Cholesterol and Egg Intakes with Cardiometabolic and All-Cause Mortality among Chinese and Low-Income Black and White Americans
Pan XF, Yang JJ, Lipworth LP, Shu XO, Cai H, Steinwandel MD, Blot WJ, Zheng W, Yu D
Nutrients · 12 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Cohort study (indexed by PubMed)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
- Intake measured by
- Not stated
Who paid for it
- Funding
- Independent funding
- University or hospital
- Vanderbilt University
- University or hospital
- Vanderbilt-Ingram Cancer Center
- Government
- National Institutes of Health
- Government
- National Heart, Lung, and Blood Institute
- Government
- National Cancer Institute
- Government
- NCI NIH HHS
- Government
- NHLBI NIH HHS
- Grants
- Vanderbilt-Ingram Cancer Center (P30 CA 68485); National Cancer Institute (P30 CA 68485); Vanderbilt-Ingram Cancer Center (CA68485); National Cancer Institute (UM1 CA182910); Vanderbilt University (P30 CA68485); National Heart, Lung, and Blood Institute (R01 HL149779); National Cancer Institute (CA68485); National Cancer Institute (U01‐CA202979); Vanderbilt University (CA68485); National Cancer Institute (UM1 CA173640)
Based on 7 listed funder(s) and full-text disclosure statement.
Publication
- Published
- 2021-06-19 · Nutrients · vol. 13 · issue 6 · p. 2094
- Publisher
- Multidisciplinary Digital Publishing Institute
- Cited
- 14 citations · more than 85% of similar papers · 1.9× the field average
- References
- 42 works
- Access
- Open access (journal) · CC-BY
- Research areas
- Nutritional Studies and Diet · Obesity, Physical Activity, Diet · Cardiovascular Health and Risk Factors
- Keywords
- Medicine, Hazard ratio, Internal medicine, Confidence interval, Demography, Cholesterol, Proportional hazards model, Endocrinology
- MeSH
- humans, cholesterol, dietary, diet, mortality, prospective studies, poverty, eggs, adult, aged, middle aged, women's health, united states, china, female, male, men's health, metabolic syndrome, asian people, white people, black or african american
9 authors
From US
- Xiong‐Fei PanVanderbilt University Medical Center
- Jae Jeong YangVanderbilt University Medical Center
- Loren P. LipworthVanderbilt University Medical Center
- Xiao‐Ou ShuVanderbilt University Medical Center
- Hui CaiVanderbilt University Medical Center
- Mark D. SteinwandelVanderbilt University Medical Center
Abstract
We examined the associations of dietary cholesterol and egg intakes with cardiometabolic and all-cause mortality among Chinese and low-income Black and White Americans. Included were 47,789 Blacks, 20,360 Whites, and 134,280 Chinese aged 40-79 years at enrollment. Multivariable Cox models with restricted cubic splines were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality outcomes using intakes of 150 mg cholesterol/day and 1 egg/week as the references. Cholesterol intake showed a nonlinear association with increased all-cause mortality and a linear association with increased cardiometabolic mortality among Black Americans: HRs (95% CIs) associated with 300 and 600 mg/day vs. 150 mg/day were 1.07 (1.03-1.11) and 1.13 (1.05-1.21) for all-cause mortality (P-linearity = 0.04, P-nonlinearity = 0.002, and P-overall P-linearity = 0.007, P-nonlinearity = 0.07, and P-overall = 0.005). Null associations with all-cause or cardiometabolic mortality were noted for White Americans (P-linearity ≥ 0.13, P-nonlinearity ≥ 0.06, and P-overall ≥ 0.05 for both). Nonlinear inverse associations were observed among Chinese: HR (95% CI) for 300 vs. 150 mg/day was 0.94 (0.92-0.97) for all-cause mortality and 0.91 (0.87-0.95) for cardiometabolic mortality, but the inverse associations disappeared with cholesterol intake > 500 mg/day (P-linearity ≥ 0.12; P-nonlinearity ≤ 0.001; P-overall < 0.001 for both). Similarly, we observed a positive association of egg intake with all-cause mortality in Black Americans, but a null association in White Americans and a nonlinear inverse association in Chinese. In conclusion, the associations of cholesterol and egg intakes with cardiometabolic and all-cause mortality may differ across ethnicities who have different dietary patterns and cardiometabolic risk profiles. However, residual confounding remains possible.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
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