Advertisement

Egg consumption and risk of cardiovascular diseases and diabetes: A meta-analysis

  • Author Footnotes
    1 Yuehua Li and Chenghui Zhou contributed equally to this article.
    Yuehua Li
    Footnotes
    1 Yuehua Li and Chenghui Zhou contributed equally to this article.
    Affiliations
    State Key Laboratory of Cardiovascular Medicine, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China

    Department of Hypertension, Fuwai Hospital, National Center for Cardiovascular Disease, Beijing 100037, China

    Key Laboratory for Clinical Cardiovascular Genetics and Sino-German Laboratory for Molecular Medicine, Fuwai Hospital, National Center for Cardiovascular Disease, Beijing 100037, China
    Search for articles by this author
  • Author Footnotes
    1 Yuehua Li and Chenghui Zhou contributed equally to this article.
    Chenghui Zhou
    Footnotes
    1 Yuehua Li and Chenghui Zhou contributed equally to this article.
    Affiliations
    State Key Laboratory of Cardiovascular Medicine, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China

    Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Disease, Beijing 100037, China
    Search for articles by this author
  • Xianliang Zhou
    Correspondence
    Corresponding author. State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishilu, Beijing 100037, China. Tel.: +86 10 88398868; fax: +86 10 8839 8358.
    Affiliations
    State Key Laboratory of Cardiovascular Medicine, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China

    Department of Hypertension, Fuwai Hospital, National Center for Cardiovascular Disease, Beijing 100037, China
    Search for articles by this author
  • Lihuan Li
    Correspondence
    Corresponding author. State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishilu, Beijing 100037, China. Tel./fax: +86 10 88372598.
    Affiliations
    State Key Laboratory of Cardiovascular Medicine, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China

    Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Disease, Beijing 100037, China
    Search for articles by this author
  • Author Footnotes
    1 Yuehua Li and Chenghui Zhou contributed equally to this article.

      Highlights

      • Egg consumption increases the risk of cardiovascular diseases in a dose–response manner, especially in patients with diabetes.
      • There is a dose–response positive relationship between egg consumption and the risk of diabetes.
      • Individuals in other western countries seem to have a higher risk of cardiovascular diseases than the ones in the USA under high egg consumption.

      Abstract

      Objectives

      To assess the dose–response relationship between egg consumption and the risk of cardiovascular diseases (CVD) and diabetes.

      Methods

      We systematically searched MEDLINE database through December 2012. Fixed- or random-effects model was used to pool the relative risks (RRs) and their 95% confidence intervals (CIs). Subgroup analyses was performed to explore the potential sources of heterogeneity. Weighted linear regression model was used to estimate the dose–response relationship.

      Results

      Fourteen studies involving 320,778 subjects were included. The pooled RRs of the risk of CVD, CVD for separated diabetes patients, and diabetes for the highest vs lowest egg intake were 1.19 (95% CI 1.02–1.38), 1.83 (95% CI 1.42–2.37), 1.68 (95% CI 1.41–2.00), respectively. For each 4/week increment in egg intake, the RRs of the risk for CVD, CVD for separated diabetes patients, diabetes was 1.06 (95% CI 1.03–1.10), 1.40 (95% CI 1.25–1.57), 1.29 (95% CI 1.21–1.37), respectively. Subgroup analyses showed that population in other western countries have increased CVD than ones in USA (RR 2.00, 95% CI 1.14 to 3.51 vs 1.13, 95% CI 0.98 to 1.30, P = 0.02 for subgroup difference).

      Conclusions

      Our study suggests that there is a dose–response positive association between egg consumption and the risk of CVD and diabetes.

