Dietary cholesterol and cardiovascular disease: A systematic review and meta-analysis

American Journal of Clinical Nutrition

Volumn 102, Issue 2, 2015, Pages 276-294

  Berger, Samantha ^a   Raman, Gowri ^a   Vishwanathan, Rohini ^b   Jacques, Paul F ^b   Johnson, Elizabeth J ^b  

^a TUFTS MEDICAL CENTER   (United States)

^b TUFTS UNIVERSITY   (United States)

Author keywords

Cardiovascular disease; Dietary cholesterol; HDL cholesterol; LDL cholesterol; Serum cholesterol

Indexed keywords

CHOLESTEROL; HIGH DENSITY LIPOPROTEIN CHOLESTEROL; LOW DENSITY LIPOPROTEIN CHOLESTEROL; TRIACYLGLYCEROL; VERY LOW DENSITY LIPOPROTEIN CHOLESTEROL; CHOLESTEROL INTAKE;

BRAIN HEMORRHAGE; BRAIN ISCHEMIA; CARDIOVASCULAR DISEASE; CARDIOVASCULAR RISK; CEREBROVASCULAR ACCIDENT; CHOLESTEROL BLOOD LEVEL; CHOLESTEROL INTAKE; CLINICAL TRIAL (TOPIC); DATA EXTRACTION; DOSE RESPONSE; HUMAN; INTERVENTION STUDY; META ANALYSIS; NONHUMAN; PUBLISHING; QUALITY CONTROL; RANDOMIZED CONTROLLED TRIAL (TOPIC); REVIEW; SENSITIVITY ANALYSIS; SYSTEMATIC REVIEW; ADVERSE EFFECTS; BLOOD; CARDIOVASCULAR DISEASES; CONTROLLED CLINICAL TRIAL (TOPIC); CORONARY ARTERY DISEASE; EVIDENCE BASED MEDICINE; HEMORRHAGIC DISORDERS; REPRODUCIBILITY; RISK FACTOR; STROKE;

BRAIN ISCHEMIA; CARDIOVASCULAR DISEASES; CHOLESTEROL; CHOLESTEROL, DIETARY; CHOLESTEROL, HDL; CHOLESTEROL, LDL; CORONARY ARTERY DISEASE; EVIDENCE-BASED MEDICINE; HEMORRHAGIC DISORDERS; HUMANS; NON-RANDOMIZED CONTROLLED TRIALS AS TOPIC; RANDOMIZED CONTROLLED TRIALS AS TOPIC; REPRODUCIBILITY OF RESULTS; RISK FACTORS; STROKE;

EID: 84938678768     PISSN: 00029165     EISSN: 19383207     Source Type: Journal    
DOI: 10.3945/ajcn.114.100305     Document Type: Review

References (72)

