Associations of Dietary Cholesterol or Egg Consumption With Incident Cardiovascular Disease and Mortality
Zhong VW, Van Horn L, Cornelis MC, Wilkins JT, Ning H, Carnethon MR, Greenland P, Mentz RJ, Tucker KL, Zhao L, Norwood AF, Lloyd-Jones DM, Allen NB
JAMA · 227 citas
Cómo se estudió
- Diseño
- Estudio de cohortes (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
- Consumo medido con
- No se indica
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- National Heart, Lung, and Blood Institute
- Gobierno
- National Institute of Diabetes and Digestive and Kidney Diseases
- Gobierno
- NHLBI NIH HHS
- Gobierno
- NIDDK NIH HHS
- Subvenciones
- National Heart, Lung, and Blood Institute (HHSN268201300050C); National Heart, Lung, and Blood Institute (HHSN268201300046C); National Heart, Lung, and Blood Institute (R21HL085375); National Heart, Lung, and Blood Institute (R01 HL136942); National Heart, Lung, and Blood Institute (HHSN268201300048C); National Heart, Lung, and Blood Institute (HHSN268201300049C); National Heart, Lung, and Blood Institute (HHSN268201300047C); National Heart, Lung, and Blood Institute (K23 HL133601); National Institute of Diabetes and Digestive and Kidney Diseases (P30-DK092949)
Según 4 financiadores declarados.
Publicación
- Publicado
- 2019-03-15 · JAMA · vol. 321 · número 11 · pág. 1081
- Editorial
- American Medical Association
- Citado
- 328 citas · más que el 100% de estudios similares · 42.6× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 38 trabajos
- Acceso
- Lectura gratuita
- Áreas de investigación
- Nutritional Studies and Diet · Cardiovascular Health and Risk Factors · Sodium Intake and Health
- Palabras clave
- Medicine, Interquartile range, Hazard ratio, Cholesterol, Internal medicine, Confidence interval
- MeSH
- humans, cardiovascular diseases, cholesterol, dietary, diet, nutrition surveys, mortality, risk factors, prospective studies, eggs, adult, aged, middle aged, female, male, self report
13 autores
- Victor W. Zhong🇺🇸 · autor de correspondenciaNorthwestern University
- Linda Van Horn🇺🇸Northwestern University
- Marilyn C. Cornelis🇺🇸Northwestern University
- John T. Wilkins🇺🇸Northwestern University
- Hongyan Ning🇺🇸Northwestern University
- Mercedes R. Carnethon🇺🇸Northwestern University
- Philip Greenland🇺🇸Northwestern University
- Robert John Mentz🇺🇸Clinical Research Institute; Duke Medical Center
- Katherine L. Tucker🇺🇸University of Massachusetts Lowell
- Lihui Zhao🇺🇸Northwestern University
- Arnita F. Norwood🇺🇸Jackson Memorial Hospital; University of Mississippi Medical Center
- Donald M. Lloyd‐Jones🇺🇸Northwestern University
- Norrina B. Allen🇺🇸 · autor de correspondenciaNorthwestern University
Resumen
El texto original del estudio, en el idioma en que se publicó.
Importance
Cholesterol is a common nutrient in the human diet and eggs are a major source of dietary cholesterol. Whether dietary cholesterol or egg consumption is associated with cardiovascular disease (CVD) and mortality remains controversial.
Objective
To determine the associations of dietary cholesterol or egg consumption with incident CVD and all-cause mortality.
Design, setting, and participants
Individual participant data were pooled from 6 prospective US cohorts using data collected between March 25, 1985, and August 31, 2016. Self-reported diet data were harmonized using a standardized protocol.
Exposures
Dietary cholesterol (mg/day) or egg consumption (number/day).
Main outcomes and measures
Hazard ratio (HR) and absolute risk difference (ARD) over the entire follow-up for incident CVD (composite of fatal and nonfatal coronary heart disease, stroke, heart failure, and other CVD deaths) and all-cause mortality, adjusting for demographic, socioeconomic, and behavioral factors.
Results
This analysis included 29 615 participants (mean [SD] age, 51.6 [13.5] years at baseline) of whom 13 299 (44.9%) were men and 9204 (31.1%) were black. During a median follow-up of 17.5 years (interquartile range, 13.0-21.7; maximum, 31.3), there were 5400 incident CVD events and 6132 all-cause deaths. The associations of dietary cholesterol or egg consumption with incident CVD and all-cause mortality were monotonic (all P values for nonlinear terms, .19-.83). Each additional 300 mg of dietary cholesterol consumed per day was significantly associated with higher risk of incident CVD (adjusted HR, 1.17 [95% CI, 1.09-1.26]; adjusted ARD, 3.24% [95% CI, 1.39%-5.08%]) and all-cause mortality (adjusted HR, 1.18 [95% CI, 1.10-1.26]; adjusted ARD, 4.43% [95% CI, 2.51%-6.36%]). Each additional half an egg consumed per day was significantly associated with higher risk of incident CVD (adjusted HR, 1.06 [95% CI, 1.03-1.10]; adjusted ARD, 1.11% [95% CI, 0.32%-1.89%]) and all-cause mortality (adjusted HR, 1.08 [95% CI, 1.04-1.11]; adjusted ARD, 1.93% [95% CI, 1.10%-2.76%]). The associations between egg consumption and incident CVD (adjusted HR, 0.99 [95% CI, 0.93-1.05]; adjusted ARD, -0.47% [95% CI, -1.83% to 0.88%]) and all-cause mortality (adjusted HR, 1.03 [95% CI, 0.97-1.09]; adjusted ARD, 0.71% [95% CI, -0.85% to 2.28%]) were no longer significant after adjusting for dietary cholesterol consumption.
Conclusions and relevance
Among US adults, higher consumption of dietary cholesterol or eggs was significantly associated with higher risk of incident CVD and all-cause mortality in a dose-response manner. These results should be considered in the development of dietary guidelines and updates.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
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