Increased intake of dietary cholesterol, eggs detrimental to heart

Consuming dietary cholesterol and eggs in high amounts contributes to an increased risk of overall and cardiovascular disease (CVD) mortality, according to a large study.

The analysis included 27,078 men in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) study. Over an average of 18.2 years or 482,316 person-years of follow-up, a total of 22,035 deaths, including 9,110 deaths from CVD, were documented. Multivariable cause-specific Cox proportional hazards regression models revealed greater dietary cholesterol and egg consumption to be associated with an increased risk of overall and CVD mortality.

Each additional 300-mg cholesterol intake per day conferred 10–13 percent increase in the risks of overall (hazard ratio [HR], 1.10) and CVD mortality (HR, 1.13; p<0.0001 for both). Meanwhile, each additional 50-g egg consumed daily was associated with 6–9 percent increase in the risks of overall (HR, 1.06) and CVD mortality (HR, 1.09; p<0.0001 for both).

The corresponding absolute mortality risk differences at 31 years of follow-up were 1.80 percent (95 percent confidence interval [CI], 1.23–2.39) for overall mortality and 1.83 percent (95 percent CI, 1.14–2.48) for CVD mortality per each additional 300-mg cholesterol daily intake; and 1.19 percent (95 percent CI, 0.75–1.65) for overall mortality and 1.25 percent (95 percent CI, 0.72–1.74) for CVD mortality per one additional 50-g egg per day.

Results of an updated meta-analysis of cohort studies based on 49 risk estimates, 3,601,401 participants, and 255,479 events showed that consumption of one additional 50-g egg daily was likewise associated with significantly increased CVD risk (pooled relative risk [RR], 1.04, 95 percent CI, 1.00–1.08; I2, 80.1 percent).

In the subgroup analysis of geographical regions, an increase of 50-g egg consumed daily conferred a significantly higher risk of CVD in US cohorts (pooled RR, 1.08, 95 percent CI, 1.02–1.14) and a borderline risk increase in European cohorts (pooled RR, 1.05). There was no association observed in Asian cohorts.

The present data support restricted consumption of dietary cholesterol as a way to improve long-term health and longevity.