What cheeses are safe for galactosemia patients?

December 5, 2025 •

4 min read

According to the National Institutes of Health, individuals with galactosemia must avoid foods containing galactose, a sugar found in milk. While this generally includes dairy products, certain hard, aged cheeses are safe due to the cheese-making process.

Quick Summary

A lifelong low-galactose diet is required for those with galactosemia. Some aged and mature cheeses are suitable because the galactose and lactose are largely removed or consumed by bacteria during production and maturation. The article explains how to select safe cheeses and provides specific examples.

Key Points

Aged hard cheeses are generally safe: The aging process in cheeses like Parmesan, Emmental, and mature Cheddar naturally reduces galactose content to safe levels.
Fermentation and whey removal reduce galactose: During cheese making, lactose and galactose are removed with the whey and consumed by bacteria, a process that happens most effectively in hard, aged varieties.
Avoid soft cheeses: Fresh, soft cheeses like ricotta, cottage cheese, and mozzarella contain high levels of galactose and are not safe for galactosemia patients.
Be cautious with "lactose-free" products: Many commercial "lactose-free" dairy products are not suitable, as some tests have shown high galactose levels.
Vegan cheese is a safe alternative: Dairy-free cheese substitutes made from plant sources are free from galactose and a safe option, but may lack calcium.
Always check with a dietitian: It is crucial to work with a metabolic dietitian to confirm suitable food options based on individual needs and monitor for changes in product formulations.
Verify product maturity: When buying cheese, look for clear labels indicating that the cheese is extra mature, vintage, or aged to ensure sufficient processing.

The Science Behind Safe Cheese Selection

Galactosemia is a metabolic disorder where the body cannot properly break down galactose, causing it to build up to toxic levels. Galactose is a component of lactose, the main sugar in milk. The cornerstone of treatment is a strict galactose-free diet, which typically means avoiding all milk and most dairy products. However, advancements in dietary management, supported by research and advocacy groups like the UK Galactosaemia Support Group, have confirmed that certain cheeses are safe for consumption.

The safety of certain cheeses for galactosemia patients hinges on two key factors in the cheese production process:

Whey Removal: Early in the process, the lactose-containing whey is separated and removed from the curds. This dramatically reduces the lactose content of the final product.
Bacterial Fermentation: The remaining lactose is further broken down and consumed by bacteria during the aging or maturation process, converting it into lactic acid. The longer a cheese is aged, the lower its final lactose and galactose content will be.

Suitable Cheeses for Galactosemia

The following cheeses have been scientifically tested and confirmed to contain very low or undetectable levels of galactose, making them suitable for many individuals with galactosemia, in consultation with a dietitian:

Aged Cheddar: Extra mature and vintage Cheddars are often well below the safe threshold of 25 mg galactose/100 g.
Swiss Cheese (e.g., Emmental, Gruyere): These cheeses are excellent choices, as the bacteria used in their production effectively metabolize the galactose.
Parmesan (Parmigiano Reggiano): A naturally lactose-free cheese that contains less than 0.01g of galactose per 100g.
Grana Padano: Another Italian hard cheese similar to Parmesan, confirmed to be suitable.
Comté: This French cheese has consistently shown very low galactose levels in testing.
Pecorino Romano: Testing has shown this sheep's milk cheese to have undetectable galactose levels, despite initial uncertainty.
Jarlsberg: This Norwegian cheese is also regularly listed as a safe option.
Mature Muenster: This cheese has a very low lactose level, making it potentially suitable, though specific galactose testing should be referenced.
Edam and Gouda: Certain aged varieties have been confirmed to be suitable options.

Unsuitable Cheeses and Other Dairy to Avoid

While mature cheeses are often safe, many other dairy products must be strictly avoided. These include any soft or fresh cheeses, which retain much of the whey and, consequently, higher levels of lactose and galactose. Individuals should also check for "lactose-free" products, as some processed options can contain added ingredients or still have higher galactose levels than aged cheeses.

