Egg yolk consumption, smoking and carotid plaque: Reply to letters to the Editor by Sean Lucan and T Dylan Olver et al.

  • J. David Spence
    Corresponding author. Tel.: +1 519 931 5731; fax: +1 519 931 5737.
    Stroke Prevention & Atherosclerosis Research Centre, Robarts Research Institute, University of Western Ontario, 1400 Western Road, London, ON N6G 2V2, Canada
    Search for articles by this author
  • David J.A. Jenkins
    Nutrition and Metabolism, Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada
    Search for articles by this author
  • Jean Davignon
    IRCM, Clinique de nutrition métabolisme et athérosclérose, Institut de recherches cliniques de Montréal, Canada
    Faculty of medicine, University of Montreal, Canada
    Experimental Medicine, McGill University, Montréal, QC, Canada
    Search for articles by this author
      We are not saying that egg yolks should be banished entirely – egg yolks are an essential ingredient in such culinary delicacies as Hollandaise and Bérnaise sauce, and whole eggs may be important nutritionally for starving children in third world countries. However, most vascular prevention patients in the Western world are over-nourished, not undernourished. Our recommendation that people at risk of vascular disease should limit their intake of egg yolks was based not only on the findings in our recent paper [
      • Spence J.D.
      • Jenkins D.J.
      • Davignon J.
      Egg yolk consumption and carotid plaque.
      ], but also on the totality of the evidence [
      • Spence J.D.
      • Jenkins D.J.
      • Davignon J.
      Dietary cholesterol and egg yolks: not for patients at risk of vascular disease.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Atherosclerosis
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Spence J.D.
        • Jenkins D.J.
        • Davignon J.
        Egg yolk consumption and carotid plaque.
        Atherosclerosis. 2012; 224: 469-473
        • Spence J.D.
        • Jenkins D.J.
        • Davignon J.
        Dietary cholesterol and egg yolks: not for patients at risk of vascular disease.
        Can J Cardiol. 2010; 26: e336-e339
        • Spence J.D.
        Fasting lipids: the carrot in the snowman.
        Can J Cardiol. 2003; 19: 890-892
        • Fielding C.J.
        • Havel R.J.
        • Todd K.M.
        • et al.
        Effects of dietary cholesterol and fat saturation on plasma lipoproteins in an ethnically diverse population of healthy young men.
        J Clin Invest. 1995; 95: 611-618
        • Rose G.
        Sick individuals and sick populations.
        Int J Epidemiol. 2001; 30: 427-432
        • Phillips R.L.
        • Lemon F.R.
        • Beeson W.L.
        • Kuzma J.W.
        Coronary heart disease mortality among seventh-day Adventists with differing dietary habits: a preliminary report.
        Am J Clin Nutr. 1978; 31: S191-S198
        • Fraser G.E.
        Vegetarian diets: what do we know of their effects on common chronic diseases?.
        Am J Clin Nutr. 2009; 89: 1607S-1612S
        • Hu F.B.
        • Stampfer M.J.
        • Rimm E.B.
        • et al.
        A prospective study of egg consumption and risk of cardiovascular disease in men and women.
        JAMA. 1999; 281: 1387-1394
        • Qureshi A.I.
        • Suri F.K.
        • Ahmed S.
        • Nasar A.
        • Divani A.A.
        • Kirmani J.F.
        Regular egg consumption does not increase the risk of stroke and cardiovascular diseases.
        Med Sci Monit. 2007; 13: CR1-CR8
        • Djousse L.
        • Gaziano J.M.
        • Buring J.E.
        • Lee I.M.
        Egg consumption and risk of type 2 diabetes in men and women.
        Diabetes Care. 2009; 32: 295-300
        • Keys A.
        Serum cholesterol response to dietary cholesterol.
        Am J Clin Nutr. 1984; 40: 351-359
        • Hegsted D.M.
        Serum-cholesterol response to dietary cholesterol: a re-evaluation.
