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Ma Z, Wu W, Zhang D, Wu P, Guo Y, Li D, Yang F. Daily intake of up to two eggs for 11 weeks does not affect the cholesterol balance of Chinese young adults. Food Sci Nutr 2022; 10:1081-1092. [PMID: 35432976 PMCID: PMC9007305 DOI: 10.1002/fsn3.2734] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 12/13/2021] [Accepted: 01/02/2022] [Indexed: 12/22/2022] Open
Abstract
Approximately 90% of the cholesterol content of the body is derived from de novo synthesis and the enterohepatic circulation. As numerous studies have shown previously, one egg per day intake has little impact of cholesterol balance in human body. Therefore, this study assumed that intake of up two eggs a day has little effect on biomarkers of cardiovascular diseases (CVDs) risk in Chinese young adults. With the increase in egg intake, total cholesterol, low‐density lipoprotein cholesterol (LDL‐C), high‐density lipoprotein cholesterol (HDL‐C), and choline all increased among all the groups as the study progressed from autumn to winter (p < .05). However, there were no differences in the plasma triglycerides, LDL‐C/HDL‐C ratio, glucose, liver enzymes, C‐reactive protein, and urinary microalbumin during the diet periods. Subjects who ate eggs at breakfast felt less hungry and more satisfied, which were relative with decreased fasting plasma ghrelin level (p < .05). Furthermore, egg‐derived cholesterol appeared to upregulate the mRNA levels of low‐density lipoprotein receptor and lecithin–cholesterol acyltransferase, and downregulate cholesteryl ester transfer protein and flavin‐containing monooxygenase 3 mRNA levels in isolated peripheral blood mononuclear cells. These results demonstrate that intake of up to two eggs a day had little effect on biomarkers of CVDs in young, healthy Chinese college students and provided useful evidence for the dietary guidelines regarding egg consumption.
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Affiliation(s)
- Zhili Ma
- School of Laboratory Medicine Hubei University of Chinese Medicine Wuhan China
| | - Wei Wu
- School of Laboratory Medicine Hubei University of Chinese Medicine Wuhan China
| | - Dexin Zhang
- School of Laboratory Medicine Hubei University of Chinese Medicine Wuhan China
| | - Ping Wu
- School of Laboratory Medicine Hubei University of Chinese Medicine Wuhan China
| | - Yuanhua Guo
- School of Laboratory Medicine Hubei University of Chinese Medicine Wuhan China
| | - Deyuan Li
- School of Laboratory Medicine Hubei University of Chinese Medicine Wuhan China
| | - Fang Yang
- School of Laboratory Medicine Hubei University of Chinese Medicine Wuhan China
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2
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Yang PF, Wang CR, Hao FB, Peng Y, Wu JJ, Sun WP, Hu JJ, Zhong GC. OUP accepted manuscript. Nutr Rev 2022; 80:1739-1754. [PMID: 35178575 DOI: 10.1093/nutrit/nuac002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Peng-Fei Yang
- Department of Nephrology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chun-Rui Wang
- Department of Infectious Diseases, Institute for Viral Hepatitis, the Key Laboratory of Molecular Biology for Infectious Diseases, Chinese Ministry of Education, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fa-Bao Hao
- Department of Neurosurgery, Qingdao Women and Children's Hospital, Qingdao University, Qingdao, Shandong, China
| | - Yang Peng
- Department of Geriatrics, the Fifth People's Hospital of Chengdu, Chengdu, China
| | - Jing-Jing Wu
- Department of Nutrition and Food Hygiene, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Wei-Ping Sun
- Department of Gastrointestinal Surgery, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jie-Jun Hu
- Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Guo-Chao Zhong
- Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Wu F, Zhuang P, Zhang Y, Zhan C, Zhang Y, Jiao J. Egg and Dietary Cholesterol Consumption and Mortality Among Hypertensive Patients: Results From a Population-Based Nationwide Study. Front Nutr 2021; 8:739533. [PMID: 34778336 PMCID: PMC8588794 DOI: 10.3389/fnut.2021.739533] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 09/29/2021] [Indexed: 01/25/2023] Open
Abstract
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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Affiliation(s)
- Fei Wu
- Department of Nutrition, School of Public Health, Department of Clinical Nutrition of Affiliated Second Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Pan Zhuang
- National Engineering Laboratory of Intelligent Food Technology and Equipment, Zhejiang Key Laboratory for Agro-Food Processing, College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, China
| | - Yiju Zhang
- National Engineering Laboratory of Intelligent Food Technology and Equipment, Zhejiang Key Laboratory for Agro-Food Processing, College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, China
| | - Chuchu Zhan
- National Engineering Laboratory of Intelligent Food Technology and Equipment, Zhejiang Key Laboratory for Agro-Food Processing, College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, China
| | - Yu Zhang
- National Engineering Laboratory of Intelligent Food Technology and Equipment, Zhejiang Key Laboratory for Agro-Food Processing, College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, China
| | - Jingjing Jiao
- Department of Nutrition, School of Public Health, Department of Clinical Nutrition of Affiliated Second Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Wan Z, Sun N, Luo M, Gan B, Yao Z, Cao X, Wang H, Pan K, Shu G, Zeng Y, Zeng D, Ni X. Promotion of Egg Production Rate and Quality Using Limosilactobacillus oris BSLO 1801, a Potential Probiotic Screened from Feces of Laying Hens with Higher Egg Productive Performance. Probiotics Antimicrob Proteins 2021; 15:535-547. [PMID: 34697775 DOI: 10.1007/s12602-021-09856-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2021] [Indexed: 02/08/2023]
Abstract
In this experiment, laying hens were divided into a high productive group (group H) and a low productive group (group L). The purpose of this experiment was to screen and isolate a potential probiotic associated with the laying rate from group H by comparing the results via 16S rDNA high-throughput sequencing. The high-throughput sequencing analysis results showed that there were some differences in the composition of the gut microbiome between groups H and L on the Phylum and Genus levels. Through isolation and identification, we screened 16 lactobacilli strains. Among the 16 strains, S5 showed good acid tolerance, bile salt tolerance, and cholesterol degradation. Therefore, we chose strain S5 (identified as Limosilactobacillus oris, named Limosilactobacillus oris BSLO 1801) as a potential probiotic to promote the productivity of ordinary laying hens. During the animal experiment, 288 Hy-line white hens (30 weeks old) were divided into four groups, with six replications (n = 12) per group. The control group received the basic diet, and the treatment groups received the same basic diet supplemented with 107 CFU/kg, 108 CFU/kg, and 109 CFU/kg of BSLO 1801. The laying hens were acclimated to the environment for 1 week before the initiation of the experiment. Dietary supplementation with 107 CFU/kg and 109 CFU/kg of BSLO 1801 increased the laying rate significantly, and the potential probiotic improved the egg weight in all treatment groups. Additionally, the cholesterol content of the yolk dropped significantly in the 109 CFU/kg group, and the weight of egg yolk was significantly increased in all treatment groups. However, no significant differences in eggshell strength, eggshell thickness, protein height, and Haugh unit were observed among the four groups. These results revealed that lactobacilli spp. are important bacteria of the intestinal microbiome in highly productive laying hens, and BSLO 1801 was isolated as a potential probiotic. Through these animal experiments, we also found that adding BSLO 1801 to the basic diet of laying hens could effectively improve the laying rate, average egg weight, and yolk weight and reduce the cholesterol content in egg yolk.
