Guo-Chong Chen1, Li-Hua Chen2, Yasmin Mossavar-Rahmani1, Victor Kamensky1, Aladdin H Shadyab3, Bernhard Haring4, Robert A Wild5, Brian Silver6, Lewis H Kuller7, Yangbo Sun8, Nazmus Saquib9, Barbara Howard10,11, Linda G Snetselaar8, Marian L Neuhouser12, Matthew A Allison3, Linda Van Horn13, JoAnn E Manson14, Sylvia Wassertheil-Smoller1, Qibin Qi1,15. 1. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA. 2. Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China. 3. Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, La Jolla, CA, USA. 4. Department of Medicine I, University of Würzburg, Würzburg, Germany. 5. Clinical Epidemiology and Obstetrics and Gynecology, Oklahoma University Health Sciences Center, Oklahoma City, OK, USA. 6. UMass Memorial Medical Center, Worcester, MA, USA. 7. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA. 8. Department of Epidemiology, College of Public Health, University of Iowa, Iowa, IA, USA. 9. College of Medicine, Sulaiman AlRajhi University, Al Bukayriah, Saudi Arabia. 10. MedStar Health Research Institute Georgetown University, Washington, DC, USA. 11. Georgetown University School of Medicine, Washington, DC, USA. 12. Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. 13. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. 14. Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. 15. Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA.
Abstract
BACKGROUND: The potential cardiovascular impact of dietary cholesterol intake has been actively debated for decades. OBJECTIVES: We aimed to evaluate associations of dietary cholesterol and egg intakes with incident cardiovascular disease (CVD) and all-cause and cause-specific mortality. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
BACKGROUND: The potential cardiovascular impact of dietary cholesterol intake has been actively debated for decades. OBJECTIVES: We aimed to evaluate associations of dietary cholesterol and egg intakes with incident cardiovascular disease (CVD) and all-cause and cause-specific mortality. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Authors: Ross L Prentice; Aaron K Aragaki; Linda Van Horn; Cynthia A Thomson; Shirley Aa Beresford; Jennifer Robinson; Linda Snetselaar; Garnet L Anderson; JoAnn E Manson; Matthew A Allison; Jacques E Rossouw; Barbara V Howard Journal: Am J Clin Nutr Date: 2017-05-17 Impact factor: 7.045
Authors: Jean-Philippe Drouin-Chartier; Siyu Chen; Yanping Li; Amanda L Schwab; Meir J Stampfer; Frank M Sacks; Bernard Rosner; Walter C Willett; Frank B Hu; Shilpa N Bhupathiraju Journal: BMJ Date: 2020-03-04
Authors: Peter F Schnatz; Xuezhi Jiang; Aaron K Aragaki; Matthew Nudy; David M O'Sullivan; Mark Williams; Erin S LeBlanc; Lisa W Martin; JoAnn E Manson; James M Shikany; Karen C Johnson; Marcia L Stefanick; Martha E Payne; Jane A Cauley; Barbara V Howard; John Robbins Journal: Obstet Gynecol Date: 2017-01 Impact factor: 7.661
Authors: Seyed Mohammad Mousavi; Nikan Zargarzadeh; Somaye Rigi; Emma Persad; Ana Beatriz Pizarro; Shirin Hasani-Ranjbar; Bagher Larijani; Walter C Willett; Ahmad Esmaillzadeh Journal: Adv Nutr Date: 2022-10-02 Impact factor: 11.567