Association of Egg Consumption with Risk of All-Cause and Cardiovascular Disease Mortality: A Systematic Review and Dose–Response Meta-Analysis of Observational Studies

Abstract

Background Recent studies have reported conflicting associations between egg consumption and the risk of all-cause or cardiovascular disease (CVD) mortality, including ischemic heart disease (IHD) mortality and stroke mortality. With accumulating evidence, up-to-date evidence about the association should be synthesized. Objective To assess the association of the risk of all-cause and CVD mortality with egg consumption. Methods We searched PubMed, EMBASE, and Web of Science databases through November 3, 2021 for observational studies conducted in participants ≥18 y of age and provided ORs or RRs or HRs and 95% CIs for ≥3 egg consumption categories or for increased intake of egg with the associations of interest. Random-effects model was used to pool the reported risk estimates. Restricted cubic splines were used to examine the dose–response association. Results Twenty-four articles with 48 reports (25 for all-cause mortality, 11 for CVD mortality, 6 for IHD mortality, and 6 for stroke mortality) involving 11,890,695 participants were included. Intake of each 1 egg/day increment was associated with increased risk of all-cause mortality (RR 1.06; 95% CI 1.02, 1.10; P = 0.008), but the association was restricted to women, Americans, and studies with adjustments for hyperlipidemia. Egg consumption was linearly associated with CVD mortality only in participants >60 y of age, Americans, studies with follow-up duration≥15 years, and adjustments for hyperlipidemia (P ≤0.018). No significant association was found between egg consumption and IHD or stroke mortality (P ≥0.080). Conclusions Egg consumption was linearly associated with a modestly risk of all-cause mortality and, in older participants, Americans, studies with longer follow-up or adjustments for hyperlipidemia, CVD mortality. These findings suggest that it may be prudent to avoid high egg consumption.

Eggs and Cardiovascular Disease Risk: An Update of Recent Evidence

“…This was similar to earlier reviews which also found mixed results. A meta-analysis of 39 observational studies including nearly 2 million individuals found no association between the highest intake of eggs and CVD mortality [55], and similar findings were presented in another meta-analysis of 24 observational studies of over 11 million individuals that found no association between highest intake of eggs and CVD mortality [56]. However, contrasting findings were reported in a meta-analysis of 19 observational studies that found a nonlinear dose-response association between egg consumption and CVD mortality, although the certainty of the evidence for these observations was rated as very low [57].…”

Eggs: Healthy or Risky? A Review of Evidence from High Quality Studies on Hen’s Eggs

“…A further SRMA also found that overall consumption of each additional egg/day was associated with a small but significant increase in risk of CVD of 4% [ 51 ]. However, the other three SRMA looking at risk of CVD found no significant effects of egg consumption [ 52 , 53 , 54 ] and studies on CVD mortality largely found no association between egg intake and risk of death from CVD [ 49 , 55 , 56 , 57 , 58 ]. The exception was the SRMA by Yang et al, which reported an overall 7% increased risk of CVD mortality with each increment of 1 egg/day [ 59 ].…”

“…At intakes of 1–4 eggs/week, there was a decreased risk of stroke which switched to an increased risk in those consuming 10+ eggs/week [ 62 ]. None of the studies found a significant association between egg intake and risk of stroke mortality [ 49 , 55 , 57 , 58 , 59 ].…”

“…Another SRMA found a significant 11% reduced risk when comparing higher consumers (>1 egg/day) to lower (≤1 egg/day) [ 54 ]. No associations between egg intake and CHD mortality risk were found [ 55 , 57 , 58 ]. The one SRMA to look at heart failure risk found that intakes of 7 eggs/week was associated with an increased risk of 15%, rising to 23% for 9 eggs/week, when compared with no consumption [ 49 ].…”

Report of the Scientific Committee of the Spanish Agency for Food Safety and Nutrition (AESAN) on sustainable dietary and physical activity recommendations for the Spanish population

“…In addition, 2 very recent meta-analyses addressing the association between egg consumption and mortality have been published. The first of these, with 24 observational studies, found that an additional increase of 1 egg/day in habitual consumption was associated with a modest increase (6 %) in the risk of premature mortality, especially in older people, in studies carried out with the United States population (Ma et al, 2022). The second meta-analysis, with 32 observational studies, concluded that egg consumption was not associated with all-cause mortality, cardiovascular or respiratory, but the highest consumption category, compared to the lowest consumption category, was associated with a 20 % higher risk of cancer mortality.…”