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Affiliation(s)
- Zhiqiang Wan
- Animal Microecology Institute, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - Ning Sun
- Animal Microecology Institute, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - Min Luo
- Animal Microecology Institute, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - Baoxing Gan
- Animal Microecology Institute, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - Zhipeng Yao
- Animal Microecology Institute, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - Xi Cao
- Animal Microecology Institute, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - Hesong Wang
- Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Institute of Gastroenterology of Guangdong Province, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Kangcheng Pan
- Animal Microecology Institute, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - Gang Shu
- Animal Microecology Institute, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - Yan Zeng
- Animal Microecology Institute, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China
| | - Dong Zeng
- Animal Microecology Institute, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China.
| | - Xueqin Ni
- Animal Microecology Institute, College of Veterinary Medicine, Sichuan Agricultural University, Chengdu, China.
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Schnebelen-Berthier C, Acar N, Simon E, Thabuis C, Bourdillon A, Mathiaud A, Dauchet L, Delcourt C, Benlian P, Crochet M, Defoort S, Tailleux A, Staels B, Bretillon L, Lecerf JM. The ALGOVUE Clinical Trial: Effects of the Daily Consumption of Eggs Enriched with Lutein and Docosahexaenoic Acid on Plasma Composition and Macular Pigment Optical Density. Nutrients 2021; 13:nu13103347. [PMID: 34684356 PMCID: PMC8541434 DOI: 10.3390/nu13103347] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/14/2021] [Accepted: 09/17/2021] [Indexed: 12/22/2022] Open
Abstract
Background. Carotenoids and docosahexaenoic acid (DHA) were identified as essential components for eye health and are both naturally present in eggs. Objective. We aimed to evaluate the effect of the daily consumption of two eggs enriched with lutein/zeaxanthin and DHA on macular pigment optical density (MPOD) and on circulating xanthophyll and fatty acid concentrations in healthy participants. Methods. Ninety-nine healthy volunteers consumed either two standard eggs or two enriched eggs per day for 4 months. MPOD was measured at baseline (V0) and at follow-up (V4) using a modified confocal scanning laser ophthalmoscope (primary outcome). Blood samples were collected to determine total plasma and lipoprotein fatty acids and lutein/zeaxanthin compositions at V0 and V4 (secondary outcomes). Results. A slight but significant increase in MPOD was observed for all study participants consuming two eggs per day for 4 months at all eccentricities (0.5°, 1°, 2°, and 4°). Plasma and lipoprotein lutein, zeaxanthin, and DHA concentrations significantly increased in both groups but were greater in the enriched group (for the enriched group (V0 vs. V4): lutein, 167 vs. 369 ng/mL; zeaxanthin, 17.7 vs. 29.2 ng/mL; DHA, 1.89 vs. 2.56% of total fatty acids). Interestingly, lutein from high-density lipoprotein (HDL) was strongly correlated with MPOD at 0.5 and 1° eccentricities (rho = 0.385, p = 0.008, and rho = 0.461, p = 0.001, respectively). Conclusions. MPOD was slightly increased in both groups. Lutein, zeaxanthin, and DHA plasma concentrations were strongly enhanced in the enriched group compared with the standard group. A significant correlation was found between MPOD level and lutein concentration in HDL.
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Affiliation(s)
- Coralie Schnebelen-Berthier
- Service Nutrition & Activité Physique, Institut Pasteur de Lille, F-59019 Lille, France; (E.S.); (J.-M.L.)
- Correspondence: ; Tel.: +33-20-87-73-33
| | - Niyazi Acar
- Centre des Sciences du Goût et de l’Alimentation, Agrosup Dijon, CNRS, INRA, Université Bourgogne Franche-Comté, F-21000 Dijon, France; (N.A.); (L.B.)
| | - Emilie Simon
- Service Nutrition & Activité Physique, Institut Pasteur de Lille, F-59019 Lille, France; (E.S.); (J.-M.L.)
| | | | - Anne Bourdillon
- MIXSCIENCE, Centre d’Affaires Odyssée, ZAC Cicé Blossac, F-35172 Bruz, France; (A.B.); (A.M.)
| | - Adeline Mathiaud
- MIXSCIENCE, Centre d’Affaires Odyssée, ZAC Cicé Blossac, F-35172 Bruz, France; (A.B.); (A.M.)
| | - Luc Dauchet
- CNRS, INSERM, CHU de Lille, Institut Pasteur de Lille, UMR 1283-EGID, “Integrative Genomics and Modelling of Metabolic Diseases”, Université de Lille, F-59045 Lille, France; (L.D.); (P.B.); (A.T.); (B.S.)
| | - Cécile Delcourt
- “Bordeaux Population Health Research Center” (BPH), INSERM, UMR1219, “Lifelong Exposures, Health and Ageing” (LEHA) Group, Université de Bordeaux, F-33076 Bordeaux, France;
| | - Pascale Benlian
- CNRS, INSERM, CHU de Lille, Institut Pasteur de Lille, UMR 1283-EGID, “Integrative Genomics and Modelling of Metabolic Diseases”, Université de Lille, F-59045 Lille, France; (L.D.); (P.B.); (A.T.); (B.S.)
| | - Martine Crochet
- CHU Lille, Service d’Exploration de la Vision et Neuro-Ophtalmologie, F-59000 Lille, France; (M.C.); (S.D.)
| | - Sabine Defoort
- CHU Lille, Service d’Exploration de la Vision et Neuro-Ophtalmologie, F-59000 Lille, France; (M.C.); (S.D.)
| | - Anne Tailleux
- CNRS, INSERM, CHU de Lille, Institut Pasteur de Lille, UMR 1283-EGID, “Integrative Genomics and Modelling of Metabolic Diseases”, Université de Lille, F-59045 Lille, France; (L.D.); (P.B.); (A.T.); (B.S.)
| | - Bart Staels
- CNRS, INSERM, CHU de Lille, Institut Pasteur de Lille, UMR 1283-EGID, “Integrative Genomics and Modelling of Metabolic Diseases”, Université de Lille, F-59045 Lille, France; (L.D.); (P.B.); (A.T.); (B.S.)
| | - Lionel Bretillon
- Centre des Sciences du Goût et de l’Alimentation, Agrosup Dijon, CNRS, INRA, Université Bourgogne Franche-Comté, F-21000 Dijon, France; (N.A.); (L.B.)
| | - Jean-Michel Lecerf
- Service Nutrition & Activité Physique, Institut Pasteur de Lille, F-59019 Lille, France; (E.S.); (J.-M.L.)
