Associations of egg and cholesterol intakes with carotid intima-media thickness and risk of incident coronary artery disease according to apolipoprotein E phenotype in men: the Kuopio Ischaemic Heart Disease Risk Factor Study

  • J. K. Virtanen, J. Mursu, H. E. Virtanen, M. Fogelholm, J. T. Salonen, T. T. Koskinen, S. Voutilainen, T.-P. Tuomainen
  • American Journal of Clinical Nutrition, February 2016, American Society for Nutrition
  • DOI: 10.3945/ajcn.115.122317

Dietary cholesterol, eggs and risk of coronary artery disease

What is it about?

We investigated whether intake of dietary cholesterol or one of its major sources, eggs, were associated with a higher risk of coronary artery disease in 1032 men, who were follow up for an average 21 years. Our main interest was to see, if the association would be different among those people with APOE4 phenotype, because among them dietary cholesterol has a greater impact on serum cholesterol levels. However, we did not find any evidence that cholesterol or egg intakes (up to 1 egg per day) would be associated with a higher risk in the whole study population or among those with the APOE4 phenotype.

Why is it important?

There is very little data about how genetics affect the associations between cholesterol intake and risk of coronary heart disease. APOE4 phenotype is quite common in some populations, and in Finland about a third of the population has that phenotype. Because dietary cholesterol intakes has a greater impact on serum cholesterol levels among those with the APOE4 phenotype, it could be hypothesized that limiting dietary cholesterol intake would be more important for them than for a general population. However, our study suggest that dietary cholesterol is not an important risk factor for coronary heart disease even among the APOE4 carriers. These findings also support the recent changes to dietary recommendations of several countries and organizations, which no longer set limits for dietary cholesterol intake.


Dr Jyrki K Virtanen
Ita-Suomen yliopisto

In this study we did not investigate other dietary sources of cholesterol than eggs, so the results do not indicate that high-cholesterol foods, such as butter and meats, would not be associated with the risk of heart disease. Also, few participants in our study consumed more than one egg per day, so the findings may be different with higher intakes.

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The following have contributed to this page: Dr Jyrki K Virtanen

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