      Keywords

      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:

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

      References

        • 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
        • Song W.O.
        • Kerver J.M.
        Nutritional contribution of eggs to American diets.
        J Am Coll Nutr. 2000; 19: 556S-562S
        • Lewington S.
        • Whitlock G.
        • Clarke R.
        • et al.
        Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55,000 vascular deaths.
        Lancet. 2007; 370: 1829-1839
        • Dawber T.R.
        • Nickerson R.J.
        • Brand F.N.
        • et al.
        Eggs, serum cholesterol, and coronary heart disease.
        Am J Clin Nutr. 1982; 36: 617-625
        • Weggemans R.M.
        • Zock P.L.
        • Katan M.B.
        Dietary cholesterol from eggs increases the ratio of total cholesterol to high-density lipoprotein cholesterol in humans: a meta-analysis.
        Am J Clin Nutr. 2001; 73: 885-891
        • McNamara D.J.
        Dietary cholesterol and atherosclerosis.
        Biochim Biophys Acta. 2000; 1529: 310-320
        • Spence J.D.
        Fasting lipids: the carrot in the snowman.
        Can J Cardiol. 2003; 19: 890-892
        • 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
        • Njike V.
        • Faridi Z.
        • Dutta S.
        • et al.
        Daily egg consumption in hyperlipidemic adults–effects on endothelial function and cardiovascular risk.
        Nutr J. 2010; 9: 28
        • Rak K.
        • Rader D.J.
        Cardiovascular disease: the diet-microbe morbid union.
        Nature. 2011; 472: 40-41
        • Wang Z.
        • Klipfell E.
        • Bennett B.J.
        • et al.
        Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease.
        Nature. 2011; 472: 57-63
      1. Executive summary of the third report of the National Cholesterol Education Program (Ncep) Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III).
        JAMA. 2001; 285: 2486-2497
      2. Third report of the National Cholesterol Education Program (Ncep) Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) Final Report.
        Circulation. 2002; 106: 3143-3421
        • Krauss R.M.
        • Deckelbaum R.J.
        • Ernst N.
        • et al.
        Dietary guidelines for healthy American adults. A statement for health professionals from the Nutrition Committee, American heart association.
        Circulation. 1996; 94: 1795-1800
        • Agency Food Standards
        Fsa unveils first steps of saturated fat and energy intake programme.
        2008
        • Food and Agricultural Organization of the United Nations
        Food based dietary guidelines by country.
        2009
        • Mann J.I.
        • Appleby P.N.
        • Key T.J.
        • et al.
        Dietary determinants of ischaemic heart disease in health conscious individuals.
        Heart. 1997; 78: 450-455
        • Burke V.
        • Zhao Y.
        • Lee A.H.
        • et al.
        Health-related behaviours as predictors of mortality and morbidity in Australian Aborigines.
        Prev Med. 2007; 44: 135-142
        • Djousse L.
        • Gaziano J.M.
        Egg consumption and risk of heart failure in the Physicians' health study.
        Circulation. 2008; 117: 512-516
        • Djousse L.
        • Gaziano J.M.
        Egg consumption in relation to cardiovascular disease and mortality: the Physicians' health study.
        Am J Clin Nutr. 2008; 87: 964-969
        • Nettleton J.A.
        • Steffen L.M.
        • Loehr L.R.
        • et al.
        Incident heart failure is associated with lower whole-grain intake and greater high-fat dairy and egg intake in the atherosclerosis risk in communities (ARIC) study.
        J Am Diet Assoc. 2008; 108: 1881-1887
        • Djousse L.
        • Gaziano J.M.
        • Buring J.E.
        • et al.
        Egg consumption and risk of type 2 diabetes in men and women.
        Diabetes Care. 2009; 32: 295-300
        • Houston D.K.
        • Ding J.
        • Lee J.S.
        • et al.
        Dietary fat and cholesterol and risk of cardiovascular disease in older adults: the health Abc study.
        Nutr Metab Cardiovasc Dis. 2011; 21: 430-437
        • Shi Z.
        • Yuan B.
        • Zhang C.
        • et al.
        Egg consumption and the risk of diabetes in adults, Jiangsu, China.
        Nutrition. 2011; 27: 194-198
        • Radzeviciene L.
        • Ostrauskas R.
