Is cheese addictive? Dr Neal Barnard argues the food is bad for you

What's fattening, addictive and really bad for you? Surprise: it's not sugar this time, but cheese – at least according to The Cheese Trap, a new book by Dr Neal Barnard, adjunct associate professor of medicine at George Washington University in the US and an advocate for plant-based eating.

Cheese's potential to be addictive comes from the fact that it contains casomorphins, opiate-like substances derived from casein, the milk protein that's concentrated in cheese, says Barnard. He also points to 2015 research from the University of Michigan looking at which foods were linked to the most "addictive-like eating behaviours". In one of two studies, pizza, a cheesy food, ranked first, while in the second study it came fourth (after French fries, ice cream and chocolate). Cheese itself rated lower, coming tenth in one study (below cake and soft drink) and sixteenth in the second study, trailing soft drink and fried chicken.

There's no denying that cheese is easy to overeat – not just because its salty, more-ish flavour keeps you coming back but because it's an easy source of protein and flavour add to bread, pasta, and pizza.

But that doesn't make it addictive, says nutrition scientist Dr Tim Crowe who blogs at Thinking Nutrition.

"Addiction and liking something are different. You can have a desire for a food that activates the reward system in the brain, but to be truly addicted to something you have to have withdrawal symptoms," he says.

"The foods that have been most closely linked to food addiction also tend to be sugary carbohydrate foods," he adds.

Although Neal Barnard also argues that cheese causes weight gain and plays a part in a list of problems from period pain to prostate cancer and heart disease, Tim Crowe maintains it's the overall dietary pattern that matters to health and weight rather than single foods.

"Taking the cheese out of a burger doesn't make the burger healthy. If you like cheese, then if it's eaten in modest amounts as part of plant-based diet that's still a healthy way to eat. But eating a lot of cheese with a lot of fast food isn't healthy," he says.

Still, cheese and dairy food are full of contradictions. In February, a large Swedish study, linked diets high in non-fermented milk and butter to a higher risk of mortality from all causes – but linked high intakes of cheese and fermented milk to lower mortality. As for any connection with cancer, the Cancer Council says that milk "probably protects against bowel cancer, and there is limited suggestive evidence that milk reduces the risk of bladder cancer". On the downside, there's 'limited suggestive evidence that milk and dairy foods increase the risk of prostate cancer, and cheese increases the risk of bowel cancer".

As for contributing to heart disease, research is beginning to show that cheese may be less problematic than we thought.

"Some studies suggest cheese may be protective against heart disease but overall the evidence is that cheese is neutral – in other words it's neither helpful nor harmful," says Crowe. "Although cheese is high in saturated fat it also contains hundreds of different compounds some of which are anti-inflammatory and may offset any harmful effects of saturated fat."

While it's not hard to pick holes in some of Barnard's anti-cheese arguments, the book has good advice on what to eat instead. It's easy to get in a cheese rut, reaching for the cheddar when you need something to eat with bread or biscuits but for anyone who wants to broaden their diet, eat less cheese or drop dairy altogether there are alternatives. (And let's not forget that some people who avoid or reduce dairy do so because of concerns about animal welfare in the dairy industry – not their own health.)

Either way, there are other things to eat – they might not taste exactly like cheese, but are still pretty good.

For topping pizza: sautéed onion with big flavoured mushrooms like Portobello or shitake, roasted vegetables and flavour boosters like olive, capers or artichoke hearts. When the pizza comes out of the oven, add avocado cream (1 large avocado cubed and blended with 2 tablespoons lemon or lime juice, ½ teaspoon sea salt and a little water to thin the consistency).

With bread or biscuits: nut based pesto, tapenade or hummus.

Nut "Parmesan": One and half cups cashews or almonds processed until fine and crumbly. Mix with 1 tablespoon nutritional yeast, ½ teaspoon sea salt, 1½ teaspoons lemon juice. Heat oven to 150 degrees. Spread nut mixture on a baking sheet. Bake for 20-30 minutes, turning frequently. Store in a jar in the fridge.

The Cheese Trap: How breaking a surprising addiction will help you lose weight, gain energy and get healthy by Dr Neal Barnard is published by Simon & Schuster, $36.85.