Egg consumption and cardiovascular risk: a dose–response meta-analysis of prospective cohort studies

Godos, Justyna; Micek, Agnieszka; Brzostek, Tomasz; Toledo, Estefanía; Iacoviello, Licia; Astrup, Arne; Franco, Oscar H.; Galvano, Fabio; Grosso, Giuseppe

doi:10.1007/s00394-020-02345-7

Cited by 49 publications

(45 citation statements)

References 82 publications

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“…Recently, a dose-response meta-analysis of prospective cohort studies found no association with risk of cardiovascular outcomes following the habitual consumption of one egg per day compared to no intake, with exception of the risk of heart failure, which resulted higher especially in men from US cohorts [36].…”

Section: Discussionmentioning

confidence: 99%

Egg consumption and risk of all-cause and cause-specific mortality in an Italian adult population

et al. 2021

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Purpose Dietary guidelines recommend to limit egg consumption to 4 servings per week but the relation between egg intake and health outcomes is still controversial. To evaluate the association of egg consumption and mortality risk in Italian adults and to investigate nutritional factors and serum lipids as potentially explaining such associations. Methods Longitudinal analysis on 20,562 men and women aged ≥ 35y, free from cardiovascular disease (CVD) and cancer belonging to the Moli-sani Study cohort (enrolled 2005–2010) followed up for a median of 8.2 years. Results In multivariable-adjusted analysis as compared to low intake (> 0 ≤ 1 egg/week), eating > 4 eggs/week led to an increased risk of all-cause (Hazard ratio [HR] = 1.50; 95%CI 1.13–1.99), CVD (HR = 1.75; 1.07–2.87) and cancer mortality (HR = 1.52; 0.99–2.33). Similarly, an intake of 2–4 eggs/week was associated with higher all-cause (HR = 1.22; 1.01–1.46) and CVD mortality risk (HR = 1.43; 1.03–1.97). An increase of 1 egg per week was associated with higher mortality risk among high-risk individuals, such as those with hypertension and hyperlipidaemia. Dietary cholesterol explained about 43.0% and 39.3% (p values < 0.0001) of the association of eggs with all-cause and CVD mortality, respectively, while serum lipids (e.g., total cholesterol) accounted for a small proportion of egg-mortality relation. Conclusions Among Italian adults, high egg consumption leads to an increased risk of all-cause and CVD mortality, with the risk being evident even at the recommended intake of 2–4 eggs per week. A substantial part of this association was likely due to the egg contribution to dietary cholesterol. Our findings suggest limiting the consumption of eggs in the diet and these results should be considered in the development of dietary guidelines and updates.

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Section: Discussionmentioning

confidence: 99%

Egg consumption and risk of all-cause and cause-specific mortality in an Italian adult population

et al. 2021

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“…Although a review of the observational studies concluded no significant associations of egg consumption with some health outcomes, such as cancer, CVD, and metabolic diseases, they observed a protective relationship between egg consumption and stroke risk (8). A recent meta-analysis also showed an inverse association of up to 6 eggs/wk consumption with CVD incidence and/or mortality (9). Among the US population, they observed a lower risk of CVD for 4 eggs/wk [relative risk (RR) (95%): 0.94 (0.89-0.99), I 2 (%) = 20].…”

Section: Introductionmentioning

confidence: 99%

Egg and Dietary Cholesterol Consumption and Mortality Among Hypertensive Patients: Results From a Population-Based Nationwide Study

Zhuang

Zhang

et al. 2021

Front. Nutr.

