Dietary cholesterol and egg intake in relation to incident cardiovascular disease and all-cause and cause-specific mortality in postmenopausal women

Guo-Chong Chen; Li-Hua Chen; Yasmin Mossavar-Rahmani; Victor Kamensky; Aladdin H Shadyab; Bernhard Haring; Robert A Wild; Brian Silver; Lewis H Kuller; Yangbo Sun; Nazmus Saquib; Barbara Howard; Linda G Snetselaar; Marian L Neuhouser; Matthew A Allison; Linda Van Horn; JoAnn E Manson; Sylvia Wassertheil-Smoller; Qibin Qi

doi:10.1093/ajcn/nqaa353

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Dietary cholesterol and egg intake in relation to incident cardiovascular disease and all-cause and cause-specific mortality in postmenopausal women

Journal article

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Dietary cholesterol and egg intake in relation to incident cardiovascular disease and all-cause and cause-specific mortality in postmenopausal women

Guo-Chong Chen, Li-Hua Chen, Yasmin Mossavar-Rahmani, Victor Kamensky, Aladdin H Shadyab, Bernhard Haring, Robert A Wild, Brian Silver, Lewis H Kuller, Yangbo Sun, …

The American journal of clinical nutrition, Vol.113(4), pp.948-959

04/06/2021

DOI: 10.1093/ajcn/nqaa353

PMCID: PMC8023834

PMID: 33330926

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Abstract

The potential cardiovascular impact of dietary cholesterol intake has been actively debated for decades. We aimed to evaluate associations of dietary cholesterol and egg intakes with incident cardiovascular disease (CVD) and all-cause and cause-specific mortality. We included 96,831 US postmenopausal women aged 50-79 y without known CVD or cancer during baseline enrollment (1993-1998) of the Women's Health Initiative. Dietary information was collected using a validated FFQ. Incident CVD [i.e., ischemic heart disease (IHD) and stroke] and all-cause and cause-specific mortality were ascertained and adjudicated through February 2018. A total of 9808 incident CVD cases and 19,508 all-cause deaths occurred during a median follow-up of 17.8 y and 18.9 y, respectively. After multivariable adjustment for traditional risk factors and key dietary nutrients including dietary saturated fat, there were modest associations of dietary cholesterol intake with incident CVD (HRQ5versusQ1: 1.12; 95% CI: 1.03, 1.21; P-trend < 0.001) and all-cause mortality (HRQ5versusQ1: 1.09; 95% CI: 1.02, 1.15; P-trend < 0.001). Significant positive associations were also observed between dietary cholesterol and incident IHD (P-trend = 0.007), incident ischemic stroke (P-trend = 0.002), and CVD mortality (P-trend = 0.002), whereas there was an inverse association for incident hemorrhagic stroke (P-trend = 0.037) and no association for mortality from cancer, Alzheimer disease/dementia, respiratory diseases, or other causes (P-trend > 0.05). Higher egg consumption was also associated with modestly higher risk of incident CVD (P-trend = 0.004) and all-cause mortality (P-trend < 0.001), with HRs of 1.14 (95% CI: 1.04, 1.25) and 1.14 (95% CI: 1.07, 1.22), respectively, when comparing ≥1 egg/d with <1 egg/wk. Both higher dietary cholesterol intake and higher egg consumption appeared to be associated with modestly elevated risk of incident CVD and all-cause mortality in US postmenopausal women.

Aged

Cardiovascular Diseases

Cholesterol, Dietary

Eggs

Feeding Behavior

Female

Humans

Middle Aged

Mortality

Postmenopause

Details

Title: Subtitle: Dietary cholesterol and egg intake in relation to incident cardiovascular disease and all-cause and cause-specific mortality in postmenopausal women
Creators: Guo-Chong Chen - Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
Li-Hua Chen - Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
Yasmin Mossavar-Rahmani - Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
Victor Kamensky - Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
Aladdin H Shadyab - Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, La Jolla, CA, USA
Bernhard Haring - Department of Medicine I, University of Würzburg, Würzburg, Germany
Robert A Wild - Clinical Epidemiology and Obstetrics and Gynecology, Oklahoma University Health Sciences Center, Oklahoma City, OK, USA
Brian Silver - UMass Memorial Medical Center, Worcester, MA, USA
Lewis H Kuller - Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
Yangbo Sun - Department of Epidemiology, College of Public Health, University of Iowa, Iowa, IA, USA
Nazmus Saquib - College of Medicine, Sulaiman AlRajhi University, Al Bukayriah, Saudi Arabia
Barbara Howard - Georgetown University School of Medicine, Washington, DC, USA
Linda G Snetselaar - Department of Epidemiology, College of Public Health, University of Iowa, Iowa, IA, USA
Marian L Neuhouser - Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
Matthew A Allison - Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, La Jolla, CA, USA
Linda Van Horn - Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
JoAnn E Manson - Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
Sylvia Wassertheil-Smoller - Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
Qibin Qi - Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
Resource Type: Journal article
Publication Details: The American journal of clinical nutrition, Vol.113(4), pp.948-959
DOI: 10.1093/ajcn/nqaa353
PMID: 33330926
PMCID: PMC8023834
NLM abbreviation: Am J Clin Nutr
ISSN: 0002-9165
eISSN: 1938-3207
Grant note: R01 HL140976 / NHLBI NIH HHS P30 DK111022 / NIDDK NIH HHS R01 DK120870 / NIDDK NIH HHS HHSN268201600004C / NHLBI NIH HHS
Language: English
Date published: 04/06/2021
Academic Unit: Epidemiology; Fraternal Order of Eagles Diabetes Research Center; Internal Medicine
Record Identifier: 9984215138902771

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