Associations of Dietary Cholesterol, Serum Cholesterol, and Egg Consumption With Overall and Cause-Specific Mortality: Systematic Review and Updated Meta-Analysis
Zhao B, Zhao B, Gan L, Graubard BI, Männistö S, Albanes D, Huang J
Circulation · 63 citations
How it was studied
- Design
- Meta-analysis (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
- Government
- National Institutes of Health
- Government
- Intramural NIH HHS
- Grants
- National Institutes of Health (Z01 SC000100)
Based on 2 listed funder(s).
Publication
- Published
- 2022-04-01 · Circulation · vol. 145 · issue 20 · pp. 1506–1520
- Publisher
- Lippincott Williams & Wilkins
- Cited
- 87 citations · more than 97% of similar papers · 4.7× the field average
- Impact
- Top 10% most cited in its field
- References
- 63 works
- Access
- Open access (repository copy)
- Research areas
- Nutritional Studies and Diet · Antioxidant Activity and Oxidative Stress · Cholesterol and Lipid Metabolism
- Keywords
- Medicine, Hazard ratio, Proportional hazards model, Cohort study, Cholesterol, Cohort, Internal medicine, Meta-analysis, Confidence interval
- MeSH
- humans, cardiovascular diseases, cholesterol, dietary, cause of death, risk factors, prospective studies, eggs, male
6 authors
From CN, US, FI
- Bin ZhaoCentral South University; Second Xiangya Hospital of Central South University
- Lu GanCentral South University; Second Xiangya Hospital of Central South University
- Barry I. GraubardDepartment of Health and Human Services
- Satu MännistöFinnish Institute for Health and Welfare
- Demetrius AlbanesDepartment of Health and Human Services
- Jiaqi HuangCentral South University; Second Xiangya Hospital of Central South University; Department of Health and Human Services
Abstract
Background
Despite substantial research highlighting the importance of exogenous dietary cholesterol intake and endogenous serum cholesterol level in human health, a thorough evaluation of the associations is lacking. Our study objective was to examine overall and cause-specific mortality in relation to dietary and serum cholesterol, as well as egg consumption, and conduct an updated meta-regression analysis of cohort studies.
Methods
We conducted a prospective analysis of 27 078 men in the ATBC Study (Alpha-Tocopherol, Beta-Carotene Cancer Prevention). Multivariable-controlled cause-specific Cox proportional hazards regression models were used to calculate hazard ratios and 31-year absolute mortality risk differences. A systematic review and meta-analysis of cohort studies was also performed (PROSPERO [URL: https://www.crd.york.ac.uk/prospero/; Unique identifier: CRD42021272756]).
Results
Based on 482 316 person-years of follow-up, we identified 22 035 deaths, including 9110 deaths from cardiovascular disease (CVD). Greater dietary cholesterol and egg consumption were associated with increased risk of overall and CVD-related mortality. Hazard ratios for each additional 300 mg cholesterol intake per day were 1.10 and 1.13 for overall and CVD-related mortality, respectively; for each additional 50-g egg consumed daily, hazard ratios were 1.06 and 1.09, respectively, for overall and CVD-related mortality (all P valuesP2=80.1%). In the subgroup analysis of geographic regions (Pinteraction=0.02), an increase of 50-g egg consumed daily was associated with a higher risk of CVD in US cohorts (pooled relative risk, 1.08 [95% CI, 1.02-1.14]) and appeared related to a higher CVD risk in European cohorts with borderline significance (pooled relative risk, 1.05), but was not associated with CVD risk in Asian cohorts.
Conclusions
In this prospective cohort study and updated meta-analysis, greater dietary cholesterol and egg consumption were associated with increased risk of overall and CVD-related mortality. Our findings support restricted consumption of dietary cholesterol as a means to improve long-term health and longevity.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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