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Background: Hypertensive patients are sensitive to the amount of dietary cholesterol intake, especially cholesterol from the whole eggs. Whether whole egg and dietary cholesterol consumption are suitable for hypertensive patients is still controversial.Aim: The objective of the study was to examine the associations of intake of eggs as well as the dietary cholesterol with total mortality in a Chinese nationwide cohort.Methods: We utilized data from the China Health and Nutrition Survey (CHNS) from the year of 1991 to 2015. Cumulative averages of egg and cholesterol intake were calculated to represent the consumption of the long-term diet of the participants in each available round of the survey. Cox regression models were employed to estimate the effects of eggs and dietary cholesterol from the different sources on mortality among hypertensive patients.Results: A total of 8,095 participants were included in the final analysis and followed up for a mean of 11.4 years. Finally, 927 cases of death were detected. After adjustment for the multivariate factors, consuming more than seven eggs per week was related to 29% lower mortality among the hypertensive patients compared with the consumers with not more than two eggs per week [hazard ratio (HR): 0.71; 95% CI: 0.59–0.85; P < 0.001]. Similarly, the egg-sourced cholesterol intake was inversely associated with mortality (P = 0.002) whereas intake of the dietary cholesterol from the non-egg sources was significantly related to the higher mortality (P < 0.001). However, total cholesterol intake was not related to mortality among hypertensive patients. Substituting eggs for an equivalent amount of non-egg-sourced protein-abundant foods was also associated with lower mortality.Conclusion: Higher consumption of eggs and egg-sourced dietary cholesterol was associated with lower mortality among the enrolled Chinese hypertensive patients but non-egg-sourced cholesterol intake was related to higher mortality. Therefore, our findings do not support the view that hypertensive patients should avoid whole egg consumption for the purpose of restricting dietary cholesterol intake.

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“…18 Moreover, confounding the issue, inconsistent and sometimes conflicting results have been reported regarding the potential health risks of egg consumption. [19][20][21][22] The present study assessed the effect of whole egg consumption on cognitive functioning among US older adults. It contributed to the literature in three aspects.…”

Section: Introductionmentioning

confidence: 99%

“…Limitations of the existing studies include crude daily egg intake measures (e.g., by a single question item or food frequency questionnaire) and lack of US‐based studies (only one based on our literature search) 18 . Moreover, confounding the issue, inconsistent and sometimes conflicting results have been reported regarding the potential health risks of egg consumption 19–22 …”

Section: Introductionmentioning

confidence: 99%

Whole egg consumption and cognitive function among US older adults

McCaffrey

et al. 2021

J Human Nutrition Diet

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Background: Eggs are an affordable food providing many shortfall nutrients with the potential to improve cognitive health. We assessed the relationship between whole egg consumption and cognitive functioning among a US nationally representative sample of older adults. Methods: Individual-level data (2816 adults, aged ≥ 60 years) were obtained from the National Health and Nutrition Examination Survey (NHANES) 2011-2012 and 2013-2014 waves. Cognitive assessments included the Consortium to Establish a Registry for Alzheimer's Disease Word List Learning Test (CERAD-WL), Word List Recall Test (CERAD-DR), Animal Fluency Test (AF) and Digit Symbol Substitution Test (DSST). A composite cognitive z-score was constructed based on the individual tests to represent one's overall cognitive functioning. Multiple linear and logistic regressions were performed to examine the effect of whole egg consumption on cognitive functioning, adjusting for individual characteristics and survey design.Results: Approximately 57% of older adults consumed whole eggs, with an average daily intake of 34 g of whole egg equivalent among consumers. The average z-scores of the CERAD-WL, CERAD-DR, AF and DSST tests were −0.08, 0.23, 0.37 and 0.42, respectively, and the overall composite cognitive z-score was 0.24 among older adults. Regression analyses found that neither whole egg consumption status, nor daily intake quantity was associated with cognitive test scores. Conclusions: No association was found between whole egg consumption and cognitive functioning among US older adults. Study limitations included cross-sectional study design and measurement errors. Future studies with longitudinal or experimental design are warranted to examine the possible link between egg consumption and cognition in older adults.food choice, attitudes and behaviour, cognition, cellular and physiological function, elderly, dietary advice, food intake, dietary influences, health eating Key points• In a large sample of 2816 adults aged ≥ 60 years in the 2011-2014 US National Health and Nutrition Examination Survey (NHANES), we report that no statistically significant association was found between whole egg consumption and cognitive function. • Neither whole egg consumption status, nor daily intake quantity measured by the NHANES 24-h dietary recall was found to be associated with the multidomain cognitive performance nor the overall cognitive score.

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Egg consumption and cardiovascular risk: a dose–response meta-analysis of prospective cohort studies

Cited by 49 publications

References 82 publications

Egg consumption and risk of all-cause and cause-specific mortality in an Italian adult population

Egg consumption and risk of all-cause and cause-specific mortality in an Italian adult population

Egg and Dietary Cholesterol Consumption and Mortality Among Hypertensive Patients: Results From a Population-Based Nationwide Study

Whole egg consumption and cognitive function among US older adults

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