coronary artery plaque-the leading cause of death in the United States-resembles cheese in so many ways. "—Kim Allan Williams, Sr., M.D., MACC, FAHA, MASNC, FESC Immediate Past President, American College of Cardiology
  • "This informative and entertaining book clearly and compellingly lays out the reasons why cheese should not be part of our diet. I highly recommend it!"—Ted D. Barnett, MD, Medical Director and CEO, Rochester Lifestyle Medicine
  • "Do you love cheese? Think again! Dr. Barnard makes it crystal clear why you'll want to steer clear of cheese as if your life depends on it because, guess what-it does!"—Rip Esselstyn, #1 New York Times bestselling author of The Engine 2 Seven-Day Rescue Diet
  • "Dr. Barnard shares the truth about one of America's greatest addictions. A must read for anyone wanting to be empowered to go fully plant-based."—Chad Sarno and Derek Sarno, Chefs, Brothers, and Founders of Wicked Healthy

On Sale
Feb 28, 2017
Page Count
320 pages

Neal D Barnard, MD, MD, FACC

About the Author

Dr. Neal D. Barnard, MD, FACC, is a faculty member of the George Washington University School of Medicine and President of the Physicians Committee for Responsible Medicine. Dr. Barnard is editor-in-chief of the Nutrition Guide for Clinicians, a nutrition textbook given to all second year medical students in the U.S. He is also editor of Good Medicine, a magazine with a circulation of 150,000. He is the New York Times bestselling author of Dr. Neal Barnard's Program for Reversing Diabetes, The Get Healthy Go Vegan Cookbook, Power Foods for the Brain, The 21-Day Weight-Loss Kickstart, and most recently Your Body in Balance, among many others.

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