Let cheese consumption be integrated into the daily diet of Chinese people

Ren Huan, Industry Center, Zhongying Hui Nutrition and Health Research Institute

Professor Wang Yingyao, Chinese Nutrition Society/Zhongyinghui Institute of Nutrition and Health

In recent years, cheese has become an important growth point of China's dairy product consumption, but at present, the per capita consumption of cheese in China is still far below the world average
.
In order to better popularize cheese knowledge and culture, scientifically guide cheese consumption, guide enterprises to increase R&D and technological innovation investment, and develop cheese suitable for the dietary habits and nutritional needs of Chinese residents, the Institute of Nutrition and Health of the Chinese Nutrition Society and the Zhongyinghui Nutrition and Health Research Institute organized many experts in the field of nutrition and food to write the "Cheese Consumption and Health" research report (hereinafter referred to as the "Report"), which was professionally participated and supported by Shanghai Miaoke Landuo Food Co.
, Ltd.
and its team
。

The report objectively presents the types and nutritional characteristics of cheese, the consumption status of major countries in the world, adopts evidence-based nutrition methods, analyzes the scientific evidence of cheese intake and different health outcomes (i.
e.
the relationship between cheese consumption and health), and puts forward the direction of cheese upgrading and development based on the physiological characteristics, nutritional status and needs of people of different ages in China, as well as consumers' awareness and consumption habits of cheese, which provides reference for technology and product innovation in the cheese industry in the next 3-5 years
.

Reasonable intake of cheese, health benefits are clear

Scientific analysis has shown that the intake of milk and its products can increase bone density in children, adolescents and postmenopausal women, and the recommended grade is B
.

Cheese is an ancient fermented dairy product, there are currently more than 2,600 varieties of cheese in the world, different dairy animals, origins, production and maturation processes, showing different tastes and flavors
.
Cheese is rich in nutritional value, containing high-quality protein, fat, vitamins (vitamin A, vitamin D, riboflavin, folic acid, vitamin B12, etc.
) and minerals (calcium, phosphorus, magnesium, etc.
).

In order to objectively and systematically present the health effects of cheese, the literature information on the relationship between cheese intake and health from the establishment of the database to November 2021 in PubMed, Cochrane, Embase and SinoMed databases was systematically searched, and the original studies (mainly prospective cohort studies) on cheese consumption and different health outcomes were comprehensively evaluated according to the evidence evaluation methods and standards recommended by the Chinese Nutrition Society "Food and Health - Scientific Evidence Consensus".
Form a comprehensive evaluation level
.

Results showed that increased cheese intake reduced the risk of morbidity and/or mortality of total cardiovascular events, coronary heart disease and stroke; At the same time, cheese consumption reduced adult serum triglyceride (TC) and low-density lipoprotein cholesterol (LDL-C) levels compared to consuming butter containing the same fat content; In addition, cheese consumption was not
associated with hip fractures, diabetes, metabolic syndrome, hypertension, overall cancer morbidity and mortality, and all-cause mortality.
The evidence level for the above conclusions is B (Note: Indicates that in most cases, the conclusions of this body of evidence are credible; The quality of the evidence was high and the application value was large).

It is worth noting that cheese, as part of a healthy diet, needs to be properly paired with other foods and balanced in order to obtain the greatest health benefits
.

The acceptance level is relatively high, and the frequency of consumption is generally low

Traditionally, the dairy consumption of Chinese residents is mainly
liquid milk.
In recent years, with the upgrading of residents' consumption, the dairy industry has innovated in cheese production, processing and research and development of new cheese products (including hand-pulled cheese, processed cheese slices, cheese sticks, etc.
), and cheese has become an important growth point
for China's dairy consumption.
However, the per capita consumption of cheese in China is still far below the world average, and in 2020, the annual per capita consumption of cheese in the world was 3.
13 kg, while China's was only 0.
28 kg
.

The study surveyed more than 2,500 consumers about their perceptions, attitudes and behaviours towards cheese, covering different regions, ages, education levels, occupations and average monthly incomes
.
The results showed that respondents generally agreed with the view that "cheese is better for health than most snacks on the market" (56.
4%); 64.
4% of respondents have a positive attitude towards cheese and would choose a certain food because it is used, reflecting the relatively high
acceptance of cheese among respondents.

However, respondents generally consume cheese less frequently and are relatively unfamiliar with how cheese is eaten, with only 17.
6% of respondents consuming cheese
every week.
People who have consumed cheese in the past six months are mainly eaten directly as snacks between meals and added to baked snacks such as bread and cakes, and they are not accustomed to heating cheese
in three meals.
In the past six months, 26.
8% of the respondents had not consumed cheese, and the top three reasons were not eating cheese (71.
8%), not understanding the nutritional value of cheese (28.
4%) and high price (25.
7%)
.

When it comes to suggestions for improving cheese products, respondents are most interested in introducing cheese products with more taste and nutritional characteristics (56.
1%), followed by reducing their saturated fat content (45.
0%) and reducing the price of cheese (44.
4%)
.

Respondents' cheese consumption (n=1867).

Reasons why respondents did not consume cheese (n=682).