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Schade DS, Gonzales K, Kaminsky N, Adolphe A, Shey L, Eaton RP. Resolving the Egg and Cholesterol Intake Controversy: New Clinical Insights Into Cholesterol Regulation by the Liver and Intestine. Endocr Pract 2021; 28:102-109. [PMID: 34547473 DOI: 10.1016/j.eprac.2021.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 08/19/2021] [Accepted: 09/09/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Cardiovascular disease is the number one cause of death. Achieving American Heart Association low-density lipoprotein (LDL) cholesterol treatment goals is very difficult for many patients. The importance of a low cholesterol diet is controversial and not emphasized by most physicians. Of critical importance is determining whether each individual is a "hyper- or hypo-absorber" of dietary cholesterol. Furthermore, the quantity of each individual's baseline daily dietary cholesterol and saturated fat intake is important in assessing the effect of added egg yolk cholesterol and saturated fat on blood LDL cholesterol. METHODS Gut cholesterol is absorbed via a specific enteric receptor (the Niemann- Pick-like receptor). Dietary cholesterol contributes one fourth of the absorbed cholesterol, while the remaining gut cholesterol is derived from secreted bile cholesterol. This dietary quantity of cholesterol is significant when other determinants are constant. For some individuals, dietary cholesterol has no adverse effects and in others, a significant elevation in blood LDL cholesterol may occur. RESULTS There are no readily available blood tests to determine the effect of egg yolk cholesterol and saturated fat on an individual's plasma LDL cholesterol. However, a one month trial of a low cholesterol and saturated fat diet will provide the needed information to make clinical decisions. CONCLUSION This article delineates the mechanisms that are altered by genetic and environmental factors that determine the net effects of dietary cholesterol and saturated fat on circulating LDL cholesterol. It then makes a practical clinical recommendation based on these mechanisms.
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Affiliation(s)
- David S Schade
- Division of Endocrinology, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.
| | - Kristen Gonzales
- Division of Endocrinology, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - Neil Kaminsky
- Division of Endocrinology, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - Allen Adolphe
- Division of Internal Medicine, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
| | - Lynda Shey
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Diabetes Comprehensive Care Center, Albuquerque, New Mexico
| | - Robert Philip Eaton
- Division of Endocrinology, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
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Hahn J, Dehghan M, Drouin-Chartier JP, Mentz RJ, Jneid H, Virani SS, Tang WHW, Krittanawong C. Egg Consumption and Risk of Cardiovascular Disease: a Critical Review. CURRENT EMERGENCY AND HOSPITAL MEDICINE REPORTS 2021. [DOI: 10.1007/s40138-021-00225-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Sugano M, Matsuoka R. Nutritional Viewpoints on Eggs and Cholesterol. Foods 2021; 10:494. [PMID: 33669005 PMCID: PMC7996514 DOI: 10.3390/foods10030494] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/20/2021] [Accepted: 02/22/2021] [Indexed: 12/17/2022] Open
Abstract
Although most current epidemiologic studies indicate no significant association between consuming one egg daily and blood cholesterol levels and cardiovascular risk, arguments still persist with a positive association. Since the diet is one of the most influential factors for this association, we illustrate characteristic features in Japanese people whose dietary pattern is distinct from that, for example, the US (United States) population. Available epidemiologic studies in healthy Japanese people show no association between consumption of one egg daily and blood cholesterol level, consistent with those observed in the US population. However, when consumption of major nutrients and food sources of cholesterol are compared to the US population, Japanese people may have an extra-reserve against the influence of eggs on cardiovascular risk markers, despite consuming relatively more eggs. Further discussion on the influence of nutrients contained in the egg and dietary pattern, including interaction with gut microbes, is necessary. In addition, special consideration at the personalized level is needed for judgment regarding dietary cholesterol not only for hypercholesterolemic patients but for hyper-responsive healthy persons. Although randomized controlled trials with long-term follow-up are required to evaluate the association between consumption of eggs and human health, available information, at least from the nutritional viewpoint, suggests that egg is a healthy and cost-efficient food worldwide.
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Affiliation(s)
- Michihiro Sugano
- Kyushu University, Fukuoka 819-0395, Japan;
- Prefectural University of Kumamoto, Kumamoto 862-8502, Japan
- Japan Egg Science Society, Tokyo 182-0002, Japan
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Schade DS, Shey L, Eaton RP. Cholesterol Review: A Metabolically Important Molecule. Endocr Pract 2021; 26:1514-1523. [PMID: 33471744 DOI: 10.4158/ep-2020-0347] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 06/27/2020] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Cholesterol is an important molecule in humans and both its excess and its deficiency cause disease. Most clinicians appreciate its role in stabilizing cellular plasma membranes but are unaware of its myriad other functions. METHODS This review highlights cholesterol's newly recognized important roles in human physiology and pathophysiology. RESULTS The basis for cholesterol's ubiquitous presence in eukaryote organisms is its three part structure involving hydrophilic, hydrophobic, and rigid domains. This structure permits cholesterol to regulate multiple cellular processes ranging from membrane fluidity and permeability to gene transcription. Cholesterol not only serves as a molecule of regulation itself, but also forms the backbone of all steroid hormones and vitamin D analogs. Cholesterol is responsible for growth and development throughout life and may be useful as an anticancer facilitator. Because humans have a limited ability to catabolize cholesterol, it readily accumulates in the body when an excess from the diet or a genetic abnormality occurs. This accumulation results in the foremost cause of death and disease (atherosclerosis) in the Western world. Identification of cholesterol's disease-producing capabilities dates back 5,000 years to the Tyrolean iceman and more recently to ancient mummies from many cultures throughout the world. In contrast, a deficiency of cholesterol in the circulation may result in an inability to distribute vitamins K and E to vital organs with serious consequences. CONCLUSION Understanding the benefits and hazards of cholesterol in the clinical setting will improve the endocrinologist's ability to control diseases associated with this unique molecule. ABBREVIATIONS CVD = cardiovascular disease; HDL = high-density lipoprotein; LDL = low-density lipoprotein; NPC1L1 = Niemann-Pick C-1-like-1 protein; U.S. = United States; USDA = U.S. Department of Agriculture.
