Gallery

Dietary Cholesterol and Cancer

A 2001 study published in Cancer Epidemiology, Biomarkers & Prevention (Mayne et al.) found a statistically significant increase in risk of cancer of the esophagus and stomach with high intake of dietary cholesterol (75th percentile compared to 25th percentile). Adjusted ORs (95% CI) were 1.74 (1.36–2.23) for esophageal adenocarcinoma, 1.63 (1.22–2.18) for esophageal squamous cell carcinoma, 1.68 (1.35–2.09) for non-cardia gastric cancer, and 1.50 (1.19–1.90) for gastric cardia adenocarcinoma. [1]

A 2012 study in Annals of Oncology (Hu et al.) found a significant association between dietary cholesterol and several cancers. “Results: Dietary cholesterol was positively associated with the risk of cancers of the stomach, colon, rectum, pancreas, lung, breast (mainly postmenopausal), kidney, bladder and NHL: the ORs for the highest versus the lowest quartile ranged from 1.4 to 1.7.” [2]

A 1998 study in International Journal of Cancer (De Stefani et al.) found increased risk of breast cancer for the upper two quartiles of cholesterol intake. Fully-adjusted ORs (95% CI) were 2.13 (1.17–3.86) and 4.31 (2.11–8.81) with a p-trend of 538 mg/d, respectively. “In our study, dietary cholesterol was associated with an increased risk of breast cancer. This was similar in pre- and post-menopausal women….” [4]

A 2011 study published in Medical Hypotheses and Research (De Stefani et al.) found increased risk of colon cancer for the upper quartile of cholesterol intake (≥573 mg/d) and increased risk of lung, breast, prostate, and bladder cancers for the upper two quartiles (444 to 572 and ≥573 mg/d). ORs ranged from 1.22 to 2.57, all with high statistical significance.

A 2004 study in Cancer Epidemiology, Biomarkers & Prevention (Pan et al.) found a statistically significant increase in risk of ovarian cancer with high intake dietary cholesterol. The multivariate adjusted odds ratio (95% CI) for the fourth quartile of dietary cholesterol intake was 1.42 (1.03–1.97). [5] Other studies (cited by Pan) found similar results. A 1999 study in American Journal of Epidemiology (Kushi et al.) found an increase in risk of ovarian cancer (OR 1.81) for a moderate intake of eggs (>4/week). [6] Eggs are a major source of cholesterol in many diets. The same study found borderline association between high cholesterol and ovarian cancer (OR 1.86; p-trend 0.06). [7]

A 2008 study in American Journal of Clinical Nutrition (Djousse and Gaziano) found high statistical significance (P for trend < 0.0001) to an association between high egg consumption and total mortality with an OR of 1.23 for ≥7 eggs/week. [8] "This association was stronger among diabetic subjects, in whom the risk of death in a comparison of the highest with the lowest category of egg consumption was twofold…. egg consumption was positively related to mortality, more strongly so in diabetic subjects, in the study population." [9]

The same authors, in a 2008 study published in Diabetes Cared, reported an increased risk of Type 2 Diabetes with high egg consumption (≥7 eggs/wk). [10] The ORs (95% CI) were 1.58 (1.25–2.01) for men and 1.77 (1.28–2.43) with a p-trend in both groups of < 0.0001. "These data suggest that high levels of egg consumption (daily) are associated with an increased risk of type 2 diabetes in men and women." [11]

Moderate to high intake of dietary cholesterol is positively associated with an increase in risk of cancer. Several studies have linked dietary cholesterol to risk of particular types of cancer, including breast, ovarian, gastric, esophageal, colorectal, pancreatic, kidney and bladder cancer and non-Hodgkin's lymphoma (NHL). Other studies have shown an increase in all-cause mortality and Type 2 Diabetes with high intake of eggs.

The final version of the "Dietary Guidelines for Americans, 2015" should recommend limiting intake of dietary cholesterol in order to reduce risk of cancer. Eggs, specifically the yolks, are the most significant source of dietary cholesterol in many diets. Other foods particularly high in cholesterol include liver, other variety meats (organ meats), and fish oil. [12] The 2015 Guidelines should caution Americans against excess intake of eggs and other high cholesterol foods.

by Ronald L. Conte Jr.
author of Healthy Eating versus Mortality

[1] Mayne et al., Nutrient Intake and Risk of Subtypes of Esophageal and Gastric Cancer; Cancer Epidemiology, Biomarkers & Prevention. October 2001 10; 1055.
[2] Hu et al., Dietary cholesterol intake and cancer; Annals of Oncology. (2012) 23 (2): 491-500.
[3] Stefani et al., Essential Fatty Acids and Breast Cancer: A Case-Control Study in Uruguay; International Journal of Cancer. 76, 491–494 (1998). [PDF file]
[4] Ibid.
[5] Pan et al., A Case-Control Study of Diet and the Risk of Ovarian Cancer; Cancer Epidemiology, Biomarkers & Prevention. September 2004 13; 1521.
[6] Kushi et al., Prospective Study of Diet and Ovarian Cancer; American Journal of Epidemiology. (1999) 149 (1): 21-31.
[7] Ibid.
[8] Djoussé and Gaziano, Egg consumption in relation to cardiovascular disease and mortality: the Physicians’ Health Study; American Journal of Clinical Nutrition. April 2008 vol. 87 no. 4 964-969.
[9] Ibid.
[10] Djoussé and Gaziano, Egg Consumption and Risk of Type 2 Diabetes in Men and Women; Diabetes Care. February 2009 vol. 32 no. 2 295-300.
[11] Ibid.
[12] USDA National Nutrient Database for Standard Reference, Release 27.

Advertisements

Comments are closed.