Poster Topical Area: Aging and Chronic Disease
Poster Board Number: 77
Objective: After years of concern about dietary cholesterol and cardiovascular disease risk, the 2015 Dietary Guidelines determined that dietary cholesterol was no longer a nutrient of concern. Some questions have remained, however, about whether dietary cholesterol might have adverse cardiovascular effects among the special population of adults with impaired fasting glucose or diabetes. To address this question, we examined the association between dietary cholesterol and lipid levels (LDL, HDL, and triglycerides) among this population with metabolic dysfunction as well as long-term risk of cardiovascular disease in this same population.
We used data for 993 subjects (40.9% female), ages 35-65 years, with impaired fasting glucose or type 2 diabetes in the prospective Framingham Offspring Study. Dietary cholesterol was assessed using 3-day diet records at exams 3 and 5. Serum lipid data from the same exams were used for cross-sectional analyses. Prospective analyses were used to examine risk of cardiovascular disease according to sex-specific tertiles of average dietary cholesterol intake. Statistical analyses included analysis of covariance and Cox proportional hazards models to adjust for confounding by sex, age, cigarette smoking, waist circumference, lipid-lowering medicine, and saturated fat and carbohydrate intake.
We found there was no statistically significant association between dietary cholesterol intake and fasting LDL or HDL or LDL/HDL ratio, regardless of lipid-lowering medication use over 20 years of follow-up. In longitudinal Cox proportional hazards analyses, the adjusted HR for CVD in the highest sex-specific tertile of dietary cholesterol intake was 0.61 (95% CI: 0.41 to 0.9).
Among subjects with impaired fasting glucose or diabetes, there was no evidence for an adverse effect of dietary cholesterol on serum lipids or total cardiovascular risk. In fact, those with the highest intakes of dietary cholesterol had lower LDL-C levels and a non-statistically significant reduction in cardiovascular risk.
Boston University School of medicine