        Am J Clin Nutr. 1986; 44: 299-305
        • Healthy People
        National health promotion and disease prevention objectives.
        United States Department of Health and Human Services, 2000 (1991)
        • Catapano A.L.
        • Reiner Z.
        • De B.G.
        • et al.
        ESC/EAS guidelines for the management of dyslipidaemias: the task force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS).
        Atherosclerosis. 2011; 217: S1-S44
        • Njike V.
        • Faridi Z.
        • Dutta S.
        • Gonzalez-Simon A.L.
        • Katz D.L.
        Daily egg consumption in hyperlipidemic adults–effects on endothelial function and cardiovascular risk.
        Nutr J. 2010; 9: 28
        • Sirtori C.R.
        • Agradi E.
        • Conti F.
        • Mantero O.
        • Gatti E.
        Soybean-protein diet in the treatment of type-II hyperlipoproteinaemia.
        Lancet. 1977; 1: 275-277
        • Anderson J.W.
        • Johnstone B.M.
        • Cook-Newell M.E.
        Meta-analysis of the effects of soy protein intake on serum lipids.
        N Engl J Med. 1995; 333: 276-282
        • Jenkins D.J.
        • Mirrahimi A.
        • Srichaikul K.
        • et al.
        Soy protein reduces serum cholesterol by both intrinsic and food displacement mechanisms.
        J Nutr. 2010; 140: 2302S-2311S
        • Wang Z.
        • Klipfell E.
        • Bennett B.J.
        • et al.
        Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease.
        Nature. 2011; 472: 57-63
        • Rak K.
        • Rader D.J.
        Cardiovascular disease: the diet-microbe morbid union.
        Nature. 2011; 472: 40-41
        • Clemente J.C.
        • Ursell L.K.
        • Parfrey L.W.
        • Knight R.
        The impact of the gut microbiota on human health: an integrative view.
        Cell. 2012; 148: 1258-1270
        • Dandona P.
        • Ghanim H.
        • Chaudhuri A.
        • Dhindsa S.
        • Kim S.S.
        Macronutrient intake induces oxidative and inflammatory stress: potential relevance to atherosclerosis and insulin resistance.
        Exp Mol Med. 2010; 42: 245-253
        • van Bussel B.C.
        • Soedamah-Muthu S.S.
        • Henry R.M.
        • et al.
        Unhealthy dietary patterns associated with inflammation and endothelial dysfunction in type 1 diabetes: the EURODIAB study.
        Nutr Metab Cardiovasc Dis. 2012; (epub ahead of print PMID: 22795869)
        • Spence J.D.
        • Jenkins D.J.A.
        • Davignon J.
        Egg yolk consumption, smoking and carotid plaque: reply to letter to the Editor.
        Canadian Journal of Cardiology. 2011; 27: 264.e7-264.e8
        • Inaba Y.
        • Chen J.A.
        • Bergmann S.R.
        Carotid plaque, compared with carotid intima-media thickness, more accurately predicts coronary artery disease events: a meta-analysis.
        Atherosclerosis. 2011; 220: 128-133
        • Spence J.D.
        • Eliasziw M.
        • DiCicco M.
        • Hackam D.G.
        • Galil R.
        • Lohmann T.
        Carotid plaque area: a tool for targeting and evaluating vascular preventive therapy.
        Stroke. 2002; 33: 2916-2922
        • Johnsen S.H.
        • Mathiesen E.B.
        • Joakimsen O.
        • et al.
        Carotid atherosclerosis is a stronger predictor of myocardial infarction in women than in men: a 6-year follow-up study of 6226 persons: the Tromso study.
        Stroke. 2007; 38: 2873-2880
        • Mathiesen E.B.
        • Johnsen S.H.
        • Wilsgaard T.
        • Bonaa K.H.
        • Lochen M.L.
        • Njolstad I.
        Carotid plaque area and intima-media thickness in prediction of first-ever ischemic stroke: a 10-year follow-up of 6584 men and women: the Tromso study.
        Stroke. 2011; 42: 972-978

      Linked Article