Dietary cholesterol, egg intake up risk of CVD, all-cause death in postmenopausal women

In postmenopausal women, both higher dietary cholesterol intake and egg consumption appear to moderately increase the risk of incidence cardiovascular disease (CVD) and all-cause mortality, as shown in a recent US study.

The investigators enrolled 96,831 US postmenopausal women aged 50–79 years without known CVD or cancer during baseline enrolment (1993–1998) of the Women’s Health Initiative. They collected dietary information using a validated food frequency questionnaire. Incidence CVD (ie, ischaemic heart disease [IHD] and stroke) as well as all-cause and cause-specific mortality were ascertained and adjudicated through February 2018.

Overall, 9,808 incidence CVD cases and 19,508 all-cause deaths occurred during a median follow-up of 17.8 and 18.9 years, respectively. Dietary cholesterol intake was found to be modestly associated with incident CVD (Q5 vs Q1: hazard ratio [HR], 1.12, 95 percent confidence interval [CI], 1.03–1.21; p_trend<0.001) and all-cause mortality (Q5 vs Q1: HR, 1.09, 95 percent CI, 1.02–1.15; p_trend<0.001) after multivariable adjustment for traditional risk factors and key dietary nutrients including saturated fat.

Dietary cholesterol was also significantly associated with incident IHD (p_trend=0.007), incident ischaemic stroke (p_trend=0.002), and CVD mortality (p_trend=0.002) and inversely associated with incident haemorrhagic stroke (p_trend=0.037). Moreover, dietary cholesterol showed no association with mortality from cancer, Alzheimer disease/dementia, respiratory diseases, or other causes (p_trend>0.05).

In addition, higher egg intake (≥1 egg/d) correlated with moderately higher risk of incident CVD (HR, 1.14, 95 percent CI, 1.04–1.25; p_trend=0.004) and all-cause mortality (HR, 1.14, 95 percent CI, 1.07–1.22; p_trend<0.0001) compared with consumption of <1 egg/wk.