| 45) Houston DK (2010) | The Health ABC Study | 1,941 black and white men and women aged 70-79 without prevalent CVD.
(USA) | 9
(1999-?) | 203 | CVD incidence (nonfatal MI, coronary death, or stroke) | Dietary cholesterol (not defined) |
HR = 1.47 (0.93-2.32; P = 0.10) for the highest vs lowest tertile of consumption.
Amount specific data (mg/1000 kcal):
67.3: HR = 1.
100.7: HR = 1.22 (0.82-1.79).
147.2: HR = 1.47 (0.93-2.32).
Stratified by type 2 diabetes status:
Diabetes
(45 cases) | No diabetes
(158 cases) |
HR = 3.66 (1.09-12.29; P = 0.04) for the highest vs lowest tertile of consumption.
Amount specific data (mg/1000 kcal):
67.3: HR = 1.
100.7: HR = 2.37 (0.79-7.12).
147.2: HR = 3.66 (1.09-12.29).
|
HR = 1.30 (0.78-2.16; P = 0.31) for the highest vs lowest tertile of consumption.
Amount specific data (mg/1000 kcal):
67.3: HR = 1.
100.7: HR = 1.14 (0.75-1.73).
147.2: HR = 1.30 (0.78-2.16).
|
Age, gender, race, education, field center, smoking, alcohol use, physical activity, BMI, total energy intake, protein intake, fiber intake, multivitamin use, supplemental vitamin E use, statin use, aspirin use, oral estrogen use (women only), prevalent diabetes or hypertension, saturated fat, MUFA, PUFA, and trans fat. |
| 32) Laaksonen DE (2005) | The Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD) | 1,551 men aged 42-60, and free of CVD, cancer, and diabetes.
(Finland) | 14.6
(1984-89 to 2001) | 78? | Cardiovascular death | Dietary cholesterol (not defined) | Cases did not consume significantly less (386 mg/d) than the entire cohort (393 mg/d). | Age, energy. |
| 28) Erkkilä AT (2003) | The Finnish cohort of the EUROASPIRE Study | 415 subjects (285 men and 130 women) aged 33-74 with CAD admitted to Kuopio University Hospital. | 5 | 44 | CVD risk (CVD death, AMI, or stroke | Cholesterol (not defined) | RR = 1.10 (0.81-1.50; P = 0.583) per 1-SD increment in intake. | Age, sex, diagnostic category, energy intake, serum cholesterol, serum triaglycerol, diabetes, BMI, and education. |
| 13) Tanasescu M (2004) | The Nurses' Health Study | 5,672 women with type 2 diabetes, but without CVD or cancer. | 1980 to 1994-98 | 619? | CVD events (nonfatal myocardial infarction, fatal coronary heart disease, and stroke) | Cholesterol (not defined) |
RR = 1.39 (1.04-1.88; P = 0.01) for the highest vs lowest quintile of consumption.
Amount specific data (mg/1000 kcal):
139.6: RR = 1.
175.9: RR = 0.96 (0.72-1.27).
203.6: RR = 1.16 (0.88-1.54).
236.5: RR = 1.14 (0.85-1.53).
298.2: RR = 1.39 (1.04-1.88). | Age, smoking, postmenopausal hormone use, parental history of MI before age 60, alcohol intake, moderate vigorous activities, BMI, total caloric intake, protein intake, fiber intake, multivitamin use, vitamin E supplement use, medication use, saturated, monounsaturated, polyunsaturated, and trans unsaturated fats. |
| 1) Shekelle RB (1989) | The Western Electric Study | 1,824 men aged 40-55 without IHD. | 25
(1957-58 to ?) | 396? | Death from all CVD | Dietary cholesterol (not defined) | RH = 1.46 (1.10-1.94) for the highest vs lowest quintile of consumption (difference of 184 mg/1000 kcal).
This association remained after men who were on a diet were excluded: RH = 1.50 (1.09-2.06).
Stratified by total serum cholesterol:
| < 220 mg/dl | 220-259 mg/dl | ≥ 260 mg/dl |
| RH = 1.58 (0.90-2.78)
|
RH = 1.50 (0.91-2.48)
|
RH = 1.41 (0.90-2.20)
|
Age.
The association persisted after adjustment for serum cholesterol, diastolic blood pressure, cigarette smoking, age, body mass index, and intake of energy, alcohol, saturated fatty acids, and polyunsaturated fatty acids. |
Prospective studies of dietary cholesterol and coronary heart disease:
| Author | Cohort name | Subjects | Years of follow-up | Cases | End point | Consumption of | Relative Risk (RR) | Adjustments |
| 38) Nettleton JA (2008) | The Atherosclerosis Risk In Communities (ARIC) Study. | 14,153 African-American and white adults age 45-64.