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Affiliation(s)
- David S Schade
- From the (1)University of New Mexico School of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Albuquerque, New Mexico, and the.
| | - Lynda Shey
- University of New Mexico Hospital, Diabetes Comprehensive Care Center, Albuquerque, New Mexico
| | - R Philip Eaton
- From the (1)University of New Mexico School of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Albuquerque, New Mexico, and the
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Krittanawong C, Narasimhan B, Wang Z, Virk HUH, Farrell AM, Zhang H, Tang WHW. Association Between Egg Consumption and Risk of Cardiovascular Outcomes: A Systematic Review and Meta-Analysis. Am J Med 2021; 134:76-83.e2. [PMID: 32653422 DOI: 10.1016/j.amjmed.2020.05.046] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 05/13/2020] [Accepted: 05/13/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Considerable controversy remains on the relationship between egg consumption and cardiovascular disease risk. The objective of this systematic review and meta-analysis was to explore the association between egg consumption and overall cardiovascular disease events. METHODS We systematically searched Ovid MEDLINE, Ovid Embase, Ovid Cochrane Database of Systematic Reviews, Scopus, and Web of Science from database inception in 1966 through January 2020 for observational studies that reported the association between egg consumption and cardiovascular disease events. Two investigators independently reviewed data. Conflicts were resolved through consensus. Random-effects meta-analyses were used. Sources of heterogeneity were analyzed. RESULTS We identified 23 prospective studies with a median follow-up of 12.28 years. A total of 1,415,839 individuals with a total of 123,660 cases and 157,324 cardiovascular disease events were included. Compared with the consumption of no or 1 egg/day, higher egg consumption (more than 1 egg/day) was not associated with significantly increased risk of overall cardiovascular disease events (pooled hazard ratios, 0.99; 95% confidence interval, 0.93-1.06; P < .001; I² = 72.1%). Higher egg consumption (more than 1 egg/day) was associated with a significantly decreased risk of coronary artery disease (pooled hazard ratios, 0.89; 95% confidence interval, 0.86-0.93; P < .001; I² = 0%), compared with consumption of no or 1 egg/day. CONCLUSIONS Our analysis suggests that higher consumption of eggs (more than 1 egg/day) was not associated with increased risk of cardiovascular disease, but was associated with a significant reduction in risk of coronary artery disease.
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Affiliation(s)
- Chayakrit Krittanawong
- The Michael E. DeBakey VA Medical Center, Houston, Texas; Section of Cardiology, Baylor College of Medicine, Houston, Texas; The Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, Mount Sinai Heart, New York, NY.
| | - Bharat Narasimhan
- The Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, Mount Sinai Heart, New York, NY
| | - Zhen Wang
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota; Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Hafeez Ul Hassan Virk
- Department of Cardiovascular Diseases, Case Western Reserve University/ Cleveland Medical Center, Cleveland, Ohio
| | - Ann M Farrell
- Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota
| | - HongJu Zhang
- Mayo Clinic Libraries, Mayo Clinic, Rochester, Minnesota
| | - W H Wilson Tang
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Ohio
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Panaite TD, Turcu RP, Soica C, Visinescu P. Nutritional parameters of eggs from laying hens fed with flaxseed meal or mixture with rapeseed meal or rice bran. JOURNAL OF APPLIED ANIMAL RESEARCH 2020. [DOI: 10.1080/09712119.2020.1848846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Tatiana Dumitra Panaite
- Laboratory of Nutrition and Physiology, National Research-Development Institute for Biology and Animal Nutrition (IBNA), Balotesti, Romania
| | - Raluca Paula Turcu
- Laboratory of Nutrition and Physiology, National Research-Development Institute for Biology and Animal Nutrition (IBNA), Balotesti, Romania
| | - Cristina Soica
- Laboratory of Nutrition and Physiology, National Research-Development Institute for Biology and Animal Nutrition (IBNA), Balotesti, Romania
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12
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Egg and egg-sourced cholesterol consumption in relation to mortality: Findings from population-based nationwide cohort. Clin Nutr 2020; 39:3520-3527. [DOI: 10.1016/j.clnu.2020.03.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 03/16/2020] [Accepted: 03/17/2020] [Indexed: 12/28/2022]
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13
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Godos J, Micek A, Brzostek T, Toledo E, Iacoviello L, Astrup A, Franco OH, Galvano F, Martinez-Gonzalez MA, Grosso G. Egg consumption and cardiovascular risk: a dose-response meta-analysis of prospective cohort studies. Eur J Nutr 2020; 60:1833-1862. [PMID: 32865658 PMCID: PMC8137614 DOI: 10.1007/s00394-020-02345-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 07/21/2020] [Indexed: 12/11/2022]
Abstract
Purpose Cardiovascular disease (CVD) is a leading cause of mortality globally and is strongly influenced by dietary risk factors. The aim was to assess the association between egg consumption and risk of CVD risk/mortality, including coronary heart disease (CHD), stroke, and heart failure. Methods MEDLINE, Embase, and Web of Science databases were searched through April 2020 for prospective studies. Two independent reviewers screened and extracted the data through standardized methods. Size effects were calculated as summary relative risks (SRRs) in a dose–response fashion through random-effects meta-analyses. Results Thirty-nine studies including nearly 2 million individuals and 85,053 CHD, 25,103 stroke, 7536 heart failure, and 147,124 CVD cases were included. The summary analysis including 17 datasets from 14 studies conducted on CVD (incidence and/or mortality) showed that intake of up to six eggs per week is inversely associated with CVD events, when compared to no consumption [for four eggs per week, SRR = 0.95 (95% CI: 0.90; 1.00)]; a decreased risk of CVD incidence was observed for consumption of up to one egg per day [SRR = 0.94 (95% CI: 0.89; 0.99)]. The summary analysis for CHD incidence/mortality including 24 datasets from 16 studies showed a decreased risk up to two eggs per week [(SRR = 0.96 (95% CI: 0.91; 1.00)]. No associations were retrieved with risk of stroke. The summary analysis for heart failure risk including six datasets from four studies showed that intake of one egg per day was associated with increased risk raising for higher intakes compared to no consumption [for 1 egg per day, SRR = 1.15 (95% CI:1.02; 1.30)]. After considering GRADE criteria for strength of the evidence, it was rated low for all outcomes but stroke, for which it was moderate (yet referring to no risk). Conclusion There is no conclusive evidence on the role of egg in CVD risk, despite the fact that higher quality studies are warranted to obtain stronger evidence for a possible protection of CVD associated with moderate weekly egg consumption compared to no intake; equally, future studies may strengthen the evidence for increased heart failure risk associated with high regular egg consumption. Electronic supplementary material The online version of this article (10.1007/s00394-020-02345-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Agnieszka Micek
- Department of Nursing Management and Epidemiology Nursing, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland
| | - Tomasz Brzostek
- Department of Internal Medicine and Community Nursing, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland
| | - Estefania Toledo
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Navarre, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Navarra Institute for Health Research, IdiSNA, Pamplona, Navarre, Spain
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, IS, Italy.,Department of Medicine and Surgery, Research Centre in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy
| | - Arne Astrup
- Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Nørre Campus, Copenhagen, Denmark
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.,Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Fabio Galvano
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia 97, 95123, Catania, Italy
| | - Miguel A Martinez-Gonzalez
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Navarre, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Navarra Institute for Health Research, IdiSNA, Pamplona, Navarre, Spain.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Giuseppe Grosso
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia 97, 95123, Catania, Italy.
