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

Abstract

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.

Egg and Dietary Cholesterol Intake and Risk of All-Cause, Cardiovascular, and Cancer Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies

“…Therefore, we included the risk estimates reported for the general population and excluded those related to patients with vascular diseases. In total, 55 studies (51 publications) remained for the final meta-analysis ( 1 , 8 – 15 , 17 – 26 , 48 , 50 – 80 ), of which 25 studies examined the association of egg consumption with all-cause mortality ( 1 , 8 , 9 , 12 – 15 , 17 – 23 , 25 , 26 , 53 , 57 , 65 , 68 , 74 – 76 , 79 , 80 ), 21 with CVD mortality ( 1 , 8 – 13 , 15 , 18 , 19 , 21 , 22 , 25 , 26 , 56 , 64 , 65 , 71 , 73 , 75 , 76 ), and 19 with cancer mortality ( 9 , 12 , 15 , 19 , 21 , 25 , 26 , 48 , 52 , 59 , 61 – 63 , 65 , 66 , 69 , 75 – 78 ). In terms of dietary cholesterol intake, 11 publications reported risk estimates for all-cause mortality ( 1 , 8 , 14 , 15 , 18 , 22 , 24 , 54 , 55 , ...…”

“…Also, nine included only men ( 48 , 50 , 52 , 53 , 57 , 58 , 67 , 74 , 79 ), six included only women ( 9 , 21 , 24 , 51 , 69 , 72 ), and five publications reported risk estimates for men and women separately ( 61 , 65 , 71 , 77 , 78 ). A total of 13 studies were from the United States ( 15 , 17 , 21 , 22 , 24 , 50 – 54 , 56 , 58 , 63 , 66 , 68 , 71 ), 12 were from Europe ( 12 , 18 , 25 , 26 , 55 , 57 , 58 , 67 , 73 , 74 , 76 , 79 , 80 ), 17 were from Asia ( 9 – 11 , 13 , 14 , 19 , 20 , 23 , 58 , 59 , 61 , 62 , 65 , 69 , 70 , 75 , 77 , 78 ), and four publications (13 studies) describe studies that recruited populations from more than one country ( 1 , 8 , 48 , 60 ). Dieta...…”

“…A total of 27 studies (22 publications) ( 1 , 8 , 9 , 12 – 15 , 17 – 23 , 25 , 26 , 53 , 57 , 65 , 68 , 74 , 79 ) examined the association between egg consumption and risk of all-cause mortality by comparing the highest and lowest egg intakes. In these studies, the median egg intake classified as “high” was 1.07 eggs/day (IQR: 0.73–1.24) and 0.03 egg/day (IQR: 0–0.07) as “low,” with one study not providing quantification ( 20 ).…”

“…A total of 28 studies (23 publications) ( 1 , 8 , 9 , 13 – 15 , 17 – 23 , 25 , 26 , 53 , 57 , 65 , 68 , 74 – 76 , 80 ) were identified for inclusion in the dose–response analysis. Each additional egg per day was associated with a 7% higher risk of all-cause mortality (Pooled RR: 1.07, 95% CI: 1.02–1.12, I 2 = 84.8%, P heterogeneity < 0.001) ( Table 1 ; Supplementary Figure 2 ).…”

Lang bekannt und meist ungenutzt: Lebensstilmaßnahmen zur Unterstützung der lipidsenkenden Therapie

“…So waren zum Beispiel Nahrungscholesterin und Eierverzehr in US-amerikanischen Kohortenstudien mit 29 615 Männern und Frauen dosisabhängig mit einem erhöhten Risiko für kardiovaskuläre Ereignisse (HR 1,17 [95 %-KI 1,09–1,26]) und Gesamtsterblichkeit (HR 1,18 [95 %-KI 1,10–1,26]) assoziiert 17 . In der in Italien durchgeführten Moli-sani-Study mit 20 562 gesunden Erwachsenen wurde ebenfalls ein Zusammenhang zwischen Eierverzehr und Gesamtletalität, kardiovaskulären Erkrankungen und Krebssterblichkeit beobachtet 18 . Bereits der Verzehr von 2–4 Eiern pro Woche war mit erhöhter Gesamtletalität (HR 1,22 [95 %-KI 1,01–1,46]) und kardiovaskulärer Sterblichkeit (HR 1,43 [95 %-KI 1,03–1,97]) assoziiert.…”