(USA) | 13.3
(1987-89 to 2003) | 1,140? (639 men, 501 women) | Incident heart failure | Dietary cholesterol (not defined) | Cases consumed more cholesterol (267.8 mg) than controls (249.4 mg; P = < 0.001). | Total energy. |
| 35) Xu J (2006) | The Strong Heart Study | 2,938 American Indians aged 47-79, and free of CHD, dialysis treatment, liver cirrhosis, or having had a kidney transplant.
(USA) | 7.2
(1993-95 to 2002) | See variables | First CHD event (nonfatal CHD [definite MI, definite CHD, and electrocardiogram-evident definite MI], and fatal CHD [death from definite MI, definite sudden death due to CHD, definite fatal CHD, and possible fatal CHD]) | Cholesterol (not defined) |
CHD event
(403 cases) | Nonfatal CHD
(298 cases) |
HR = 1.09 (0.77-1.54; P = 0.43) for the highest vs lowest quartile of consumption.
Amount specific data (mg):
83: HR = 1.
188: HR = 0.97 (0.70-1.34).
378: HR = 1.13 (0.82-1.55).
607: HR = 1.09 (0.77-1.54).
|
HR = 1.14 (0.76-1.70; P = 0.23) for the highest vs lowest quartile of consumption.
Amount specific data (mg):
83: HR = 1.
188: HR = 0.88 (0.60-1.30).
378: HR = 1.16 (0.80-1.67).
607: HR = 1.14 (0.76-1.70).
|
CHD death.
Stratified by age:
47-59
(46 cases) | 60-79
(92 cases) |
HR = 1.53 (0.46-5.13; P = 0.77) for the highest vs lowest quartile of consumption.
Amount specific data (mg):
85: HR = 1.
197: HR = 1.90 (0.60-6.04).
396: HR = 2.64 (0.88-7.88).
641: HR = 1.53 (0.46-5.13).
|
HR = 0.76 (0.38-1.54; P = 0.41) for the highest vs lowest quartile of consumption.
Amount specific data (mg):
79: HR = 1.
170: HR = 0.93 (0.49-1.77).
357: HR = 0.81 (0.42-1.56).
587: HR = 0.76 (0.38-1.54).
|
Variable of interest as a % of energy, sex, age, study center, diabetes status, BMI, HDL, LDL, triaglycerol, smoking, alcohol, hypertension, protein, and total energy. |
| 28) Erkkilä AT (2003) | The Finnish cohort of the EUROASPIRE Study | 415 subjects (285 men and 130 women) aged 33-74 with CAD admitted to Kuopio University Hospital. | 5 | See variables | CAD | Cholesterol (not defined) |
CAD death
(16 cases) | CAD death or AMI
(34 cases) |
| RR = 0.76 (0.45-1.28; P = 0.302) per 1-SD increment in intake.
|
RR = 0.97 (0.68-1.40; P = 0.887) per 1-SD increment in intake.
|
Age, sex, diagnostic category, energy intake, serum cholesterol, serum triaglycerol, diabetes, BMI, and education. |
| 28) Erkkilä AT (2003) | The Finnish cohort of the EUROASPIRE Study | 415 subjects (285 men and 130 women) aged 33-74 with CAD admitted to Kuopio University Hospital. | 5 | 38 | Revascularization | Cholesterol (not defined) | RR = 1.23 (0.91-1.66; P = 0.184) per 1-SD increment in intake. | Age, sex, diagnostic category, energy intake, serum cholesterol, serum triaglycerol, diabetes, BMI, and education. |
| 21) Mann JI (1997) | The Oxford Vegetarian Study | 10,802 subjects (4102 men and 6700 women) aged 16-79, and without pre-existing disease.
(UK) | 13.3
(1980-84 to 1995) | 45 | Ischaemic heart disease death | Dietary cholesterol (from meat, eggs, milk, cheese) |
Death rate ratio = 353 (157-796; P = < 0.001) for the highest vs lowest tertile of consumption.
Amount specific data (Tertiles not defined):
T1: DRR = 100.
T2: DRR = 181 (77-429).
T3: DRR = 353 (157-796). | Age, sex, smoking and social class.
DRR's did not appreciably change after additional adjustment for BMI. |
| 19) Pietinen P (1997) | The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study | 21,930 male smokers (≥ 5 cigarettes/day) aged 50-69, and free of CVD, diabetes or cancer.
