Dietary cholesterol may not increase risk of stroke, study says
A moderately high intake of dietary cholesterol or consumption of up to one egg per day is not associated with an elevated risk of stroke, according to a new study by researchers at the University of Eastern Finland, which was published in the American Journal of Clinical Nutrition.
No association was found in carriers of the apolipoprotein E phenotype 4 (APOE4) phenotype, which affects cholesterol metabolism and is remarkably common among the Finnish population, the researchers said.
Researchers looked at the dietary habits of 1,950 men aged between 42 and 60 years with no baseline diagnosis of a cardiovascular disease at the onset of the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD), conducted by the university in 1984-1989. APOE phenotype data were available for 1,015 of the men participating in the study. Of those, 32 percent were known carriers of APOE4, according to the study.
During a follow-up of 21 years, 217 men were diagnosed with stroke. The study found that neither dietary cholesterol nor egg consumption was associated with the risk of stroke, including in carriers of APOE4.
Findings from earlier studies addressing the association of dietary cholesterol or egg intake with the risk of stroke have been contradictory. Some studies have found an association between high dietary cholesterol intake and an increased risk of stroke, while others have associated the consumption of eggs, which are high in cholesterol, with a reduced risk of stroke. For most people, dietary cholesterol plays a very small role in affecting their serum cholesterol levels. However, in carriers of the APOE4, which significantly impacts cholesterol metabolism, the effect of dietary cholesterol on serum cholesterol levels is greater.
In Finland, the prevalence of APOE4, which is a hereditary variant, is exceptionally high, with approximately one third of the population presenting as carriers. Yet, research data on the association between a high intake of dietary cholesterol and the risk of stroke in this population group has not previously been available.
The findings suggest that moderate cholesterol intake or daily egg consumption are not associated with the risk of stroke, even in persons who are genetically predisposed to a greater effect of dietary cholesterol on serum cholesterol levels, researchers say. In the highest control group, the study participants had an average daily dietary cholesterol intake of 520 milligrams, and they consumed an average of one egg per day, which means that the findings cannot be generalized beyond these levels, the researchers said.
One egg contains approximately 200 milligrams of cholesterol. In this study, about a fourth of the total dietary cholesterol consumed came from eggs. Furthermore, the generalizability of this study is also weakened by the fact that the study population did not have a pre-existing cardiovascular disease at baseline and the size of the study population was relatively small. Therefore, researchers say the findings of the study should be verified in a larger cohort as well as in people with a pre-existing cardiovascular disease, who are currently advised to limit their intake of cholesterol and eggs.