Summary: Controlled dietary trial in mildly hypercholesterolemic subjects grouped by ApoE genotype (3/3, 3/4, 4/4; n=15 each, matched for sex, age, BMI, menopausal status, baseline cholesterol), following a fixed sequence of a standardized baseline diet, an NCEP-modified diet, and a dietary-cholesterol increase. ApoE genotype modified the lipid response to both fat and cholesterol changes: the 4/4 group showed the largest response, with even a moderate dietary-cholesterol increase producing a ~10% rise in serum total cholesterol in that group. Outcome is a surrogate endpoint (serum lipid response).
Relevance: Direct primary evidence for the anti-egg-for-ApoE4-carriers heterogeneity claim named in the brief — a genotype-defined subgroup with a materially larger cholesterol response to the same dietary-cholesterol increase that DIABEGG/Katan-type populations show little average response to.