(Finland) | 6.1
(1985-88 to 1993) | See variables | Major coronary events (first nonfatal myocardial infarction, or coronary heart disease death) | Cholesterol (not defined) |
Major coronary events
(1,399 cases) | Coronary death
(635 cases) |
RR = 0.93 (0.79-1.10; P = 0.813) for the highest vs lowest quintile of consumption.
Amount specific data (intake in mg):
390: RR = 1.
477: RR = 0.86 (0.72-1.02).
543: RR = 0.91 (0.77-1.08).
621: RR = 0.87 (0.73-1.03).
768: RR = 0.93 (0.79-1.10).
|
RR = 0.92 (0.72-1.18; P = 0.767) for the highest vs lowest quintile of consumption.
Amount specific data (intake in mg):
390: RR = 1.
477: RR = 0.90 (0.71-1.16).
543: RR = 0.81 (0.63-1.05).
621: RR = 0.86 (0.67-1.11).
768: RR = 0.92 (0.72-1.18).
|
Age, treatment group, smoking, BMI, blood pressure, intakes of energy, alcohol, and fiber, education, and physical activity. |
| 18) Esrey KL (1996) | The Lipid Research Clinics Prevalence Follow-Up Study | 4,546 men and women aged 30-79 and free of CVD.
(USA) | 12.4
(1972-76 to 1987) | See variables | CHD mortality | Cholesterol (not defined) |
Stratified by age
30-59
(52? cases) | 60-79
(40? cases) |
| RR = 1.00 (0.99-1.02) for cholesterol in 10 mg per 5000 kj.
|
RR = 1.01 (0.98-1.03) for cholesterol in 10 mg per 5000 kj.
|
Age, sex, energy intake, serum lipids, systolic blood pressure, cigarette smoking status, BMI, and glucose intolerance. |
| 16) Kromhout D (1995) | Cohort name not defined | 272 subjects (137 men and 135 women) aged 64-87 from a general practice in Rotterdam.
(The Netherlands) | 17
(1971-1987) | 58? | Primary & secondary CHD mortality | Dietary cholesterol (not defined) | No association was found with CHD mortality (no data shown). | Age, gender, and prevalence of myocardial infarction and angina pectoris. |
| 15) Knekt P (1994) | The Finnish Mobile Clinic Health Cohort | 5,133 men and women aged 30-69, and free of heart disease. | 14
(1968-72 to 1984) | 186? men, and 58? women. | CHD mortality | Cholesterol (not defined) |
| Men: | Women: |
| Cases consumed nonsignificantly more (593 mg) than controls (562 mg; P = 0.08).
|
Cases did not consume significantly more (423 mg) than controls (405 mg; P = 0.43).
|
Effect modification: No significant interaction was found with smoking, hypertension, and serum cholesterol (data not shown).Age. |
| 13) Hu FB (1997) | The Nurses' Health Study | 80,082 women aged 34-59 and without CVD, diabetes, hypercholesterolemia, or cancer. | 14
(1980-1994) | 939? | Coronary heart disease incidence (nonfatal myocardial infarction or fatal coronary disease) | Cholesterol (not defined) |
RR = 1.17 (0.92-1.50; P = 0.24) for the highest vs lowest quintile of consumption.
Amount specific data (% of energy):
132: RR = 1.
163: RR = 1.15 (0.93-1.43).
188: RR = 1.08 (0.87-1.36).
217: RR = 1.24 (0.99-1.56).
273: RR = 1.17 (0.92-1.50). | Age, time period, BMI, cigarette smoking, menopausal status, parental history of MI before age 65, multivitamin use, vitamin E supplement use, alcohol consumption, history of hypertension, aspirin use, vigorous exercise, % energy from protein, saturated fat, monounsaturated fat, polyunsaturated fat, and trans unsaturated fat. |
| 13) Ascherio A (1996) | The Health Professionals Follow Up Study | 43,757 men aged 40-75.
(USA) | 6
(1986-1992) | See variables | Coronary heart disease | Cholesterol (not defined) |
Total MI (including non-fatal MI and fatal cHD):
(734 cases) | Fatal CHD:
(229 cases) |
RR = 1.03 (0.81-1.32; P = 0.48) for the highest vs lowest quintile of consumption.
Amount specific data (mg/day):
189: RR = 1.
246: RR = 0.86 (0.67-1.11).
290: RR = 0.98 (0.76-1.25).
338: RR = 0.94 (0.73-1.20).
