Meta-analysisindependent cross-checkabstract only checked I-EGG-07 standard review
Dietary cholesterol and LDL
Meta-regression analysis of the effects of dietary cholesterol intake on LDL and HDL cholesterol.
Overview
Vincent MJ et al.. Am J Clin Nutr 2019 · PMID 30596814 · DOI 10.1093/ajcn/nqy273
More dietary cholesterol modestly raises LDL cholesterol.
Does the study support the specific claim? Partly · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Dose-response of dietary cholesterol on LDL and HDL
- How was the study done?
Bayesian meta-regression of randomised dietary intervention trials
- How many people, animals or samples were studied?
55 studies; 2,652 subjects; Trial participants
- What was actually found?
+100 mg/d cholesterol: LDL +1.90 (linear), +4.46 (MM), +4.58 (Hill) mg/dL.
- How large was the observed effect?
Linear, Michaelis-Menten, Hill models
- What do the results mean in everyday life?
Matters most for people with high LDL.
- What are the study's limitations?
Surrogate endpoint
- What does it say about Elawady's specific claim?
Supports a mechanism, not outcomes.
- Do the results apply to Germany and Europe?
High.
- What can explicitly not be concluded from this study?
Cannot show heart disease effect.
Scientific in-depth review
1. Full reference
- Authors
- Vincent MJ et al.
- Journal
- Am J Clin Nutr
- Year
- 2019
- Identifier
- PMID 30596814 DOI 10.1093/ajcn/nqy273
- Verification
- verified – PubMed efetch 2026-10-25
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
None stated in record
2. Research question
Dose-response of dietary cholesterol on LDL and HDL
3. Study design and population
- Study design
- Meta-analysis – Bayesian meta-regression of randomised dietary intervention trials
- Population
Trial participants
- Country
Multinational
- Period
Not stated
- Sample size
55 studies; 2,652 subjects
- Inclusion and exclusion criteria
Randomised dietary intervention trials
4. Methods and endpoints
- Exposure / intervention
Change in dietary cholesterol (0-1500 mg/d), adjusted for fatty acids
- Comparator
Lower cholesterol
- Endpoints
LDL, HDL change
- Statistical methods
Linear, Michaelis-Menten, Hill models
5. Actual results
- Results
+100 mg/d cholesterol: LDL +1.90 (linear), +4.46 (MM), +4.58 (Hill) mg/dL.
- Absolute risks
not applicable
- Authors' conclusion
Dietary cholesterol positively associated with LDL change.
6. Strengths
- RCT data
7. Weaknesses
- Surrogate endpoint
8. Risk of bias
- Orienting tool
- AMSTAR 2
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Simplified.
9. Assessment of the statistical interpretation
Modest LDL effect per 100 mg/day; translation to clinical events not assessed in the study.
10. Relevance to the specific claim
C-EGG-04 (supporting the LDL mechanism).
11. Independent contrary findings
Clinical outcomes not shown.
12. Transferability to Germany and Europe
High.
13. Overall methodological judgement
Confirms modest LDL effect.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | moderate |
| Directness | indirect |
| Reproducibility | replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Clinical relevance.