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The Role of Dietary Cholesterol in Atherosclerosis

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutritional Epidemiology".

Deadline for manuscript submissions: closed (30 May 2023) | Viewed by 16190

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Special Issue Editor

Dr. Matilda Florentin

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Guest Editor

Section of Internal Medicine, University of Ioannina | UOI, Ioannina, Greece
Interests: lipid disorders; atherosclerosis; thrombosis; stroke; hypertension

Special Issue Information

Dear Colleagues,

The role of dietary cholesterol in lipid disorders and atherosclerosis is complex and not straightforward. A lot of research has been made and is currently ongoing regarding the effects of different dietary patterns and certain types of food on lipid profiles and atherosclerosis and, subsequently, cardiovascular disease (CVD). In this context, a Special Issue summarizing recent data about the relationship of dietary cholesterol with CVD risk with a special focus on specific food products (e.g., eggs, dairy where the literature is broad and inconsistent) would be very interesting and of clinical value to the readers.

Our ambition in this Special Issue is to provide new insights towards the understanding of the role of dietary cholesterol in atherosclerosis and CVD. I encourage authors to submit their original research on this attractive topic. An up-to-date review article describing the association of dietary cholesterol with the risk of developing and/or aggravating CVD would very well fit as the initiating paper of this Special Issue. Any other suggestions from experts in the field are more than welcome.

Dr. Matilda Florentin
Guest Editor

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Keywords

cholesterol
eggs
dairy
atherosclerosis
cardiovascular disease
diet
mediterranean diet
red meat

Published Papers (3 papers)

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Research

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10 pages, 249 KiB

Open AccessArticle

Egg Consumption, Cardiovascular Disease and Cardiometabolic Risk Factors: The Interaction with Saturated Fatty Acids. Results from the ATTICA Cohort Study (2002–2012)

by Matina Kouvari, Evangelia Damigou, Matilda Florentin, Rena I. Kosti, Christina Chrysohoou, Christos S. Pitsavos and Demosthenes B. Panagiotakos

Nutrients 2022, 14(24), 5291; https://doi.org/10.3390/nu14245291 - 12 Dec 2022

Cited by 6 | Viewed by 7973

Abstract

Purpose: To examine the association of egg intake with 10-year risk of cardiovascular disease (CVD) and other cardiometabolic risk factors in a sample of individuals of Mediterranean origin. Methods: In 2001–2002, n = 1514 men and n = 1528 women (>18 years old) from the greater Athens area, Greece, were enrolled. Information on any egg intake, eaten as a whole, partly or in recipes was assessed via a validated semi-quantitative food frequency questionnaire. Follow-up for CVD evaluation (2011–2012) was achieved in n = 2020 participants (n = 317 CVD cases). Results: Ranking from lowest (<1 serving/week) to intermediate (1–4 servings/week) and high (4–7 servings/week) egg consumption tertiles, lower CVD incidence was observed (18%, 9% and 8%, respectively, p-for-trend = 0.004). Unadjusted analysis revealed that 1–3 eggs/week and 4–7 eggs/week were associated with a 60% and 75%, respectively, lower risk of developing CVD compared with the reference group (<1 egg/week). When adjusting for sociodemographic, lifestyle and clinical factors, significance was retained only for 1–3 eggs/week (hazard ratio (HR) = 0.53, 95% confidence interval (95% CI) = 0.28, 1.00). When total saturated fatty acid (SFA) intake was taken into account, this inverse association was non-significant. Multi-adjusted analysis revealed that in participants of low SFA intake, 1 serving/day increase in egg intake resulted in 45% lower risk of developing CVD. In the case of higher SFA consumption, only 1–3 eggs/week seemed to protect against CVD (HR = 0.25, 95% CI = 0.07, 0.86). In the case of intermediate cardiometabolic disorders, no significant trend was observed. Conclusions: Overall dietary habits principally in terms of SFA intake may be detrimental to define the role of eggs in cardiac health. Full article

(This article belongs to the Special Issue The Role of Dietary Cholesterol in Atherosclerosis)

12 pages, 696 KiB

Open AccessArticle

Higher Intake of Dairy Is Associated with Lower Cardiometabolic Risks and Metabolic Syndrome in Asian Indians

by Ramatu Wuni, Nagarajan Lakshmipriya, Kuzhandaivelu Abirami, Eduard Flores Ventura, Ranjit Mohan Anjana, Vasudevan Sudha, Shanmugam Shobana, Ranjit Unnikrishnan, Kamala Krishnaswamy, Karani Santhanakrishnan Vimaleswaran and Viswanathan Mohan