422: RR = 1.03 (0.81-1.32).
RR for a proportion of energy of 100 mg/1000 kcal.:
RR = 1.04 (0.91-1.18).
After additional adjustment for total fat: RR = 1.03 (0.90-1.19).
|
RR = 1.25 (0.80-1.97; P = 0.21) for the highest vs lowest quintile of consumption.
Amount specific data (mg/day):
189: RR = 1.
246: RR = 0.92 (0.56-1.50).
290: RR = 1.18 (0.75-1.87).
338: RR = 1.11 (0.70-1.76).
422: RR = 1.25 (0.80-1.97).
RR for a proportion of energy of 100 mg/1000 kcal.:
RR = 1.10 (0.88-1.38).
After additional adjustment for total fat: RR = 1.06 (0.84-1.35).
|
Age, BMI, smoking habits, alcohol consumption, physical activity, history of hypertension or high blood cholesterol, family history of before age 60, profession, and fibre intake. |
| 8) Kushi LH (1985) | The Ireland-Boston Diet-Heart Study | 1,001 middle-aged men of Irish descent. | 20
(1959-65 to 1982) | 110? | CHD mortality (death from coronary or ischemic disease) | Cholesterol (not defined) | Cases consumed more cholesterol in mg/1000 kcal than noncases (P = 0.10). | Age, systolic blood pressure, total serum cholesterol, cigarette smoking, alcohol intake, and cohort. |
| 7) Kromhout D (1984) | The Zutphen Study
(The Dutch part of The Seven Countries Study) | 857 CHD-free men aged 40-59. | 10
(1960-1970) | 30 | CHD death | Dietary cholesterol (not defined) |
| Consumption in g: | Consumption in mg/Mcal: |
| No significant difference in consumption was found between cases (445.8 mg) and noncases (428.5 mg; P = 0.714).
|
No significant difference in mg/Mcal was found between cases (164.6) and controls (142.4; P = 0.192).
|
Unadjusted. |
| 6) Marr JW (1981) | Cohort name not defined | 337 UK bank and busmen. | 10-20 | 50? | CHD death + nonfatal disease | Dietary cholesterol (not defined) | Cases consumed the same amount of dietary cholesterol (516 mg/d) as noncases (566 mg/d; P = not significant). | Age and occupation. |
| 5) Posner BM (1991) | The Framingham Study | 793 men aged 45-65 without preexisting CVD or cancer. | 16
(1966-69 to ?) | See variables | CHD incidence (angina pectoris, coronary insufficiency, MI, sudden death, or nonsudden death from CHD) | Dietary cholesterol (not defined) |
Men aged 45-55:
(99? cases) | Men aged 56-65:
(114? cases) |
| RR = 0.99 (0.82-1.20) for consumption 300 g (NCEP recommendation) vs 529.6 g.
|
RR = 0.93 (0.79-1.09) for consumption 300 g (NCEP recommendation) vs 531.8 g.
|
Energy intake, physical activity, serum cholesterol level, systolic blood pressure, left ventricular hypertrophy, cigarette smoking, glucose intolerance, and Metropolitan relative weight. |
| 5) Gordon T (1981) | The Framingham Study | 859 men aged 45-64 and free of CHD. | 4
(1966-69 to ?) | 14? | CHD death | Cholesterol (not defined) | Cases consumed the same amount (505 mg) as noncases (530 mg). | Age. |
| 5) Gordon T (1981) | The Framingham Study | 859 men aged 45-64 and free of CHD. | 4
(1966-69 to ?) | See variables | CHD incidence | Cholesterol (not defined) |
Total CHD
(MI, CHD death and angina pectoris)
(79? cases) | MI or CHD death
(51? cases) | Other CHD
(angina pectoris)
(28? cases) |
| Cases consumed the same amount (534 mg) as noncases (529 mg).
|
Cases consumed the same amount (497 mg) as noncases (529 mg).
|
Cases consumed the same amount (594 mg) as noncases (529 mg).
|
Age. |
| 5) Gordon T (1981) | The Puerto Rico Heart Health Program | 8,218 men aged 45-64 and free of CHD. | 6
(1965-68 to ?) | 71? | CHD death | Cholesterol (not defined) | Cases consumed the same amount (405 mg) as noncases (419 mg). | Age. |
| 5) Gordon T (1981) | The Puerto Rico Heart Health Program | 8,218 men aged 45-64 and free of CHD. | 6
(1965-68 to ?) | See variables | CHD incidence | Cholesterol (not defined) |
Total CHD
(MI, CHD death and angina pectoris)
(286? cases) | MI or CHD death
(163? cases) | Other CHD
(angina pectoris)
(123? cases) |
| Cases consumed the same amount (419 mg) as noncases (417 mg).
