From Brian Keyser | Leigh Friend | Composing the Cheese Plate | Running Press, 2016
Knowing how to make a cheese plate used to be a relatively simple thing. But entertaining’s gotten a little complicated given everyone’s increasingly complex food proclivities and pronouncements not to mention denouncements. So while it may seem as though cheese, glorious cheese, ought to be the great equalizer among us all, it has its trickiness. Especially for the lactose intolerant and the pregnant. We’re actually okay with there not being a cheese to cater to every last person’s chosen preferences, although we aren’t okay with there not being a cheese for those with actual physical conditions that limit their options. Rather than bore you with the same typical cheese plate advice you’ve already heard regarding how you ought to include a soft, a hard, a stinky, and so on, we’re instead sharing some advice from the kind and learned folks at Casellula Cheese & Wine Café in Manhattan that will help you be as inclusive as possible the next time you set out an array of lovely cheeses so that everyone who wants to may partake.—Renee Schettler Rossi
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Lactose Intolerance

Lactose intolerance and dairy allergies are two different things, but they share some symptoms, such as intestinal discomfort and bloating, causing many people to think they have one problem when it’s really the other. Lactose intolerance occurs when a person’s body doesn’t produce lactase, the enzyme that allows us to digest lactose, a sugar contained in milk. An allergy, on the other hand, is when a person’s body treats something otherwise harmless, such as peanuts, shellfish, or milk, as a pathogen.
If you’re allergic to milk, you’ll need to avoid all dairy, including cheese. Sorry. For the lactose intolerant, however, there is good news. Milk contains lactose, but a lot of cheeses don’t. Most of the lactose from milk is lost with the whey in the cheese-making process. In addition, lactose breaks down over time, so most aged cheeses—whether cow, goat, sheep, or buffalo—contain little or no lactose and therefore aren’t a problem for the lactose intolerant.
If you have trouble digesting cheese or dairy products in general, discuss possible solutions with your doctor. Don’t assume you can’t eat any cheese just because you’ve had a bad experience or two. Experiment with different kinds of cheeses and different remedies. Some people find that they digest goat’s milk and sheep’s milk cheeses easier than cow’s milk cheeses due to the fact that those milks have smaller fat molecules. Over-the-counter medications, such as Lactaid, introduce lactase into the system and allow for the proper breakdown of lactose. Maybe you’ll be good with goat or lovely with Lactid. Most likely you’ll be agreeable with aged cheeses.
Pregnancy
Common wisdom is that pregnant women should avoid raw milk cheeses and eat only cheeses made from pasteurized milk. According to the Mayo Clinic, pregnant women should “avoid soft cheeses, such as Brie, feta, and blue cheese, unless they are clearly labeled as being pasteurized or made with pasteurized milk.” The logic behind the statement is that pasteurization has killed any pathogens that could make the mother sick and thus endanger the fetus.
This advice is well-intentioned and common. But wrong.
Pasteurization was a gift to the world that saved and improved millions of lives by making milk (and lots of other items) safer to consume. In the late nineteenth century, as Europe and North America were transforming from agrarian to industrialized societies, people were moving to farms, where food was easily accessible, to cities, where food had to be brought in. By the time milk reached consumers in cities from dairy farms, it was sometimes days old and hadn’t been properly refrigerated, giving pathogens, if they existed in the raw milk, time to multiply and become dangerous. Pasteurization, invented in 1864, killed the potential pathogens in milk, making it cleaner and safer to drink. In the late 19th and early 20th centuries, when refrigeration was rare, pasteurization saved millions of people from getting sick.
Pasteurization, however, is not a magic force that makes milk, cheese, or any other food perfectly safe to consume. It’s a process that kills most of or all the bacteria, good and bad, at a given point early in the process of transporting food and drink from farm to table. The problem is that some dangerous bacteria, including E. coli and listeria, can get into food after it is pasteurized. Furthermore, any low-acid, high-moisture cheeses, including but not limited to those listed above, can be breeding grounds for pathogens.
Most of the time, pathogens aren’t present in milk or cheese, so there’s nothing dangerous to breed, and if the product in question is kept properly refrigerated below 42ºF, any dangerous bacteria are prevented from growing rapidly enough to become a threat. But when that very rare, perfect storm of pathogen, moisture, and lack of refrigeration happens, it can cause sickness, which can sometimes result in miscarriage.
Therefore, pregnant women shouldn’t worry about pasteurization, which prevents most pathogens from growing most of the time; they should eat only cheeses that won’t support the growth of pathogens. Period. Hard, aged cheeses (in other words, low-moisture cheeses) are too high in acid and too low in moisture for dangerous bacteria to grow. So whether the milk was pasteurized or not, whether pathogens were present in the cheese at some point or not, and even if the cheese is not refrigerated, these cheeses cannot host dangerous pathogens.
We’re not doctors or scientists, but our advice to you, if you’re pregnant, is to avoid soft, high-moisture cheeses like Brie, feta, and fresh chèvre, even the pasteurized ones, because, although it’s very unlikely, they can host pathogens. Instead, eat lots and lots of hard aged cheeses, especially raw milk cheeses, as raw milk contains good bacteria. Good bacteria help to create an environment in the cheese that discourages the growth of dangerous bacteria, if any are present.
Bottom line: Cheese is good for you and your baby. (Although we always recommend checking with your doctor before enjoying it.)