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Recent dietary guidelines declared that restriction of dietary cholesterol is unnecessary for the prevention of cardiovascular disease. We analyzed the risk fro subclinical atherosclerosis assessed by coronary artery calcium score (CACS), which is based on dietary cholesterol intake in apparently healthy Korean adults.This was a cross-sectional study performed in 30,068 participants (mean age 40.8 yrs; 87.5% men) in a health screening program. Total energy intake and dietary cholesterol intake was assessed with food frequency questionnaire. The participants were stratified into four groups according to dietary cholesterol intake. CACS was measured by multi-detector computed tomography. The presence of coronary artery calcification (CAC) was defined by CACS>0.In four groups divided by dietary cholesterol intake, dietary cholesterol intake did not correlate with mean serum low-density lipoprotein cholesterol (LDL-C) level. The odds ratio (OR) for CAC did not significantly increase as dietary cholesterol increased (as assessed by quartiles) similarly in both genders. When the subjects were divided into 6 groups according to baseline LDL-C level, the OR for CAC did not significantly increase in male participants with LDL-C < 130 mg/dL, but is increased in male participants with LDL-C> = 130 mg/dL [OR (95% CI) 1.59 (1.13–1.56), 1.97 (1.39–2.78), and 2.59 (1.78–3.77) in participants with LDL-C levels: 130–159, 160–190 and >190 mg/dL]. In women, the OR (95% CI) for CAC started to increase in participants with an LDL-C> = 160 mg/dL [5.85 (1.48–12.09), 5.54 (1.25–24.60) in participants with LDL-C levels 160–190 and >190 mg/dL).Dietary cholesterol intake did not have an association with LDL-C levels or with the risk for CAC in apparently healthy Korean adults. The risk for CAC increased in men with LDL-C levels > 130 mg/dL and women with an LDL-C > 160 mg/dL.