|
Cases consumed the same amount (431 mg) as noncases (417 mg).
|
Cases consumed the same amount (399 mg) as noncases (417 mg).
|
Age. |
| 4) Garcia-Palmieri MR (1980) | The Puerto Rico Heart Health Program | 8,218 men aged 45-64 who were free of CHD at entry. | 6
(1965-?) | See variables | CHD incidence | Cholesterol (not defined) |
Total CHD (MI, CHD death, coronary insufficiency, and angina pectoris):
Urban men
(213 cases) | Rural men
(73 cases) |
Consumption in g: No significant difference was found between cases (449 mg), and noncases (442 mg).
Consumption /100 kcal: No significant difference was found between cases (19.4), and noncases (18.7).
|
Consumption in g: No significant difference was found between cases (335 mg), and noncases (358 mg).
Consumption /100 kcal: No significant difference was found between cases (14.2), and noncases (15.4).
|
MI and CHD death:
Urban men
(129 cases) | Rural men
(34 cases) |
Consumption in g: No significant difference was found between cases (457 mg), and noncases (442 mg).
Consumption /100 kcal: No significant difference was found between cases (20.0%), and noncases (18.7%).
|
Consumption in g: No significant difference was found between cases (333 mg), and noncases (358 mg).
Consumption /100 kcal: No significant difference was found between cases (15.1), and noncases (15.4).
|
CHD death:
Urban men
(57 cases) | Rural men
(14 cases) |
| Consumption in g: No significant difference was found between cases (420 mg), and noncases (445 mg).
|
Consumption in g: No significant difference was found between cases (363 mg), and noncases (358 mg).
|
Coronary insufficiency:
Urban men
(31 cases) | Rural men
(14 cases) |
| Consumption in g: No significant difference was found between cases (369 mg), and noncases (442 mg).
|
Consumption in g: No significant difference was found between cases (234 mg), and noncases (358 mg).
|
Angina pectoris:
Urban men
(53 cases) | Rural men
(25 cases) |
| Consumption in g: No significant difference was found between cases (454 mg), and noncases (442 mg).
|
Consumption in g: No significant difference was found between cases (398 mg), and noncases (358 mg).
|
Age. |
| 3) McGee (1985) | The Honolulu Heart Program | 7,088 men of Japanese ancestry without CVD or cancer, and living on the island of Oahu. | 10
(1965-68 to ?) | 99? | CHD death | Dietary cholesterol (not defined) |
| Consumption in mg: | Consumption per 1000 calories: |
| No significant association was found (risk was > 1; no data shown).
|
A positive association was found (No data shown; P = < 0.05).
|
Age, systolic blood pressure, BMI, physical activity index, and cigarettes smoked per day. |
| 3) McGee DL (1984) | The Honolulu Heart Program | 7,088 men of Japanese ancestry aged 45-68, and without coronary heart disease, stroke, or cancer.
(Oahu island) | 10
(1965-68 to ?) | See variables | Coronary heart disease incidence (myocardial infarction, CHD death, angina pectoris, or coronary insufficiency) | Cholesterol (not defined) |
Mg.
Age adjusted:
Total CHD
(456? cases) | MI or CHD death
(309? cases) | Angina pectoris or coronary insufficiency
(147? cases) |
| Cases did not consume significantly more (558.1 mg) than controls (552.2 mg).
|
Cases did not consume significantly more (561.8 mg) than controls (552.2 mg).
|
Cases did not consume significantly less (550.3 mg) than controls (552.2 mg).
|
Cholesterol/1000 calories:
Total CHD
(456? cases) | MI or CHD death
(309? cases) | Angina pectoris or coronary insufficiency
(147? cases) |
| Cases consumed significantly more than controls (SLC = 0.10; P = < 0.05).
|
Cases consumed significantly more than controls (SLC = 0.12; P = < 0.05).
|
Cases did not consume significantly more than controls (SLC = 0.04).
