O-58 - Each +300 mg-day dietary cholesterol associated with higher CVD (HR 1.17) and mortality (1.18) across 6 US cohorts
The dietary-cholesterol exposure result. Associations were monotonic with no significant nonlinear terms (P for nonlinear 0.19-0.83), i.e. no apparent threshold.
Link to originalMethodology
Individual-participant-data pooling of 6 US prospective cohorts (ARIC, CARDIA, CHS, Framingham Offspring, Jackson Heart Study, MESA — the NHLBI Lifetime Risk Pooling Project; D-1), 29,615 participants (mean age 51.6; 44.9% men; 31.1% Black), data 1985-2016, median follow-up 17.5 years (max 31.3); 5,400 incident CVD events, 6,132 deaths. Self-reported diet (mostly a single baseline FFQ/diet-history per cohort) was harmonized across instruments via a standardized protocol. Exposures: dietary cholesterol (mg/day) and egg consumption (number/day). Outcomes: incident CVD (composite of fatal/nonfatal CHD, stroke, heart failure, other CVD death) and all-cause mortality, reported as HR and absolute risk difference over follow-up, adjusted for demographic, socioeconomic, and behavioral factors; a further model adds dietary cholesterol to the egg model. Observational design with mostly single-baseline diet (regression-dilution and residual-confounding vulnerability).
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Why this is evidence
Dietary cholesterol from all sources carries a monotonic CVD/mortality dose-response, i.e. cholesterol per se (not egg per se) is the graded exposure — direct support for H-26. H-3 predicts cholesterol quantity is a minor lever; H-54 predicts even this cholesterol association is confounded.