1. Lichtenstein AH, Appel LJ, Brands M, Carnethon M, Daniels S, Franch HA, Franklin B, Kris-Etherton P, Harris WS, Howard B, et al. Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee. Circulation 2006;114:82-96.
2. USDA and US Dsepartment of Health and Human Services. Dietary guidelines for Americans. 7th ed. 2010. Washington (DC): US Government Printing Office; 2010.
3. Expert Dyslipidemia Panel of the International Atherosclerosis Society Panel members. An International Atheroslerosis Society Position Paper: global recommendations for the management of dyslipidemia-full report. J Clin Lipidol 2014;8:29-60.
4. McNamara DJ. Dietary cholesterol and atherosclerosis. Biochim Biophys Acta 2000;1529:310-20.
5. Graham I, Atar D, Borch-Johnsen K, Boysen G, Burell G, Cifkova R, Dallongeville J, De BG, Ebrahim S, Gjelsvik B, et al. European guidelines on cardiovascular disease prevention in clinical practice: executive summary: Fourth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J 2007;28:2375-414.
6. Houston DK, Ding J, Lee JS, Garcia M, Kanaya AM, Tylavsky FA, Newman AB, Visser M, Kritchevsky SB. Dietary fat and cholesterol and risk of cardiovascular disease in older adults: the Health ABC Study. Nutr Metab Cardiovasc Dis 2011;21:430-7.
7. Howell WH, McNamara DJ, Tosca MA, Smith BT, Gaines JA. Plasma lipid and lipoprotein responses to dietary fat and cholesterol: a metaanalysis. Am J Clin Nutr 1997;65:1747-64.
8. Nissinen MJ, Gylling H, Miettinen TA. Responses of surrogate markers of cholesterol absorption and synthesis to changes in cholesterol metabolism during various amounts of fat and cholesterol feeding among healthy men. Br J Nutr 2008;99:370-8.
9. Larsson SC, Virtamo J, Wolk A. Dietary fats and dietary cholesterol and risk of stroke in women. Atherosclerosis 2012;221:282-6.
10. Keys A, Parlin RW. Serum cholesterol response to changes in dietary lipids. Am J Clin Nutr 1966;19:175-81.
11. Harman NL, Leeds AR, Griffin BA. Increased dietary cholesterol does not increase plasma low density lipoprotein when accompanied by an energy-restricted diet and weight loss. Eur J Nutr 2008;47:287-93.
12. Herron KL, Lofgren IE, Sharman M, Volek JS, Fernandez ML. High intake of cholesterol results in less atherogenic low-density lipoprotein particles in men and women independent of response classification. Metabolism 2004;53:823-30.
13. Iso H, Stampfer MJ, Manson JE, Rexrode K, Hu F, Hennekens CH, Colditz GA, Speizer FE, Willett WC. Prospective study of fat and protein intake and risk of intraparenchymal hemorrhage in women. Circulation 2001;103:856-63.
14. Moher D, Liberati A, Tetzalff J, Altman D, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;6:e1000097.
15. Methods reference guide for effectiveness and comparative effectiveness reviews: version 1.0 [Internet]. (2007) Rockville (MD): Agency for Healthcare Research and Quality. [cited 2014 Mar 12]. Available from: http://effectivehealthcare.ahrq.gov/repFiles/2007-10DraftMethodsGuide.pdf.
16. Wells GA, Shea B, O?Connell D, Peterson J, Welch V. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analysis. Ottawa (ON): Ottawa Hospital Research Institute, 2011. [cited 2014 Mar 12]. Available from: http://www.ohri.ca/programs/clinical-epidemiology/oxford.asp.
17. Higgins JP, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA. The Cochrane Collaboration?s tool for assessing risk of bias in randomised trials. BMJ 2011; 343:d5928.
18. Lichtenstein AH, Yetley EA, Lau J. Application of systematic review methodology to the field of nutrition. J Nutr 2008;138:2297-306.
19. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials 1986;7:177-88.
20. Higgins JP, Thompson SG. Quantifying heterogeneity in a metaanalysis. Stat Med 2002;21:1539-58.
21. Ascherio A, Rimm EB, Giovannucci EL, Spiegelman D, Stampfer M, Willett WC. Dietary fat and risk of coronary heart disease in men: cohort follow up study in the United States. BMJ 1996;313:84-90.
22. Esrey KL, Joseph L, Grover SA. Relationship between dietary intake and coronary heart disease mortality: lipid research clinics prevalence follow-up study. J Clin Epidemiol 1996;49:211-6.
23. Garcia-Palmieri MR, Sorlie P, Tillotson J, Costas R Jr., Cordero E, Rodriguez M. Relationship of dietary intake to subsequent coronary heart disease incidence: the Puerto Rico Heart Health Program. Am J Clin Nutr 1980;33:1818-27.
24. He K, Merchant A, Rimm EB, Rosner BA, Stampfer MJ, Willett WC, Ascherio A. Dietary fat intake and risk of stroke in male US healthcare professionals: 14 year prospective cohort study. BMJ 2003;327: 777-82.
25. Kushi LH, Lew RA, Stare FJ, Ellison CR, el Lozy M, Bourke G, Daly L, Graham I, Hickey N, Mulcahy R, et al. Diet and 20-year mortality from coronary heart disease: the Ireland-Boston Diet-Heart Study. N Engl J Med 1985;312:811-8.
26. Mann JI, Appleby PN, Key TJ, Thorogood M. Dietary determinants of ischaemic heart disease in health conscious individuals. Heart 1997;78: 450-5.
27. McGee DL, Reed DM, Yano K, Kagan A, Tillotson J. Ten-year incidence of coronary heart disease in the Honolulu Heart Program: relationship to nutrient intake. Am J Epidemiol 1984;119:667-76.
28. Pietinen P, Ascherio A, Korhonen P, Hartman AM, Willett WC, Albanes D, Virtamo J. Intake of fatty acids and risk of coronary heart disease in a cohort of Finnish men: the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Am J Epidemiol 1997;145:876-87.
29. Posner BM, Cobb JL, Belanger AJ, Cupples LA, D'Agostino RB, Stokes J III. Dietary lipid predictors of coronary heart disease in men: the Framingham Study. Arch Intern Med 1991;151:1181-7.
30. Sauvaget C, Nagano J, Hayashi M, Yamada M. Animal protein, animal fat, and cholesterol intakes and risk of cerebral infarction mortality in the adult health study. Stroke 2004;35:1531-7.
31. Seino F, Date C, Nakayama T, Yoshiike N, Yokoyama T, Yamaguchi M, Tanaka H. Dietary lipids and incidence of cerebral infarction in a Japanese rural community. J Nutr Sci Vitaminol (Tokyo) 1997;43: 83-99.
32. Shekelle RB, Shryock AM, Paul O, Lepper M, Stamler J, Liu S, Raynor WJ Jr. Diet, serum cholesterol, and death from coronary heart disease: the Western Electric study. N Engl J Med 1981;304:65-70.
33. Shekelle RB, Stamler J. Dietary cholesterol and ischaemic heart disease. Lancet 1989;1:1177-9.
34. Stamler J, Dyer AR, Shekelle RB, Neaton J, Stamler R. Relationship of baseline major risk factors to coronary and all-cause mortality, and to longevity: findings from long-term follow-up of Chicago cohorts. Cardiology 1993;82:191-222.
35. Xu J, Eilat-Adar S, Loria C, Goldbourt U, Howard BV, Fabsitz RR, Zephier EM, Mattil C, Lee ET. Dietary fat intake and risk of coronary heart disease: the Strong Heart Study. Am J Clin Nutr 2006;84: 894-902.
36. Yaemsiri S, Sen S, Tinker L, Rosamond W, Wassertheil-Smoller S, He K. Trans fat, aspirin, and ischemic stroke in postmenopausal women. Ann Neurol 2012;72:704-15.
37. Bowman MP, Van DJ, Taper LJ, Thye FW, Ritchey SJ. Effect of dietary fat and cholesterol on plasma lipids and lipoprotein fractions in normolipidemic men. J Nutr 1988;118:555-60.