|
SLC = Standardized logistic coefficient.Age, systolic blood pressure, serum cholesterol, cigarettes, body weight, physical activity, and intakes of calories, carbohydrates, starch, other carbohydrates, alcohol, vegetable protein, protein, fat, saturated fat, and polyunsaturated fat. |
| 5) Gordon T (1981) | The Honolulu Heart Study | 7,272 men aged 45-64 of Japanese ancestry and free of CHD. | 6
(1965-68 to ?) | 78? | CHD death | Cholesterol (not defined) | Cases consumed the same amount (592 g) as noncases (555 g). | Age. |
| 5) Gordon T (1981) | The Honolulu Heart Study | 7,272 men aged 45-64 of Japanese ancestry and free of CHD. | 6
(1965-68 to ?) | See variables | CHD incidence | Cholesterol (not defined) |
Total CHD
(MI, CHD death and angina pectoris)
(264? cases) | MI or CHD death
(164? cases) | Other CHD
(angina pectoris)
(100? cases) |
| Cases consumed the same amount ( g) as noncases ( g).
|
Cases consumed the same amount ( g) as noncases ( g).
|
Cases consumed the same amount ( g) as noncases ( g).
|
Age. |
| 3) Yano K (1978) | The Honolulu Heart Study | 7,705 men aged 45-68 of Japanese ancestry and living in Hawaii. | 6
(1965-68 to ) | See variables | CHD incidence (death attributable to CHD including sudden death; nonfatal myocardial infarction (MI); acute coronary insufficiency (CI) ascertained by severe chest pain lasting more than 30 minutes, with documented transient ST-T wave changes on ECG and without elevation of enzyme levels; angina pectoris (AP) ascertained by episodic substernal pain brought on by exertion and relieved by rest.) | Cholesterol (not defined) |
Consumption in amounts:
CHD death + MI
(179? cases) | Acute CI
(27? cases) | Angina
(88? cases) |
| Cases consumed the same amount of cholesterol (521 mg/d) as noncases (549 mg/d; P = not significant).
|
Cases consumed the same amount of cholesterol (557 mg/d) as noncases (549 mg/d; P = not significant).
|
Cases consumed the same amount of cholesterol (587 mg/d) as noncases (549 mg/d; P = not significant).
|
Age. |
| 1) Daviglus ML (1997) | The Chicago Western Electric Study | 1,822 men aged 40-55, and free of cardiovascular disease. | 30
(1957-59 to ?) | 293? | MI death | Dietary cholesterol (not defined) | Dietary cholesterol intake was significantly related to mortality from myocardial infarction (no data shown). | Age, education, religion, systolic pressure, serum cholesterol, number of cigarettes smoked, BMI, diabetes, electrocardiographig abnormalities, and intake of energy, saturated, monounsaturated, and polyunsaturated fatty acids, total protein, cabohydrate, alcohol, iron, thiamine, riboflavin, niacin, vitamin C, beta carotene, and retinol. |
| 1) Goff DC Jr (1992) | The Western Electric Study | 1,792 men aged 40-56 from Chicago, and without coronary heart disease or diabetes. | 25
(1958-1983) | See variables | Coronary heart disease death | Dietary cholesterol (not defined) |
Stratified by subscapular skinfold thickness:
3-14 mm
(77 cases) | 15-20 mm
(114 cases) | 21-40 mm
(106 cases) |
Amount specific data (dietary cholesterol in mg/day):
275-649: RR = 1 (Reference group
650-799: RR = 1.6
800-1,663: RR = 1.8
RR = 1.44 (1.10-1.90) for a 225 mg/day greater intake.
|
Amount specific data (dietary cholesterol in mg/day):
275-649: RR = 1.7
650-799: RR = 1.7
800-1,663: RR = 2.1
RR = 1.07 (0.84-1.36) for a 225 mg/day greater intake.
|
Amount specific data (dietary cholesterol in mg/day):
275-649: RR = 1.6
650-799: RR = 2.2
800-1,663: RR = 1.6
RR = 0.95 (0.76-1.20) for a 225 mg/day greater intake.
|
Age, % of calories from saturated and polyunsaturated fatty acids, energy intake, ethanol intake, serum total cholesterol, systolic blood pressure, cigarette smoking, family history of cardiovascular disease, and evidence of major organ disease at baseline. |
| 1) Shekelle RB (1989) | The Western Electric Study | 1,824 men aged 40-55 without IHD. | 25
(1957-58 to ?) | 307? | Ischaemic heart disease mortality | Dietary cholesterol (not defined) |
RH = 1.38 (1.00-1.90) for the highest vs lowest quintile of consumption (difference of 184 mg/1000 kcal).
25-year mortality rates/1000 person-years (mg/1000 kcal):
81-186: RR = 6.9
187-214: RR = 6.2
215-245: RR = 8.3
246-288: RR = 7.1
289-590: RR = 9.6 | Age.
