Dietary cholesterol and cardiovascular disease

The link between consuming cholesterol through food, including eggs, and developing cardiovascular disease remains controversial. Recent review of data from multiple studies suggested no significant link between the two; however, another study suggested that eggs, as a major source of cholesterol in the American diet, may actually increase risk of cardiovascular disease. Analysis of almost 30,000 participants who self-reported their diet information was released this week in JAMA (1). The primary purpose of the study was to determine if cholesterol consumed through diet or egg consumption was linked with cardiovascular disease events, including fatal or nonfatal stroke or heart failure, and also if they were linked with all-cause mortality. Participants were followed for a median of 17.5 years. Although the link was modest, there was a significantly increased risk of incident cardiovascular disease and all-cause mortality associated with dietary cholesterol or frequent (>1 per day) egg consumption. Risk increased as consumption levels increased. Although data across multiple studies are conflicting with respect to the link between dietary cholesterol, including eggs, and cardiovascular disease, the current study suggests that consumers should consider their cholesterol intake when planning a balanced diet, particularly if at risk of cardiovascular events. A registered dietitian should be consulted to better inform dietary decisions.

(1) Zhong VW et al. Associations of dietary cholesterol or egg consumption with incident cardiovascular disease and mortality. JAMA 2019;321(11):1081-1095.