Cent Eur J Public Health 2021, 29(2):117-121 | DOI: 10.21101/cejph.a6276

Association between cholesterol intake and all-cause mortality: NHANES-linked mortality study

Xiangpeng Du^{1, 2}, Hui Xin¹

¹ Department of Cardiology, Hospital of Qingdao University, Qingdao, Shandong, China

² Department of Cardiology, Weihaiwei People's Hospital, Weihai, Shandong, China

Objectives: There has been insufficient evidence for a quantitative recommendation for dietary cholesterol, therefore, we aim to investigate the optimal cholesterol intake related to a lower all-cause mortality risk.

Methods: The National Health and Nutrition Examination Survey (NHANES) is a large population survey to investigate public health in the United States. We analysed data from 1999-2002 linked with mortality data obtained through 2006. Cox proportional hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated to assess risks for all-cause mortality associated with cholesterol intake.

Results: A total of 7,728 participants were analysed in the present study, and 519 assumed death events. Compared with the third quartile (216-373 mg/day) of cholesterol intake, the risks of mortality increased in both the first two and the last quartiles (quartile 1: HR 1.53, 95% CI 1.16-2.00; quartile 2: HR 1.22, 95% CI 0.94-1.60; quartile 4: HR 1.39, 95% CI 1.05-1.83). The association between cholesterol intake and the risk of all-cause mortality followed a U-shaped curve, with the cholesterol intake associated with the lowest mortality being 328 mg/day.

Conclusions: The present study suggests an optimal cholesterol intake for lowering the all-cause mortality risk.

Keywords: cholesterol intake, all-cause mortality, NHANES, U-shaped curve, dietary

Received: May 10, 2020; Revised: May 31, 2021; Accepted: May 31, 2021; Published: June 30, 2021  Show citation