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14
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Xia X, Liu F, Yang X, Li J, Chen J, Liu X, Cao J, Shen C, Yu L, Zhao Y, Wu X, Zhao L, Li Y, Huang J, Lu X, Gu D. Associations of egg consumption with incident cardiovascular disease and all-cause mortality. SCIENCE CHINA-LIFE SCIENCES 2020; 63:1317-1327. [PMID: 32170624 DOI: 10.1007/s11427-020-1656-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 02/27/2020] [Indexed: 10/24/2022]
Abstract
Eggs are nutrient-dense while also loaded with abundant cholesterol, thus making the public hesitant about their consumption. We conducted the study to investigate if egg consumption is associated with incident cardiovascular disease (CVD) and all-cause mortality. Using the project of Prediction for Atherosclerotic Cardiovascular Disease Risk in China, we included 102,136 adults free of CVD and assessed their egg consumption with food-frequency questionnaires. CVD endpoints and all-cause mortality were confirmed during follow-ups by interviewing participants or their proxies and checking hospital records/death certificates. The HRs (95% CIs) were calculated using the cohort-stratified Cox regression models. During 777,163 person-years of follow-up, we identified 4,848 incident CVD and 5,511 deaths. U-shaped associations of egg consumption with incident CVD and all-cause mortality were observed. Compared with consumption of 3-<6/week, the multivariable-adjusted HRs (95% CIs) of <1/week and ≥10/week for incident CVD were 1.22 (1.11 to 1.35) and 1.39 (1.28 to 1.52), respectively. The corresponding HRs (95% CIs) for all-cause mortality were 1.29 (1.18 to 1.41) and 1.13 (1.04 to 1.24). Our findings identified that both low and high consumption were associated with increased risk of incident CVD and all-cause mortality, highlighting that moderate egg consumption of 3-<6/week should be recommended for CVD prevention in China.
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Affiliation(s)
- Xue Xia
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Fangchao Liu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Xueli Yang
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Jianxin Li
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Jichun Chen
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Xiaoqing Liu
- Division of Epidemiology, Guangdong Provincial People's Hospital and Cardiovascular Institute, Guangzhou, 510080, China
| | - Jie Cao
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Chong Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Ling Yu
- Department of Cardiology, Fujian Provincial Hospital, Fuzhou, 350014, China
| | - Yingxin Zhao
- Shandong First Medical University, Jinan, 271016, China
| | - Xianping Wu
- Sichuan Center for Disease Control and Prevention, Chengdu, 610041, China
| | - Liancheng Zhao
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Ying Li
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Jianfeng Huang
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Xiangfeng Lu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.
| | - Dongfeng Gu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.
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15
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Drouin-Chartier JP, Chen S, Li Y, Schwab AL, Stampfer MJ, Sacks FM, Rosner B, Willett WC, Hu FB, Bhupathiraju SN. Egg consumption and risk of cardiovascular disease: three large prospective US cohort studies, systematic review, and updated meta-analysis. BMJ 2020; 368:m513. [PMID: 32132002 PMCID: PMC7190072 DOI: 10.1136/bmj.m513] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To evaluate the association between egg intake and cardiovascular disease risk among women and men in the United States, and to conduct a meta-analysis of prospective cohort studies. DESIGN Prospective cohort study, and a systematic review and meta-analysis of prospective cohort studies. SETTING Nurses' Health Study (NHS, 1980-2012), NHS II (1991-2013), Health Professionals' Follow-Up Study (HPFS, 1986-2012). PARTICIPANTS Cohort analyses included 83 349 women from NHS, 90 214 women from NHS II, and 42 055 men from HPFS who were free of cardiovascular disease, type 2 diabetes, and cancer at baseline. MAIN OUTCOME MEASURES Incident cardiovascular disease, which included non-fatal myocardial infarction, fatal coronary heart disease, and stroke. RESULTS Over up to 32 years of follow-up (>5.54 million person years), 14 806 participants with incident cardiovascular disease were identified in the three cohorts. Participants with a higher egg intake had a higher body mass index, were less likely to be treated with statins, and consumed more red meats. Most people consumed between one and less than five eggs per week. In the pooled multivariable analysis, consumption of at least one egg per day was not associated with incident cardiovascular disease risk after adjustment for updated lifestyle and dietary factors associated with egg intake (hazard ratio for at least one egg per day v less than one egg per month 0.93, 95% confidence interval 0.82 to 1.05). In the updated meta-analysis of prospective cohort studies (33 risk estimates, 1 720 108 participants, 139 195 cardiovascular disease events), an increase of one egg per day was not associated with cardiovascular disease risk (pooled relative risk 0.98, 95% confidence interval 0.93 to 1.03, I2=62.3%). Results were similar for coronary heart disease (21 risk estimates, 1 411 261 participants, 59 713 coronary heart disease events; 0.96, 0.91 to 1.03, I2=38.2%), and stroke (22 risk estimates, 1 059 315 participants, 53 617 stroke events; 0.99, 0.91 to 1.07, I2=71.5%). In analyses stratified by geographical location (P for interaction=0.07), no association was found between egg consumption and cardiovascular disease risk among US cohorts (1.01, 0.96 to 1.06, I2=30.8%) or European cohorts (1.05, 0.92 to 1.19, I2=64.7%), but an inverse association was seen in Asian cohorts (0.92, 0.85 to 0.99, I2=44.8%). CONCLUSIONS Results from the three cohorts and from the updated meta-analysis show that moderate egg consumption (up to one egg per day) is not associated with cardiovascular disease risk overall, and is associated with potentially lower cardiovascular disease risk in Asian populations. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019129650.
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Affiliation(s)
| | - Siyu Chen
- Department of Nutrition, Harvard T H Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Yanping Li
- Department of Nutrition, Harvard T H Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Amanda L Schwab
- Department of Nutrition, Harvard T H Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Meir J Stampfer
- Department of Nutrition, Harvard T H Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Frank M Sacks
- Department of Nutrition, Harvard T H Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Bernard Rosner
- Department of Nutrition, Harvard T H Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Biostatistics, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Walter C Willett
- Department of Nutrition, Harvard T H Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Frank B Hu
- Department of Nutrition, Harvard T H Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Shilpa N Bhupathiraju
- Department of Nutrition, Harvard T H Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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16
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Takagi H, Hari Y, Nakashima K, Kuno T, Ando T. Egg Consumption and Coronary Artery Disease: A Nice Knockdown Argument. Angiology 2020; 71:589-601. [PMID: 32000503 DOI: 10.1177/0003319719897493] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
To identify prospective cohort studies enrolling adults and investigating an association of egg consumption with incidence and mortality of coronary artery disease (CAD), PubMed and Web of Science were searched through June 2019. Adjusted hazard ratios (HRs) of CAD incidence/mortality for more versus the least frequent egg consumption were extracted from each study. Study-specific estimates were pooled in the random-effects model. Sixteen eligible studies with a total of 1 285 505 participants were identified and included in the present meta-analysis. The primary meta-analysis pooling all HRs for the most versus least frequent egg consumption demonstrated that egg consumption was associated with significantly low CAD incidence/mortality (pooled HR: 0.93; 95% confidence interval: 0.89-0.98; I 2 = 9%). In the secondary meta-analyses (separately combining HRs for the third vs first tertile, the fourth vs first quartile, the third vs first quartile, the fifth vs first quintile, the fourth vs first quintile, and the third vs first quintile egg consumption), the fifth (vs first) quintile egg consumption was only associated with significantly low CAD incidence/mortality. In conclusion, egg consumption is independently associated with low incidence/mortality of CAD, which may be derived from the comparisons of the fifth versus first quintile egg consumption.