The association persisted after adjustment for serum cholesterol, diastolic blood pressure, cigarette smoking, age, body mass index, and intake of energy, alcohol, saturated fatty acids, and polyunsaturated fatty acids. |
| 1) Shekelle RB (1981) | The Western Electric Study | 1,900 men aged 40-55 who were free of CHD | 19
(1957-?) | ? | CHD death | Dietary cholesterol (not defined) |
A positive relation was found for the highest vs lowest tertile of consumption in mg/1000 kcal (P = 0.008).
Amount specific data (Tertiles not defined):
T1: 10.9
T2: 9.5
T3: 13.6 | Age, systolic blood pressure, number of cigarettes/day, serum cholesterol, alcoholic drinks/month, BMI, and ethnicity. |
1) Paul O/
Oglesby P (1963) | The Western Electric Study | 1,885 American men of Polish and Bohemian ancestry aged 40-55 without a history of MI or angina pectoris. | 4.5
(1957-?) | 88? | CHD risk (angina pectoris, MI, or CHD death. excluding sudden death) | Dietary cholesterol (not defined) | No significant difference was apparent between cases (721 mg/day), and controls (757 mg/day; no data shown). | Unadjusted. |
Prospective studies of dietary cholesterol and stroke:
| Author | Cohort name | Subjects | Years of follow-up | Cases | End point | Consumption of | Relative Risk (RR) | Adjustments |
| 41) Boden-Albala B (2009) | The Northern Manhattan Study (NOMAS) | 3,183 Hispanic, non-Hispanic white, and non-Hispanic black men and women aged > 40, and without stroke.
(USA) | 5.5
(1993-2001 to ?) | 142? | Ischemic stroke risk | Dietary cholesterol (not defined) | No increased risk was found for the highest vs lowest quintile of consumption (data not shown). | Age, race/ethnicity, sex, education, hypertension, diabetes, coronary artery disease, moderate alcohol, current and previous smoking, BMI, leisure time physical activity, sodium, potassium, fruit/vegetable, calcium, fiber, vitamin E, and calories. |
| 30) Sauvaget C (2004) | The Adult Health Study
(A subcohort of the Hiroshima/Nagasaki Life Span Study) | 3,731 male and female atomic bomb survivors aged 35-89.
(Japan) | Median 14
(1983-2001) | 60 | Cerebral infarction death | Cholesterol (not defined) |
RH = 0.38 (0.18-0.84; P = 0.0117) for the highest vs lowest tertile of consumption.
Amount specific data (mg/day):
152: RH = 1.
357: RH = 0.60 (0.32-1.13).
624: RH = 0.38 (0.18-0.84).
The effect became weaker after adjustment for animal fat: RH = 0.65 (0.29-1.45) per unit of 450 mg/d. | Stratified by sex and age.
Adjusted for radiation dose, city, BMI, smoking status, alcohol habits, medical history of hypertension and diabetes, fruit and vegetable intake and total energy intake. |
| 25) Iso H (2003) | No cohort name defined | 4,775 individuals (2,269 men and 2,506 women) aged 40-69, and without stroke.
(Japan) | 14.3
(1973-88 to 1997) | 68 | Intraparenchymal hemorrhage incidence (lasting ≥ 24 hours or until death) | Cholesterol (not defined) |
RR = 0.71 (0.35-1.41; P = 0.25) for the highest vs lowest quartile of consumption.
Amount specific data (mg/day):
98: RR = 1.
191: RR = 0.98 (0.52-1.84).
318: RR = 0.74 (0.36-1.51).
507: RR = 0.71 (0.35-1.41).
Other strokes: No correlations were found with risk of other stroke subtypes (subarachnoid hemmorhage [41 cases], and ischemic stroke [166 cases]; Data not shown). | Age, sex, total energy, BMI, hypertension, diabetes, serum total cholesterol, smoking status, ethanol intake, and menopausal status. |
| 20) Ross RK (1997) | No cohort name defined | 18,244 men aged 45-64 from Shanghai, and without cancer.
(China) | 1986-89 to 1994 | 245 | Stroke/cerebrovascular accident death | Cholesterol (not defined) |
RR = 1.2 (0.8-1.7) for the highest vs lowest tertile of consumption.
Amount specific data (Tertiles not defined):
T1: RR = 1.
T2: RR = 1.0 (0.7-1.4).
T3: RR = 1.2 (0.8-1.7). | Education, marital status, BMI, lifetime cigarette smoking, lifetime ethanol intake, and history of hypertension. |
| 13) He K (2003) | The Health Professionals Follow Up Study | 43,732 men aged 40-75, and without a history of CVD or diabetes mellitus.
