Dietary Cholesterol and Myocardial Infarction in the Million Veteran Program

Area of Science:

• Cardiovascular Disease Epidemiology
• Nutritional Science
• Public Health

Background:

• Coronary artery disease (CAD) is a major cause of death in the US, with myocardial infarction (MI) as a key complication.
• The link between dietary cholesterol and CAD risk is debated.
• This study investigates dietary cholesterol's impact on MI incidence in a large veteran cohort.

Purpose of the Study:

• To examine the association between dietary cholesterol intake and the risk of myocardial infarction (MI).
• To clarify the dose-response relationship between dietary cholesterol and MI incidence.

Main Methods:

• Analysis of data from 180,156 veterans in the prospective Million Veteran Program.
• Assessment of dietary cholesterol intake and MI risk using linear and nonlinear statistical models.
• Comparison of MI risk between high (≥300 mg/d) and low (<300 mg/d) cholesterol intake groups.

Main Results:

• A linear, dose-response relationship was observed between dietary cholesterol intake and MI risk.
• Each 100 mg/d increase in dietary cholesterol was associated with a 5% higher risk of MI (RR, 1.05; 95% CI, 1.02-1.08).
• Individuals consuming >300 mg/d had a 15% increased MI risk compared to those consuming less (RR, 1.15; 95% CI, 1.06-1.25).

Conclusions:

• Dietary cholesterol intake shows a linear association with an increased risk of myocardial infarction.
• Findings support the role of dietary cholesterol in cardiovascular health.
• Reducing dietary cholesterol, by limiting meat and egg consumption, may decrease incident MI risk.