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Affiliation(s)
- Hisato Takagi
- Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.,Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yosuke Hari
- Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.,Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Kouki Nakashima
- Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.,Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Toshiki Kuno
- Department of Medicine, Mount Sinai Beth Israel Medical Center, New York, NY, USA
| | - Tomo Ando
- Division of Interventional Cardiology, Department of Cardiology, New York Presbyterian Hospital/Columbia University Medical Center, New York, NY, USA
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17
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Carson JAS, Lichtenstein AH, Anderson CA, Appel LJ, Kris-Etherton PM, Meyer KA, Petersen K, Polonsky T, Van Horn L. Dietary Cholesterol and Cardiovascular Risk: A Science Advisory From the American Heart Association. Circulation 2020; 141:e39-e53. [DOI: 10.1161/cir.0000000000000743] [Citation(s) in RCA: 90] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The elimination of specific dietary cholesterol target recommendations in recent guidelines has raised questions about its role with respect to cardiovascular disease. This advisory was developed after a review of human studies on the relationship of dietary cholesterol with blood lipids, lipoproteins, and cardiovascular disease risk to address questions about the relevance of dietary cholesterol guidance for heart health. Evidence from observational studies conducted in several countries generally does not indicate a significant association with cardiovascular disease risk. Although meta-analyses of intervention studies differ in their findings, most associate intakes of cholesterol that exceed current average levels with elevated total or low-density lipoprotein cholesterol concentrations. Dietary guidance should focus on healthy dietary patterns (eg, Mediterranean-style and DASH [Dietary Approaches to Stop Hypertension]–style diets) that are inherently relatively low in cholesterol with typical levels similar to the current US intake. These patterns emphasize fruits, vegetables, whole grains, low-fat or fat-free dairy products, lean protein sources, nuts, seeds, and liquid vegetable oils. A recommendation that gives a specific dietary cholesterol target within the context of food-based advice is challenging for clinicians and consumers to implement; hence, guidance focused on dietary patterns is more likely to improve diet quality and to promote cardiovascular health.
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18
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Rubber seed oil supplementation enriches n-3 polyunsaturated fatty acids and reduces cholesterol contents of egg yolks in laying hens. Food Chem 2019; 301:125198. [DOI: 10.1016/j.foodchem.2019.125198] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 06/11/2019] [Accepted: 07/16/2019] [Indexed: 11/22/2022]
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19
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Wang MX, Wong CH, Kim JE. Impact of whole egg intake on blood pressure, lipids and lipoproteins in middle-aged and older population: A systematic review and meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis 2019; 29:653-664. [PMID: 31076323 DOI: 10.1016/j.numecd.2019.04.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 04/10/2019] [Accepted: 04/16/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND AIM Effects of whole egg consumption on cardiovascular diseases (CVD) risk in the middle-aged and older population remain unclear due to inconsistent findings from observational and randomized controlled trials (RCTs). This meta-analysis aimed to assess the impacts of whole egg and egg category (whole eggs versus egg substitutes) intake quantity on CVD risk factors from systematically searched RCTs. Egg substitutes were hypothesized to have minimal effects of the blood lipid and lipoprotein profile as they are void of dietary cholesterol. METHODS AND RESULTS As many as 434 studies identified from PubMed, Cochrane Library, CINAHL and Medline (Ovid) databases were screened and data were extracted from 8 selected RCTs. Quality of the selected studies were assessed and the overall effect sizes of weighted mean differences (WMD) were calculated using a random effects model. Non-differential effects in blood pressures, lipids and lipoproteins were observed when >4 whole eggs/week compared to ≤4 whole eggs/week were consumed. Intake of >4 whole eggs/week compared to equivalent amounts of egg substitutes caused greater elevations in blood total cholesterol (WMD: 0.198 mmol/L; 95% CIs: 0.056, 0.339), HDL cholesterol (WMD: 0.068 mmol/L; 95% CIs: 0.006, 0.130) and LDL cholesterol (WMD: 0.171 mmol/L; 95% CIs: 0.028, 0.315) but did not differentially affect triglycerides concentration. CONCLUSION Overall, the results support the notion that quantity of whole egg intake does not affect CVD risk factors and consuming egg substitutes may also be beneficial compared to whole eggs on lowering CVD risk in the middle-aged and older population.
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Affiliation(s)
- M X Wang
- Food Science and Technology Program, Department of Chemistry, National University of Singapore, 3 Science Drive 3, 117543, Singapore; Centre for Infectious Disease Epidemiology and Research, Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, 117549, Singapore.
| | - C H Wong
- Food Science and Technology Program, Department of Chemistry, National University of Singapore, 3 Science Drive 3, 117543, Singapore.
| | - J E Kim
- Food Science and Technology Program, Department of Chemistry, National University of Singapore, 3 Science Drive 3, 117543, Singapore.
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20
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Okami Y, Ueshima H, Nakamura Y, Okuda N, Nakagawa H, Sakata K, Saitoh S, Okayama A, Yoshita K, R Choudhury S, Chan Q, Elliott P, Stamler J, Miura K. The Relationship of Dietary Cholesterol with Serum Low-Density Lipoprotein Cholesterol and Confounding by Reverse Causality: The INTERLIPID Study. J Atheroscler Thromb 2019; 26:170-182. [PMID: 29887537 PMCID: PMC6365148 DOI: 10.5551/jat.43075] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Aim: The positive relationship between dietary cholesterol and serum cholesterol has been questioned by a set of recent cohort studies. This study aimed to investigate how employment status and education years relate to the association between dietary cholesterol and serum low-density lipoprotein cholesterol (LDL-C) in a Japanese population. Methods: A population-based, random sample, cross-sectional study (INTERLIPID) was performed. Among 1,145 Japanese individuals aged 40–59 years, 106 were excluded because of special diets, use of lipid-lowering drugs, hormone replacement, and missing data, leaving 1,039 individuals (533 men and 506 women). Dietary cholesterol was assessed from four 24-h dietary recalls, and LDL-C was measured enzymatically with an autoanalyzer. A standard questionnaire inquired about employment status and education years. Results: In men, a 1 standard deviation (SD) higher dietary cholesterol was associated with 3.16 mg/dL lower serum LDL-C (P = 0.009; unadjusted model). After adjustment for covariates, higher serum LDL-C was estimated per 1 SD higher intake of dietary cholesterol in nonemployed men [self-employed, homemakers, farmers, fishermen, and retired employees; β = +9.08, 95% confidence interval (CI) = +0.90–+17.27] and less educated men (β = +4.46, 95% CI = −0.97–+9.90), whereas an inverse association was observed in employed men (β = −3.02, 95% CI= −5.49–−0.54) and more educated men (β = −3.66, 95% CI = −6.25–−1.07). Conclusions: In men who were nonemployed and less educated, a higher intake of dietary cholesterol was associated with elevated concentrations of serum LDL-C, whereas an inverse association was observed in men who were employed and more educated.
