MedicalResearch.com Interview with:
Victor Wenze Zhong, Ph.D.
Department of Preventive Medicine
Feinberg School of Medicine
Chicago, IL 60611
MedicalResearch.com: What is the background for this study?
Response: Dietary cholesterol is a common nutrient in human diet. Eggs, specially egg yolks, are the single richest source of dietary cholesterol among all commonly consumed foods. The associations between dietary cholesterol consumption and cardiovascular disease and mortality remain controversial despite decades of research. Eating less than 300 mg of dietary cholesterol per day was the guideline recommendation before 2015. However, the most recent 2015-2020 Dietary Guidelines for Americans no longer include a daily consumption limit for dietary cholesterol and recommend weekly egg consumption as part of the healthy US-style eating pattern. Whether these recommendations are appropriate have been intensely debated.
MedicalResearch.com: What are the main findings?
Response: We identified dose-response associations of dietary cholesterol or egg consumption with incident cardiovascular disease and all-cause mortality. Greater consumption means higher risk.
- US adults who ate more dietary cholesterol had higher risk of incident cardiovascular disease and all-cause mortality.
- US adults who ate more eggs had higher risk of incident cardiovascular disease and all-cause mortality. This positive association appeared to be driven by the high dietary cholesterol content of eggs.
MedicalResearch.com: What should readers take away from your report?
Response: Contrary to the recommendation from the current Dietary Guidelines for Americans, our study suggests that dietary cholesterol is still a nutrient of concern for overconsumption. Any level of egg consumption is associated with increased risk of cardiovascular disease and mortality, because we found a dose-response association. For reducing risk of cardiovascular disease and premature death, limiting consumption of cholesterol-rich foods such as eggs (specially egg yolks), processed meat, unprocessed red meat is important. This recommendation is appropriate even for those who consume a healthy eating pattern.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Future studies are needed to understand the mechanisms underlying the positive associations of dietary cholesterol or egg consumption with incident cardiovascular disease and all-cause mortality.
MedicalResearch.com: Is there anything else you would like to add?
Response: Our study has limitations. This is an observational study that cannot prove that dietary cholesterol or egg intake can cause cardiovascular disease or death. Also, we cannot rule out residual confounding.
Zhong VW, Van Horn L, Cornelis MC, et al. Associations of Dietary Cholesterol or Egg Consumption With Incident Cardiovascular Disease and Mortality. JAMA. 2019;321(11):1081–1095. doi:10.1001/jama.2019.1572
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