38. Clifton PM, Kestin M, Abbey M, Drysdale M, Nestel PJ. Relationship between sensitivity to dietary fat and dietary cholesterol. Arteriosclerosis 1990;10:394-401.
39. Fielding CJ, Havel RJ, Todd KM, Yeo KE, Schloetter MC,Weinberg V, Frost PH. Effects of dietary cholesterol and fat saturation on plasma lipoproteins in an ethnically diverse population of healthy young men. J Clin Invest 1995;95:611-8.
40. Flaim E, Ferreri LF, Thye FW, Hill JE, Ritchey SJ. Plasma lipid and lipoprotein cholesterol concentrations in adult males consuming normal and high cholesterol diets under controlled conditions. Am J Clin Nutr 1981;34:1103-8.
41. Flynn MA, Nolph GB, Flynn TC, Kahrs R, Krause G. Effect of dietary egg on human serum cholesterol and triglycerides. Am J Clin Nutr 1979;32:1051-7.
42. Flynn MA, Nolph GB, Osio Y, Sun GY, Lanning B, Krause G, Dally JC. Serum lipids and eggs. J Am Diet Assoc 1986;86:1541-8.
43. Ginsberg HN, Karmally W, Siddiqui M, Holleran S, Tall AR, Rumsey SC, Deckelbaum RJ, Blaner WS, Ramakrishnan R. A dose-response study of the effects of dietary cholesterol on fasting and postprandial lipid and lipoprotein metabolism in healthy young men. Arterioscler Thromb 1994;14:576-86.
44. Ginsberg HN, Karmally W, Siddiqui M, Holleran S, Tall AR, Blaner WS, Ramakrishnan R. Increases in dietary cholesterol are associated with modest increases in both LDL and HDL cholesterol in healthy young women. Arterioscler Thromb Vasc Biol 1995;15:169-78.
45. Greene CM, Zern TL,Wood RJ, Shrestha S, Aggarwal D, Sharman MJ, Volek JS, Fernandez ML. Maintenance of the LDL cholesterol:HDL cholesterol ratio in an elderly population given a dietary cholesterol challenge. J Nutr 2005;135:2793-8.
46. Herron KL, Vega-Lopez S, Conde K, Ramjiganesh T, Shachter NS, Fernandez ML. Men classified as hypo- or hyperresponders to dietary cholesterol feeding exhibit differences in lipoprotein metabolism. J Nutr 2003;133:1036-42.
47. Herron KL, Vega-Lopez S, Conde K, Ramjiganesh T, Roy S, Shachter NS, Fernandez ML. Pre-menopausal women, classified as hypo- or hyperresponders, do not alter their LDL/HDL ratio following a high dietary cholesterol challenge. J Am Coll Nutr 2002;21:250-8.
48. Johnson C, Greenland P. Effects of exercise, dietary cholesterol, and dietary fat on blood lipids. Arch Intern Med 1990;150:137-41.
49. Kestin M, Clifton PM, Rouse IL, Nestel PJ. Effect of dietary cholesterol in normolipidemic subjects is not modified by nature and amount of dietary fat. Am J Clin Nutr 1989;50:528-32.
50. Mutungi G, Ratliff J, Puglisi M, Torres-Gonzalez M, Vaishnav U, Leite JO, Quann E, Volek JS, Fernandez ML. Dietary cholesterol from eggs increases plasma HDL cholesterol in overweight men consuming a carbohydrate-restricted diet. J Nutr 2008;138:272-6.
51. Quig DW, Thye FW, Ritchey SJ, HerbertWG, Clevidence BA, Reynolds LK, Smith MC. Effects of short-term aerobic conditioning and high cholesterol feeding on plasma total and lipoprotein cholesterol levels in sedentary young men. Am J Clin Nutr 1983;38:825-34.
52. Reaven GM, Abbasi F, Bernhart S, Coulston A, Darnell B, Dashti N, Kim H, Kulkarni K, Lamendola C, McLaughlin T, et al. Insulin resistance, dietary cholesterol, and cholesterol concentration in postmenopausal women. Metabolism 2001;50:594-7.
53. Mutungi G, Waters D, Ratliff J, Puglisi M, Clark RM, Volek JS, Fernandez ML. Eggs distinctly modulate plasma carotenoid and lipoprotein subclasses in adult men following a carbohydrate-restricted diet. J Nutr Biochem 2010;21:261-7.
54. Kehoe R. Increase in egg intake minimally affects blood cholesterol level. Poultry Adviser 1995;XXVIII(IX):31-4.