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Affiliation(s)
- Yukiko Okami
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science
| | - Hirotsugu Ueshima
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science.,Department of Public Health, Shiga University of Medical Science
| | - Yasuyuki Nakamura
- Department of Food Science and Human Nutrition, Faculty of Agriculture, Ryukoku University
| | - Nagako Okuda
- Department of Health and Nutrition, University of Human Arts and Sciences
| | - Hideaki Nakagawa
- Department of Epidemiology and Public Health, Kanazawa Medical University
| | - Kiyomi Sakata
- Department of Hygiene and Preventive Medicine, Iwate Medical University
| | - Shigeyuki Saitoh
- School of Health Sciences, School of Medicine, Sapporo Medical University
| | | | | | - Sohel R Choudhury
- Department of Epidemiology and Research, National Heart Foundation Hospital and Research Institute
| | - Queenie Chan
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, Faculty of Medicine, School of Public Health, Imperial College London
| | - Paul Elliott
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, Faculty of Medicine, School of Public Health, Imperial College London
| | | | - Katsuyuki Miura
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science.,Department of Public Health, Shiga University of Medical Science
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21
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Zhao WT, Luo Y, Zhang Y, Zhou Y, Zhao TT. High protein diet is of benefit for patients with type 2 diabetes: An updated meta-analysis. Medicine (Baltimore) 2018; 97:e13149. [PMID: 30431586 PMCID: PMC6257679 DOI: 10.1097/md.0000000000013149] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 10/15/2018] [Indexed: 02/05/2023] Open
Abstract
Currently, the prevalence of type 2 diabetes is still increasing worldwide and has become a major public health burden.This meta-analysis was performed to further assess high protein (HP) diet on body weight, glycemic control, and cardiovascular disease risk factors in type 2 diabetes.A literature search was conducted in PubMed and Embase databases up to June 2018. The pooled standard mean difference (SMD) and the corresponding 95% confidence interval (CI) were calculated using RevMan 5.3 software.In total, 18 randomized control trials involving 1099 adults with type 2 diabetes were included. Pooled results indicated that HP diet could not significantly affect blood pressure of patients with type 2 diabetes, compared with low protein (LP) diet. However, the overall analyses showed the significant effect of HP diet on triglycerides reduction (SMD = -0.20, 95% CI = -0.35 to -0.05, P = .01) in patients with type 2 diabetes, compared with LP diet. Subgroup analyses showed that the ratio of energy from fat and carbohydrate in diet could affect the effect of HP diet on weight and triglyceride.HP diet could be indicated to obtain beneficial results in weight loss and lipid metabolism.
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Affiliation(s)
| | - Yu Luo
- School of Nursing, Army Medical University of Chinese PLA, Chongqing, Shapingba
| | - Ying Zhang
- Changzhi Medical College, Changzhi, Shanxi
| | - Yun Zhou
- Changzhi Medical College, Changzhi, Shanxi
| | - Ting-Ting Zhao
- Affiliated Heping Hospital of Changzhi Medical College, Changzhi, Shanxi, China
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22
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Okami Y, Ueshima H, Nakamura Y, Kondo K, Kadota A, Okuda N, Okamura T, Miura K. Time-Related Changes in Relationships Between the Keys Score, Dietary Lipids, and Serum Total Cholesterol in Japan - NIPPON DATA80/90/2010. Circ J 2018; 83:147-155. [PMID: 30333434 DOI: 10.1253/circj.cj-18-0628] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND In recent years, individuals with high serum total cholesterol (TC) have been more likely to modify their diet by reducing their intake of dietary lipids. The aim of this study was to investigate time-related changes in the relationships between the Keys score, dietary lipids, and TC between 1980 and 2010 in representative Japanese populations. Methods and Results: We used 3 cross-sectional cohort studies conducted among Japanese representative populations in 1980, 1990, and 2010 (NIPPON DATA80/90/2010) for the analyses. We analyzed data for 10,365, 7,714, and 2,657 participants, respectively, in each dataset. The relationships between TC and the Keys score (calculated by dietary lipids, cholesterol, and energy intake)/dietary lipids were examined. In men, a 1-unit higher Keys score correlated with 0.92 mg/dL and 0.64 mg/dL TC in 1980 and 1990, respectively, but not in 2010. In women, a 1-unit higher Keys score correlated with 0.70 mg/dL and 0.74 mg/dL TC in 1980 and 1990, respectively, but with 0.33 mg/dL in 2010. In men and women, dietary cholesterol, saturated fatty acid (SFA), and trans fatty acid (TFA) levels were positively associated with TC concentrations in 1980 and 1990, but not in 2010. CONCLUSIONS In these representative Japanese populations, a higher Keys score as well as dietary cholesterol, SFA, and TFA levels correlated with higher TC concentrations in 1980/1990, but the relationships were weaker or not observed in 2010.
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Affiliation(s)
- Yukiko Okami
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science
| | - Hirotsugu Ueshima
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science.,Department of Public Health, Shiga University of Medical Science
| | - Yasuyuki Nakamura
- Department of Public Health, Shiga University of Medical Science.,Department of Food Science and Human Nutrition, Faculty of Agriculture, Ryukoku University
| | - Keiko Kondo
- Department of Public Health, Shiga University of Medical Science
| | - Aya Kadota
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science.,Department of Public Health, Shiga University of Medical Science
| | - Nagako Okuda
- Department of Public Health, Shiga University of Medical Science.,Department of Health and Nutrition, University of Human Arts and Sciences
| | - Tomonori Okamura
- Department of Public Health, Shiga University of Medical Science.,Department of Preventive Medicine and Public Health, School of Medicine, Keio University
| | - Katsuyuki Miura
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science.,Department of Public Health, Shiga University of Medical Science
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23
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Kuang H, Yang F, Zhang Y, Wang T, Chen G. The Impact of Egg Nutrient Composition and Its Consumption on Cholesterol Homeostasis. CHOLESTEROL 2018; 2018:6303810. [PMID: 30210871 PMCID: PMC6126094 DOI: 10.1155/2018/6303810] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 08/08/2018] [Indexed: 02/07/2023]
Abstract
Nutrient deficiencies and excess are involved in many aspects of human health. As a source of essential nutrients, eggs have been used worldwide to support the nutritional needs of human societies. On the other hand, eggs also contain a significant amount of cholesterol, a lipid molecule that has been associated with the development of cardiovascular diseases. Whether the increase of egg consumption will lead to elevated cholesterol absorption and disruption of cholesterol homeostasis has been a concern of debate for a while. Cholesterol homeostasis is regulated through its dietary intake, endogenous biosynthesis, utilization, and excretion. Recently, some research interests have been paid to the effects of egg consumption on cholesterol homeostasis through the intestinal cholesterol absorption. Nutrient components in eggs such as phospholipids may contribute to this process. The goals of this review are to summarize the recent progress in this area and to discuss some potential benefits of egg consumption.