(USA) | 14
(1986-2000) | See variables | Stroke risk | Cholesterol (not defined) |
Ischaemic stroke
(embolism or thrombosis)
(455 cases) | Haemorrhagic stroke
(subarachnoid and intracerebral)
(125 cases) |
RR = 0.93 (0.66-1.30; P = 0.63) for the highest vs lowest quintile of consumption.
Amount specific data (mg/d):
189: RR = 1.
239: RR = 0.93 (0.68-1.27).
278: RR = 0.80 (0.57-1.10).
321: RR = 0.76 (0.54-1.06).
398: RR = 0.93 (0.66-1.30).
|
RR = 1.16 (0.61-2.20; P = 0.37) for the highest vs lowest quintile of consumption.
Amount specific data (mg/d):
189: RR = 1.
239: RR = 0.66 (0.34-1.26).
278: RR = 0.99 (0.54-1.82).
321: RR = 0.90 (0.48-1.70).
398: RR = 1.16 (0.61-2.20).
|
Age, smoking, BMI, physical activity, history of hypertension, smoking status, aspirin use, multivitamin use, and consumption of alcohol, potassium, fibre, vitamin E, total servings of fruit and vegetables, total energy, hypercholesterolaemia, polyunsaturated fat, monounsaturated fat, saturated fat, and trans fat. |
| 13) Iso H (2001) | The Nurses' Health Study | 85,764 women aged 34-59, and without cancer, angina, MI, coronary revascularization, stroke, or other CVD.
(USA) | 14
(1980-1994) | 74 | Intraparenchymal hemmorhage risk | Cholesterol (not defined) |
RR = 1.04 (0.46-2.38; P = 0.98) for the highest vs lowest quintile of consumption.
Amount specific data (mg/d):
212: RR = 1.
275: RR = 1.36 (0.63-2.93).
322: RR = 1.68 (0.83-3.51).
371: RR = 1.38 (0.64-2.98).
465: RR = 1.04 (0.46-2.38). | Age, smoking status, time interval, BMI, alcohol intake, menopausal status and postmenopausal hormone use, vigorous exercise, usual aspirin use, multivitamin use, vitamin E use, n3 fatty acid intake, calcium intake, and histories of hypertension, diabetes, and high cholesterol levels, and total energy. |
| 12) Simon JA (1995) | The Multiple Risk Factor Intervention Trial | 12,866 US men, aged 35-57.
(Nested case-control) | 6.9
(1973-76 to ?) | 96 | Stroke incidence (fatal or nonfatal) | Cholesterol (not defined) | Cases did not consume significantly more (465 mg/d) than controls (423 mg/d). | Unadjusted.
Cases matched to controls by age, clinical center, treatment group, and date of randomization. |
| 9) Seino F (1997) | The Shibata Study | 954 men and 1,329 women, age ≥ 40, and free of stroke.
(Japan) | 15.5
(1977-1992) | 141? | Stroke incidence (cerebral hemorrhage, cerebral infarction and subarachnoid hemorrhage. Excluding transient cerebral ischemic attack) | Dietary cholesterol (not defined) |
RR = 1.11 (0.48-2.56; P = 0.58) for the highest vs lowest quartile of consumption.
Amount specific data (mg/day):
246: RR = 1.
341: RR = 1.22 (0.64-2.31).
416: RR = 1.36 (0.70-2.62).
548: RR = 1.11 (0.48-2.56). | Sex, age, diastolic blood pressure, atrial fibrillation, energy, and total fat. |
| 7) Keli SO (1994) | The Zutphen Study
(The Dutch contribution to The Seven Countries Study) | 552 men aged 50-69.
(The Netherlands) | 1970-1985 | 42 | First stroke incidence (a sudden onset of neurological paralysis of > 24-hour duration or leading to death) | Dietary cholesterol (not defined) | Stroke cases consumed the same amount (36.2 mg/MJ) as noncases (38.6 mg/MJ). | Unadjusted. |
| 3) McGee (1985) | The Honolulu Heart Program | 7,088 men of Japanese ancestry without CVD or cancer, and living on the island of Oahu. | 10
(1965-68 to ?) | 61? | Stroke death | Dietary cholesterol (not defined) |
| Consumption in mg: | Consumption per 1000 calories: |
| No significant association was found (risk was < 1; no data shown).
|
No significant association was found (risk was < 1; no data shown).
|
Age, systolic blood pressure, BMI, physical activity index, and cigarettes smoked per day. |
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