55. Duane WC. Effects of soybean protein and very low dietary cholesterol on serum lipids, biliary lipids, and fecal sterols in humans. Metabolism 1999;48:489-94.
56. Vorster HH, Benade AJ, Barnard HC, Locke MM, Silvis N, Venter CS, Smuts CM, Engelbrecht GP, Marais MP. Egg intake does not change plasma lipoprotein and coagulation profiles. Am J Clin Nutr 1992;55: 400-10.
57. Imes CC, Austin MA. Low-density lipoprotein cholesterol, apolipoprotein B, and risk of coronary heart disease: from familial hyperlipidemia to genomics. Biol Res Nurs 2013;15:292-308.
58. Lecerf JM, de Lorgeril M. Dietary cholesterol: from physiology to cardiovascular risk. Br J Nutr 2011;106:6-14.
59. McGill HC Jr. The relationship of dietary cholesterol to serum cholesterol concentration and to atherosclerosis in man. Am J Clin Nutr 1979;32:2664-702.
60. Hegsted DM. Serum-cholesterol response to dietary cholesterol: a reevaluation. Am J Clin Nutr 1986;44:299-305.
61. Weggemans RM, Zock PL, Katan MB. Dietary cholesterol from eggs increases the ratio of total cholesterol to high-density lipoprotein cholesterol in humans: a meta-analysis. Am J Clin Nutr 2001;73: 885-91.
62. Hu FB, Stampfer MJ, Manson JE, Ascherio A, Colditz GA, Speizer FE, Hennekens CH, Willett WC. Dietary saturated fats and their food sources in relation to the risk of coronary heart disease in women. Am J Clin Nutr 1999;70:1001-8.
63. Goldbourt U, Yaari S, Medalie JH. Factors predictive of long-term coronary heart disease mortality among 10,059 male Israeli civil servants and municipal employees: a 23-year mortality follow-up in the Israeli Ischemic Heart Disease Study. Cardiology 1993;82:100-21.
64. Mozaffarian D, Kumanyika SK, Lemaitre RN, Olson JL, Burke GL, Siscovick DS. Cereal, fruit, and vegetable fiber intake and the risk of cardiovascular disease in elderly individuals. JAMA 2003;289:1659-66.
65. Pietinen P, Rimm EB, Korhonen P, Hartman AM, Willett WC, Albanes D, Virtamo J. Intake of dietary fiber and risk of coronary heart disease in a cohort of Finnish men: the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Circulation 1996;94:2720-7.
66. Streppel MT, Ocke MC, Boshuizen HC, Kok FJ, Kromhout D. Dietary fiber intake in relation to coronary heart disease and all-cause mortality over 40 y: the Zutphen Study. Am J Clin Nutr 2008;88:1119-25.
67. Sempos C, Cooper R, Kovar MG, McMillen M. Divergence of the recent trends in coronary mortality for the four major race-sex groups in the United States. Am J Public Health 1988;78:1422-7.
68. Lewington S, Thomsen T, Davidsen M, Sherliker P, Clarke R. Regression dilution bias in blood total and high-density lipoprotein cholesterol and blood pressure in the Glostrup and Framingham prospective studies. J Cardiovasc Risk 2003;10:143-8.
69. McNamara DJ, Kolb R, Parker TS, Batwin H, Samuel P, Brown CD, Ahrens EH Jr. Heterogeneity of cholesterol homeostasis in man: response to changes in dietary fat quality and cholesterol quantity. J Clin Invest 1987;79:1729-39.
70. Friedlander Y, Leitersdorf E, Vecsler R, Funke H, Kark J. The contribution of candidate genes to the response of plasma lipids and lipoproteins to dietary challenge. Atherosclerosis 2000;152:239-48.
71. Koba S, Hirano T, Ito Y, Tsunoda F, Yokota Y, Ban Y, Iso Y, Suzuki H, Katagiri T. Significance of small dense low-density lipoproteincholesterol concentrations in relation to the severity of coronary heart diseases. Atherosclerosis 2006;189:206-14.
72. Asztalos BF, Tani M, Schaefer EJ. Metabolic and functional relevance of HDL subspecies. Curr Opin Lipidol 2011;22:176-85.