TOPLINE:
Daily intake of > 300 mg of dietary cholesterol was associated with an increased risk for myocardial infarction (MI) among veterans; this risk was further elevated when high intake of cholesterol was accompanied by poor adherence to the Dietary Approaches to Stop Hypertension (DASH) diet.
METHODOLOGY:
- Researchers analyzed data from 180,156 veterans (mean age, 62 years; 90% men; 80% White) to examine the relationship between dietary cholesterol and the incidence of MI.
- They assessed the intake of dietary cholesterol using a self-reported questionnaire that evaluated the frequency of standard portions of each food item consumed in the previous year.
- Eggs, chicken or turkey, beef, pork, and lamb were major sources of cholesterol. A daily intake of ≥ 300 mg of dietary cholesterol was considered high, while an intake of less than 300 mg was classified as low.
- Dietary quality was estimated using the DASH score on the basis of the consumption of eight components: Fruits, vegetables, nuts and legumes, low-fat dairy products, whole grain, sweetened beverages, sodium, and red and processed meats.
- The primary outcome was incident MI, assessed over a mean follow-up duration of 3.5 years.
TAKEAWAY:
- A linear dose-response association was observed between the intake of dietary cholesterol and the risk for MI (P for trend = .003).
- Each 100-mg/d increase in the intake of dietary cholesterol was associated with a 5% increase in the risk for MI (adjusted relative risk [aRR], 1.05; 95% CI, 1.02-1.08).
- Participants with a dietary cholesterol intake of 300 mg/d of more had a 15% higher risk for MI than those whose cholesterol intake was less than 300 mg/d (aRR, 1.15; 95% CI, 1.06-1.25).
- Poor adherence to the DASH diet (a DASH score in the lower 60%) combined with a high intake of dietary cholesterol was associated with a 36% increased risk for MI (aRR, 1.36; 95% CI, 1.21-1.52), whereas each factor alone was linked to approximately a 20% higher risk for MI.
IN PRACTICE:
“Reductions in cholesterol intake, which can be achieved by lowering the intake of meat and eggs, may reduce the risk of incident MI. Encouraging such dietary recommendations to target reduced cholesterol intake may potentially improve cardiovascular fitness for veterans,” the authors the study wrote.
SOURCE:
This study, led by Xuan-Mai T. Nguyen, MD, PhD, of the Million Veteran Program Boston Coordinating Center at the Veterans Affairs Boston Healthcare System, Boston, was published online on February 08, 2025, in the Journal of the American Heart Association.
LIMITATIONS:
This study used survey data that can be subject to influence due to response bias. The study population was predominantly men and White individuals, thereby limiting the generalizability of the findings. This observational study was based on the intake of nutrients from foods, which may have restricted any causal effect of the findings.
DISCLOSURES:
This study was based on data from the Million Veteran Program supported by awards from the Department of VA and was supported by VA Merit Awards. The authors reported no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.