        Egg consumption and the risk of type 2 diabetes mellitus: a case-control study.
        Public Health Nutr. 2012; 15: 1437-1441
        • Qiu C.
        • Frederick I.O.
        • Zhang C.
        • et al.
        Risk of gestational diabetes mellitus in relation to maternal egg and cholesterol intake.
        Am J Epidemiol. 2011; 173: 649-658
        • Spence J.D.
        • Jenkins D.J.
        • Davignon J.
        Egg yolk consumption and carotid plaque.
        Atherosclerosis. 2012; 224: 469-473
        • Gramenzi A.
        • Gentile A.
        • Fasoli M.
        • et al.
        Association between certain foods and risk of acute myocardial infarction in women.
        BMJ. 1990; 300: 771-773
        • Nakamura Y.
        • Okamura T.
        • Tamaki S.
        • et al.
        Egg consumption, serum cholesterol, and cause-specific and all-cause mortality: the National Integrated Project for prospective observation of non-communicable disease and its trends in the aged, 1980 (Nippon Data80).
        Am J Clin Nutr. 2004; 80: 58-63
        • Nakamura Y.
        • Iso H.
        • Kita Y.
        • et al.
        Egg consumption, serum total cholesterol concentrations and coronary heart disease incidence: Japan Public health Center-based prospective study.
        Br J Nutr. 2006; 96: 921-928
        • Qureshi A.I.
        • Suri F.K.
        • Ahmed S.
        • et al.
        Regular egg consumption does not increase the risk of stroke and cardiovascular diseases.
        Med Sci Monit. 2007; 13: CR1-CR8
        • Djousse L.
        • Kamineni A.
        • Nelson T.L.
        • et al.
        Egg consumption and risk of type 2 diabetes in older adults.
        Am J Clin Nutr. 2010; 92: 422-427
        • Scrafford C.G.
        • Tran N.L.
        • Barraj L.M.
        • et al.
        Egg consumption and Chd and stroke mortality: a prospective study of US adults.
        Public Health Nutr. 2011; 14: 261-270
        • Zazpe I.
        • Beunza J.J.
        • Bes-Rastrollo M.
        • et al.
        Egg consumption and risk of cardiovascular disease in the sun project.
        Eur J Clin Nutr. 2011; 65: 676-682
        • Stroup D.F.
        • Berlin J.A.
        • Morton S.C.
        • et al.
        Meta-analysis of observational studies in Epidemiology: a proposal for reporting. Meta-Analysis of observational studies in Epidemiology (Moose) group.
        JAMA. 2000; 283: 2008-2012
        • DerSimonian R.
        • Laird N.
        Meta-analysis in clinical trials.
        Control Clin Trials. 1986; 7: 177-188
      3. Higgins J.P.T. Green S. Cochrane handbook for systematic reviews of interventions. Version 5.0.2. Wiley, New York, Ny2009
        • Greenland S.
        • Longnecker M.P.
        Methods for trend estimation from summarized dose-response data, with applications to meta-analysis.
        Am J Epidemiol. 1992; 135: 1301-1309
        • Egger M.
        • Davey Smith G.
        • Schneider M.
        • et al.
        Bias in meta-analysis detected by a simple, graphical test.
        BMJ. 1997; 315: 629-634
        • Lloyd-Jones D.
        • Adams R.J.
        • Brown T.M.
        • et al.
        Heart disease and stroke statistics–2010 update: a report from the American Heart Association.
        Circulation. 2010; 121: e46-e215
        • Mokdad A.H.
        • Ford E.S.
        • Bowman B.A.
        • et al.
        Prevalence of obesity, diabetes, and obesity-related health risk factors.
        JAMA. 2001; 2003: 76-79
        • Adamopoulos P.N.
        • Papamichael C.M.
        • Zampelas A.
        • et al.
        Cholesterol and unsaturated fat diets influence lipid and glucose concentrations in rats.
        Comp Biochem Physiol B Biochem Mol Biol. 1996; 113: 659-663
        • Reaven G.M.
        • Abbasi F.
        • Bernhart S.
        • et al.
        Insulin resistance, dietary cholesterol, and cholesterol concentration in postmenopausal women.
        Metabolism. 2001; 50: 594-597
        • Mutungi G.
        • Ratliff J.
        • Puglisi M.
        • et al.
        Dietary cholesterol from eggs increases plasma Hdl cholesterol in overweight men consuming a carbohydrate-restricted diet.
        J Nutr. 2008; 138: 272-276
        • Pearce K.L.
        • Clifton P.M.
        • Noakes M.
        Egg consumption as part of an energy-restricted high-protein diet improves blood lipid and blood glucose profiles in individuals with type 2 diabetes.
        Br J Nutr. 2011; 105: 584-592