Comparing Cheeses for Galactosemia


Cheese Type	Galactose Content	Suitability for Galactosemia	Notes
Mature/Aged Hard Cheese	Typically very low (<25mg/100g)	Safe	The long maturation process allows bacteria to consume most lactose and galactose.
Soft Cheeses (e.g., Ricotta, Cottage Cheese)	High	Unsuitable	These fresh cheeses retain more whey and thus more lactose and galactose.
Processed Cheeses	Can be very high	Unsuitable	Often contain milk solids and other dairy derivatives that increase galactose content.
Vegan Cheese Alternatives	Galactose-free	Safe (if dairy-free)	Made from plant-based sources like nuts or starches, but check ingredients for dairy proteins.
"Lactose-Free" Cheeses	Potentially high	Unsuitable (caution)	These are treated with lactase to break down lactose, but free galactose may remain. Some tests have shown unexpectedly high levels.

Tips for Choosing and Consuming Cheese

Verify Maturity: Always choose hard cheeses labeled as "mature," "aged," or "vintage" to ensure they have undergone sufficient fermentation.
Prioritize Independent Testing: Rely on lists and guidelines from metabolic nutrition specialists and galactosemia support groups, which are based on specific chemical analysis, not just lactose intolerance recommendations.
Consider Vegan Options: Dairy-free cheese alternatives made from plant-based ingredients are completely safe from a galactose standpoint. Just be aware that their nutritional profile, especially calcium content, may differ.
Read Labels Carefully: Always read the ingredient list to ensure no prohibited ingredients like whey, milk solids, or milk powder have been added.
Monitor Intake: Even with safe cheeses, moderation is key. Working with a registered dietitian specializing in metabolic disorders is the best way to determine appropriate portion sizes.

Conclusion

While a diagnosis of galactosemia necessitates strict dietary precautions, it does not have to mean a lifetime without cheese. Thanks to the unique properties of aging and bacterial fermentation, many delicious, mature hard cheeses are safe for consumption. By understanding the process and sticking to expert-tested varieties like extra mature Cheddar, Parmesan, and Emmental, patients can enjoy cheese as a part of their low-galactose diet, ensuring adequate calcium intake and dietary variety. As with any dietary modification for a metabolic condition, consulting with a specialized dietitian is essential for personalized advice and ongoing management.

Additional Resource

For further reading on galactosemia diet management and cheese recommendations, refer to the Galactosemia Foundation's Diet Guidelines.

Frequently Asked Questions

Some cheeses are safe for galactosemia because the galactose and lactose are significantly reduced during the cheese-making process. The whey, which contains most of the lactose, is drained off, and the remaining milk sugar is consumed by bacteria during fermentation and aging.

The key difference is the cheese's maturity. Aged, hard cheeses like Parmesan, Gruyere, and mature Cheddar are low in galactose, while fresh, soft cheeses such as ricotta, mozzarella, and cream cheese have high galactose content.

Yes, vegan cheese alternatives are typically safe, provided they are made from plant-based sources and do not contain any added dairy-based ingredients. They offer a completely galactose-free option.

People with galactosemia cannot process the sugar galactose. Since lactose, the sugar in milk, is made of galactose and glucose, and milk contains other galactose compounds, most dairy products must be avoided to prevent a harmful buildup of galactose in the body.

No, you should not automatically trust 'lactose-free' labels for a galactosemia diet. Some testing has shown that some lactose-free products can still contain high levels of free galactose.

Extra mature and vintage Cheddar, Italian Parmesan (Parmigiano Reggiano), Grana Padano, Emmental, Gruyere, Comté, Jarlsberg, and Pecorino Romano are generally considered the safest options.

The most reliable way is to refer to guidelines from galactosemia support groups, which often test specific brands and batches. The safety can vary by region and manufacturer. Always consult with a metabolic dietitian.