Background: The associations between dietary cholesterol and fatty acids and serum lipids are controversial. This study is to examine the association of dietary cholesterol and fatty acids with serum lipids and dyslipidemia in Chinese metropolitan male and female adults. Methods: 3850 participants in the Shanghai Diet and Health Survey were investigated during the period 2012–2013. Information was obtained on dietary intake, anthropometric and blood laboratory measurements. Dyslipidemia was determined by US National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III). Results: Dietary cholesterol was in line with serum TC, LDL-C and the LDL-C to HDL-C ratio in general and the partial correlation coefficients were 0.64 (95% CI: 0.13–1.15, p
= 0.015), 0.73 (95% CI: 0.21–1.24, p
= 0.006) and 0.01 (95% CI: 0.00–0.02, p
= 0.018), respectively. The partial correlation coefficients were greater in women. Dietary fatty acids were not associated with serum lipids. The highest quintile of dietary cholesterol intake (≥538.0 mg/day) was associated with an approximate 1.6-fold risk for high TC and high HDL-C compared with the lowest quintile (<193.1 mg/day) generally. Conclusions: Dietary cholesterol was associated with serum cholesterol in Chinese metropolitan adults and a higher risk of dyslipidemia was observed at a high level of dietary cholesterol intake. Whether there should be an upper limit on dietary cholesterol in the Chinese population warrants further study.
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