Leverage strengths and avoid weaknesses, and promote new highlights of products with diversification and localization

Since the implementation of the Healthy China Strategy, the people's health awareness and needs have been continuously improved, and the concept of diet has gradually changed
from eating enough to meet basic physiological needs to balanced nutrition, conducive to good health and enhancing immunity.
The people's consumption of dairy products has developed from liquid milk to more diversified directions such as nutrition and health, delicious and diverse, convenient and fast
.
This has brought great development opportunities to the cheese industry, especially in the objective reality that the intake of national dairy products is far less than the
recommended amount of dietary guidelines for Chinese residents.

The report of the 20th National Congress of the Communist Party of China proposed to improve the scientific and technological innovation system and adhere to the core position
of innovation in the overall situation of China's modernization.
At present, China's economic and social development and improvement of people's livelihood need to enhance the primary driving force
of innovation more than ever before.
The emphasis of cheese enterprises on R&D and technological innovation capabilities can better play the positive role
of this category in ensuring and improving the nutrition and health of the people.

The first is to optimize the nutrient content list and ingredient list, promote the strengths and avoid the weaknesses, and improve the nutrient density
.
The problem of insufficient per capita protein intake in China still exists, among which the proportion of protein intake of children aged 6-11 years old meeting the recommended intake (RNI) is only 52.
4%, and the proportion of protein intake below the average requirement (EAR) for the elderly aged 65 and above is as high as 69.
4%.

As a concentrated dairy product, cheese is a good source of high-quality protein, and there is great potential to develop high-quality cheese products that meet the protein needs of children, pregnant mothers, and the elderly
.
The average daily intake of cooking salt of Chinese residents is 9.
3 grams, and excessive salt intake is one of the
important factors causing hypertension.
The prevalence of hypertension in residents over 18 years old in China is 27.
9%, at the same time, the prevalence of nutrition-related chronic diseases such as overweight and obesity has increased year by year, the prevalence of overweight and obesity among adult residents has exceeded 50%, and the overall prevalence of dyslipidemia in residents over 35 years old is 34.
7
%.
Based on the current situation of national nutrition and health and the important role of prepackaged foods in a reasonable diet, cheese enterprises should focus on the high-quality flavor and taste of products, and accelerate the research and development and supply
of low-(no-)sugar, low-fat, low-sodium cheese and its products.

The second is to develop new products
with diversified health appeals.
Under the trend that brain health, skin health, bone health, intestinal health, sleep improvement and other demands have attracted consumer attention, cheese as a good food carrier for many nutritional fortifiers, adding functional ingredients and nutritional fortifiers such as DHA, lutein esters, L-theanine, taurine, galacto-oligosaccharides, fructooligosaccharides, phytosterols, vitamins and minerals and nutritional fortifiers will also become opportunities
for cheese product innovation.

In addition, the diversification of consumption scenarios and the localization of original cheese are also important development tensions in
the industry.
Develop products suitable for different tables and consumption scenarios, such as halloumi cheese that can be used in hot pot, barbecue and other scenarios, which can be fried or grilled; Based on cheese sauce, cheese balls, cheese powder, etc.
, we develop new forms of cheese snacks, such as crisps, sticks, balls, etc
.
At the same time, excavating and carrying forward the essence of Chinese traditional cheese culture, supplementing local specialty cheeses such as "milk tofu", "milk fan" and "milk pimples" with modern craftsmanship and consumption scenes will likely become a new fashion trend
.
In addition, the appropriate improvement of well-known foreign cheeses such as mascarpone cheese and emmental cheese to meet the taste of Chinese people, and the integration with Chinese food culture, will also give birth to new highlights
of products.

【Consumption tips】Cheese intake recommendations for different groups of people

The "Dietary Guidelines for Chinese Residents (2022 Edition)" recommends that adults with daily energy consumption between 1600-2400kcal should consume 300g of liquid milk or equivalent dairy products
per day.
As a fermented dairy product, cheese can be eaten with confidence by people who are lactose intolerant; Overweight and obese people and "three high" people need to properly control cheese intake and try to choose low-sugar, low-fat, reduced-salt cheese
.

For preschool children (2 to 5 years of age), guidelines recommend 350 to 500 mL of liquid milk or an equivalent amount of dairy products per day to meet calcium requirements
.
It is recommended to choose liquid milk, yogurt, cheese and other dairy products
without added sugar.
Young children have limited chewing and digestion and can choose fresh soft cheese or cheese sticks for breakfast and snacks
.

For school-age children (6-17 years), guidelines recommend making dairy products an integral part of their daily diet, with a daily intake of 300 mL of liquid milk or an equivalent amount of dairy products
.
Cheese can be supplemented in an appropriate amount at breakfast or between classes to meet the needs of normal intellectual and physical development; For children with dyslipidemia, abnormal blood sugar, overweight or obesity, cheese intake should be appropriate, and low-sodium, low-fat cheese
should be selected as much as possible.

For older adults, guidelines recommend 300 to 400 mL of fresh milk or an equivalent amount of dairy products
per day.
In the elderly with malnutrition, muscle decay and inadequate calcium intake, cheese can be one of the main dairy products; Elderly people with chronic diseases should choose low-fat cheese
.
Elderly people with micronutrient deficiencies can choose the appropriate fortified cheese
according to their own situation.

Preliminary review: Li Song Responsible editor: Zhao Yu Review: Wang Jinchen