Cheese

Cheese makes you constipated

If you want to consider foods that get an unfair shake, it’s worth talking about cheese. Aaron’s son Noah loves cheese. He loves it almost as much as chicken nuggets and fries, which he would eat for three meals a day, seven days a week if permitted. It’s all part of his “beige food” diet, which someday he will turn into fame and fortune. Anyway, Aaron has been guilty of putting strict limits on Noah’s cheese intake because he, like many of you, has been told that cheese causes constipation. But is it true?

If you go to any number of Web sites dedicated to constipation, it sure seems like it’s true. (By the way, why are there so many Web sites dedicated to constipation?) These sites will tell you that both a low-fiber diet and too much dairy consumption (especially cheese), will lead to constipation.

But the science behind all of this is not nearly so cut-and-dry. The belief that dairy products cause constipation was born mostly from studies of constipation in babies. Parents are obsessed with babies’ pooping, as we detailed in our last book. So much so that parents constantly bring their children to the doctor to talk about the child’s poop. Constipation is the reason for about one in four visits to pediatric gastroenterology clinics. But baby constipation and childhood or adult constipation are two different issues.

If you look at the data from babies, there is some connection between dairy intake and firmer stools or constipation. The proteins in breast milk are easily digested, as they are designed to be. However, the proteins in baby formula are not the same as those in breast milk, and the proteins in formula most often come from cow’s milk. Infants who are fed formula (which is cow’s milk–based) have firmer stools and more frequently have problems with constipation. Other factors, like fat content, can also affect the consistency of infant stools.

But there are many problems with simply extrapolating this data about cow’s milk formula and applying it to children and adults. First of all, a lot of what those parents think is constipation is not really constipation. Second, the issues infants might have with cow’s milk formula are not the same as children or adults might have with cheese. They aren’t the same at all.

Some people have digestive issues with milk or dairy. Those issues are real. But they also usually have more to do with diarrhea, bloating, or discomfort—not constipation. Lactose intolerance, in which people cannot digest the sugar called lactose found in dairy products, generally makes your stool loose and you gassy, not constipated. In fact, a study of people who reported sensitivity to dairy products did find an association between exposure to cow’s milk and increased immune system activation (with more immunoglobulins present), but the study found no statistically significant association with constipation. Even people who were sensitive to cow’s milk did not have any issues with constipation from dairy products.

There are very few good studies examining the relationship between cheese and constipation. But there is one particularly strong study. The National Health and Nutrition Examination Survey (NHANES) was put together by the National Center for Health Statistics in 1971–1975. They gathered tons of data on diet, exercise, and bowel dysfunction (among other data). In 1990, a group of researchers looked at data from the study for over 15,000 people age twelve to seventy-four. Overall, just under 13 percent of people reported constipation. When they did analyses on what those people were eating, constipated people reported eating less cheese, not more. They also ate less beans and peas, less milk, less meat and chicken, and less fruits and vegetables. They also drank more coffee and tea.

We’re not suggesting that diet has nothing to do with constipation. We’re also not suggesting that there aren’t people who have dairy issues. But no good evidence exists to implicate cheese in causing constipation in otherwise healthy people, and what evidence does exist, actually points the other way. Noah is going to be so pleased.