Low dietary cholesterol intake vital to prevent diabetes, especially for people at higher CV risk

Dietary cholesterol, a prevalent nutrient in daily life, has been associated with impaired pancreatic β cell function.

Some studies show an association between DC and diabetes incidence, while some portray null association.

In 2013, American Diabetes Association (ADA) recommended restricting DC consumption to less than 300 mg daily. This was changed in 2015.

The background could be more evident in this context. Considering this, a meta-analysis was done to evaluate the dose–response relationship between DC consumption and the incidence of T2DM. The lead researcher of the study was Li et al.

The study could be summarised as follows:

• The authors researched PubMed, Embase, and the Cochrane Library database.
• The keywords used in the search were “dietary cholesterol” paired with “diabetes”.
• The incidence of T2DM was the primary endpoint.
• Fourteen thousand two hundred seventy-two articles by database and manual searching were identified.
• Fourteen thousand one hundred fifty-one were excluded, and 121 potential articles were selected. The studies included had a prospective design.
• Finally, the meta-analysis included 11 studies with 355 230 subjects.
• There were eight studies conducted in western countries and three from eastern countries.
• The mean age range was 49 to 73.2 years.
• The follow-up range was 5.0 to 20.8 years.
• The highest DC consumption was tied to an increased risk of T2DM, with an RR of 1.15 compared to the lowest DC consumption.
• The association was more evident in western countries, with an RR of 1.19 per subgroup analysis.
• The RR in eastern countries was 1.19.
• The pooled RR was 1.05, 1.06 and 1.01 for the incidence of T2DM, in western and eastern countries, respectively. (For 100 mg/d increment in DC intake)

To conclude, there is a positive dose–response association between the consumption of DC and the incidence of T2DM in western countries.

The researchers said our results advise low intake of DC for preventing T2DM, especially for high cardiovascular-risk populations.

As acknowledged, the work was supported by the National Natural Science Foundation of China and PUMC Youth Fund and Fundamental Research Funds for the Central Universities.

Further reading:

Li, Yuehua, et al. “Dietary Cholesterol Consumption and Incidence of Type 2 Diabetes Mellitus: A Dose–response Meta-analysis of Prospective Cohort Studies.” Nutrition, Metabolism and Cardiovascular Diseases, vol. 33, no. 1, Elsevier BV, Jan. 2023, pp. 2–10. Crossref, https://doi.org/10.1016/j.numecd.2022.07.016.