Egg, cholesterol consumption tied to CVD, mortality risk

  • Zhong VW & al.
  • JAMA
  • 19 Mar 2019

  • International Clinical Digest
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Takeaway

  • Egg and dietary cholesterol intake are tied to increased risk for cardiovascular disease (CVD) and all-cause mortality, according to this analysis of pooled data from 6 cohort studies.
  • The authors say that residual confounding is likely.

Why this matters

  • Editorial: at the population level, the finding is important, and the recommendation to limit intake of foods high in cholesterol should not be dismissed.

Key results

  • CVD incidence and all-cause mortality show a dose-response effect from egg and cholesterol intake.
  • For 300 mg added cholesterol/day, CVD risk increased: 
    • Adjusted HR, 1.17 (95% CI, 1.09-1.26).
    • Absolute risk difference (ARD): 3.24% (95% CI, 1.39%-5.08%).
  • So did all-cause mortality:
    • Adjusted HR: 1.18 (95% CI, 1.10-1.26).
    • ARD: 1.11% (95% CI, 0.32%-1.89%).
  • Associations of egg consumption with CVD and all-cause mortality risk were not significant after adjustment for cholesterol intake.
  • A stronger association between CVD and cholesterol was seen with BMI
  • It was weaker in participants with lower lipid levels.

Study design

  • Pooled individual data from 6 US cohort studies were analyzed (n=29,615).
  • Self-reported diet data, adjusted for demographic, other factors.
  • Outcome: HRs, ARDs for incident CVD, all-cause mortality.
  • Funding: NIH, universities, others.

Limitations

  • Self-reported data.
  • Causality not established.
  • Residual confounding "likely.” 

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