Nutrients 2022, 14(18), 3699; https://doi.org/10.3390/nu14183699 - 7 Sep 2022

Cited by 4 | Viewed by 3111

Abstract

There is conflicting evidence about the association between dairy products and cardiometabolic risk (CMR). We aimed to assess the association of total dairy intake with CMR factors and to investigate the association of unfermented and fermented dairy intake with CMR in Asian Indians who are known to have greater susceptibility to type 2 diabetes and cardiovascular diseases compared to white Europeans. The study comprised 1033 Asian Indian adults with normal glucose tolerance chosen from the Chennai Urban Rural Epidemiological Study (CURES). Dietary intake was assessed using a validated open-ended semi-quantitative food frequency questionnaire. Metabolic syndrome (MS) was diagnosed based on the new harmonising criteria using central obesity, dyslipidaemia [low high-density lipoprotein cholesterol (HDL) and increased serum triglycerides (TG)], hypertension and glucose intolerance. Increased consumption of dairy (≥5 cups per day of total, ≥4 cups per day of unfermented or ≥2 cups per day of fermented dairy) was associated with a lower risk of high fasting plasma glucose (FPG) [hazards ratio (HR), 95% confidence interval (CI): 0.68, 0.48–0.96 for total dairy; 0.57, 0.34–0.94 for unfermented dairy; and 0.64, 0.46–0.90 for fermented dairy; p < 0.05 for all] compared to a low dairy intake (≤1.4 cups per day of total dairy; ≤1 cup per day of unfermented dairy; and ≤0.1 cup per day of fermented dairy). A total dairy intake of ≥5 cups per day was also protective against high blood pressure (BP) (HR: 0.65, 95% CI: 0.43–0.99, p < 0.05), low HDL (HR: 0.63, 95% CI: 0.43–0.92, p < 0.05) and MS (HR: 0.71, 95% CI: 0.51–0.98, p < 0.05) compared to an intake of ≤1.4 cups per day. A high unfermented dairy intake (≥4 cups per day) was also associated with a lower risk of high body mass index (BMI) (HR: 0.52, 95% CI: 0.31–0.88, p < 0.05) compared to a low intake (≤1 cup per day), while a reduced risk of MS was observed with a fermented dairy intake of ≥2 cups per day (HR: 0.71, 95% CI: 0.51–0.98, p < 0.05) compared to an intake of ≤0.1 cup per day. In summary, increased consumption of dairy was associated with a lower risk of MS and components of CMR. Full article

(This article belongs to the Special Issue The Role of Dietary Cholesterol in Atherosclerosis)

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Review

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16 pages, 984 KiB

Open AccessReview

Plant Sterols and Plant Stanols in Cholesterol Management and Cardiovascular Prevention

by Fotios Barkas, Eirini Bathrellou, Tzortzis Nomikos, Demosthenes Panagiotakos, Evangelos Liberopoulos and Meropi D. Kontogianni

Nutrients 2023, 15(13), 2845; https://doi.org/10.3390/nu15132845 - 22 Jun 2023

Cited by 5 | Viewed by 4592

Abstract

Atherosclerotic cardiovascular disease (ASCVD) remains the major mortality cause in developed countries with hypercholesterolaemia being one of the primary modifiable causes. Lifestyle intervention constitutes the first step in cholesterol management and includes dietary modifications along with the use of functional foods and supplements. Functional foods enriched with plant sterols/stanols have become the most widely used nonprescription cholesterol-lowering approach, despite the lack of randomized trials investigating their long-term safety and cardiovascular efficacy. The cholesterol-lowering effect of plant-sterol supplementation is well-established and a potential beneficial impact on other lipoproteins and glucose homeostasis has been described. Nevertheless, experimental and human observational studies investigating the association of phytosterol supplementation or circulating plant sterols with various markers of atherosclerosis and ASCVD events have demonstrated controversial results. Compelling evidence from recent genetic studies have also linked elevated plasma concentrations of circulating plant sterols with ASCVD presence, thus raising concerns about the safety of phytosterol supplementation. Thus, the aim of this review is to provide up-to-date data on the effect of plant sterols/stanols on lipid-modification and cardiovascular outcomes, as well as to discuss any safety issues and practical concerns. Full article

(This article belongs to the Special Issue The Role of Dietary Cholesterol in Atherosclerosis)

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