Dietary cholesterol and heart health: a systematic review and meta‐analysis (267.6)

Abstract

Objectives: To conduct a systematic review and meta‐analysis evaluating the effects of dietary cholesterol on cardiovascular outcomes in healthy adults.Methods: Medline, Cochrane Central, and CAB databases were searched through March 31, 2013 for prospective studies in English‐language that quantified dietary cholesterol and cardiovascular or lipid outcomes in adults. Random effect models meta‐analysis was used when at least 3 studies reported the same outcome.Results: 28 studies (16 cohorts with 361,923 subjects and 9 randomized trials with 579 subjects) published between 1981 and 2013 were eligible. Dietary cholesterol was not significantly associated with ischemic heart disease deaths (4 cohorts, summary relative risk [RR] 1.35, 95% CI 0.91, 2.01) or ischemic stroke (4 cohorts, summary RR 1.13, 95% CI 0.99, 1.28). Dietary cholesterol intake 蠅300mg/day compared to <300 mg/day, had a small but statistically significant increase in plasma total cholesterol (9 trials, net change 6.76 mg/dL, 95% CI 0.71, 12.80, p=0.029) and LDL cholesterol (9 trials, net change 5.41 mg/dL, 95% CI 0.62, 10.20, p=0.027), but no significant change in HDL cholesterol.Conclusions: Reviewed studies were heterogeneous and lacked methodological rigor. Carefully controlled efficacy studies and well‐conducted cohort studies may still be useful to pin down the relative effects of dietary cholesterol on cardiovascular outcomes.Grant Funding Source: This study is supported by the Egg Nutrition Center