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Affiliation(s)
- Heqian Kuang
- Department of Nutrition, University of Tennessee at Knoxville, Knoxville, Tennessee, USA
| | - Fang Yang
- School of Laboratory Medicine, Hubei University of Chinese Medicine, Wuhan, Hubei, China
| | - Yan Zhang
- Department of Nutrition, University of Tennessee at Knoxville, Knoxville, Tennessee, USA
| | - Tiannan Wang
- Department of Nutrition, University of Tennessee at Knoxville, Knoxville, Tennessee, USA
| | - Guoxun Chen
- Department of Nutrition, University of Tennessee at Knoxville, Knoxville, Tennessee, USA
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24
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Fuller NR, Sainsbury A, Caterson ID, Denyer G, Fong M, Gerofi J, Leung C, Lau NS, Williams KH, Januszewski AS, Jenkins AJ, Markovic TP. Effect of a high-egg diet on cardiometabolic risk factors in people with type 2 diabetes: the Diabetes and Egg (DIABEGG) Study-randomized weight-loss and follow-up phase. Am J Clin Nutr 2018; 107:921-931. [PMID: 29741558 DOI: 10.1093/ajcn/nqy048] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 02/23/2018] [Indexed: 12/15/2022] Open
Abstract
Background Some country guidelines recommend that people with type 2 diabetes (T2D) limit their consumption of eggs and cholesterol. Our previously published 3-mo weight-maintenance study showed that a high-egg (≥12 eggs/wk) diet compared with a low-egg diet (<2 eggs/wk) did not have adverse effects on cardiometabolic risk factors in adults with T2D. Objective The current study follows the previously published 3-mo weight-maintenance study and assessed the effects of the high-egg compared with the low-egg diets as part of a 3-mo weight-loss period, followed by a 6-mo follow-up period for a total duration of 12 mo. Design Participants with prediabetes or T2D (n = 128) were prescribed a 3-mo daily energy restriction of 2.1 MJ and a macronutrient-matched diet and instructed on specific types and quantities of foods to be consumed, with an emphasis on replacing saturated fats with monounsaturated and polyunsaturated fats. Participants were followed up at the 9- and 12-mo visits. Results From 3 to 12 mo, the weight loss was similar (high-egg compared with low-egg diets: -3.1 ± 6.3 compared with -3.1 ± 5.2 kg; P = 0.48). There were no differences between groups in glycemia (plasma glucose, glycated hemoglobin, 1,5-anhydroglucitol), traditional serum lipids, markers of inflammation (high-sensitivity C-reactive protein, interleukin 6, soluble E-selectin), oxidative stress (F2-isoprostanes), or adiponectin from 3 to 12 mo or from 0 to 12 mo. Conclusions People with prediabetes or T2D who consumed a 3-mo high-egg weight-loss diet with a 6-mo follow-up exhibited no adverse changes in cardiometabolic markers compared with those who consumed a low-egg weight-loss diet. A healthy diet based on population guidelines and including more eggs than currently recommended by some countries may be safely consumed. This trial is registered at http://www.anzctr.org.au/ as ACTRN12612001266853.
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Affiliation(s)
- Nicholas R Fuller
- The Boden Institute, Sydney Medical School, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Amanda Sainsbury
- The Boden Institute, Sydney Medical School, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Ian D Caterson
- The Boden Institute, Sydney Medical School, Charles Perkins Centre, University of Sydney, Sydney, Australia.,Metabolism and Obesity Services, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Gareth Denyer
- The Boden Institute, Sydney Medical School, Charles Perkins Centre, University of Sydney, Sydney, Australia.,School of Molecular Bioscience, University of Sydney, Sydney, Australia
| | - Mackenzie Fong
- The Boden Institute, Sydney Medical School, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - James Gerofi
- The Boden Institute, Sydney Medical School, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Chloris Leung
- The Boden Institute, Sydney Medical School, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Namson S Lau
- The Boden Institute, Sydney Medical School, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Kathryn H Williams
- The Boden Institute, Sydney Medical School, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Andrzej S Januszewski
- National Health and Medical Research Council Clinical Trials Center, University of Sydney, Sydney, Australia
| | - Alicia J Jenkins
- National Health and Medical Research Council Clinical Trials Center, University of Sydney, Sydney, Australia
| | - Tania P Markovic
- The Boden Institute, Sydney Medical School, Charles Perkins Centre, University of Sydney, Sydney, Australia.,Metabolism and Obesity Services, Royal Prince Alfred Hospital, Camperdown, Australia
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25
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Jun G, Kehua W, Liang Q, Taocun D, Manman S, Meng M, Yuping H. Random regression analyses to model the longitudinal measurements of yolk proportions in the laying chicken. Poult Sci 2018; 96:3852-3857. [PMID: 29050440 DOI: 10.3382/ps/pex233] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Accepted: 09/13/2017] [Indexed: 11/20/2022] Open
Abstract
Cubic spline function was used in a genetic evaluation to model the change of yolk proportion over the lay life. A total of 19,862 yolk proportion records of 2,324 hens was used. The evaluated submodels consisted of 3 to 6 knot models. The same knots were fitted for genetic and permanent environmental splines. The residual effects were specified to be independently and normally distributed, but with heterogeneous variance for each test week. (Co)variance components were estimated by the average information restricted maximum likelihood (AIREML) method. The best fitting random regression model (RRM) was a submodel with 4 knots at 32, 36, 52, and 72 wk of age for genetic and permanent environmental effects. The estimate of genetic variance was larger than that of permanent environmental variance at the same time point. The heritability of yolk proportion ranged from 0.32 to 0.55, and the repeatability ranged between 0.45 and 0.73. The genetic correlations between test wk were from moderate to unity. To the best of our knowledge, this was the first report on the use of a RRM to evaluate yolk proportion. The results of this study showed that random regression models with the spline function could be used for improvement of yolk proportion.
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Affiliation(s)
- Guo Jun
- Jiangsu Institute of Poultry Science, Yangzhou Jiangsu 225125
| | - Wang Kehua
- Jiangsu Institute of Poultry Science, Yangzhou Jiangsu 225125
| | - Qu Liang
- Jiangsu Institute of Poultry Science, Yangzhou Jiangsu 225125
| | - Dou Taocun
- Jiangsu Institute of Poultry Science, Yangzhou Jiangsu 225125
| | - Shen Manman
- Jiangsu Institute of Poultry Science, Yangzhou Jiangsu 225125
| | - Ma Meng
- Jiangsu Institute of Poultry Science, Yangzhou Jiangsu 225125
| | - Hu Yuping
- Jiangsu Institute of Poultry Science, Yangzhou Jiangsu 225125
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26
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Park SJ, Jung JH, Choi SW, Lee HJ. Association between Egg Consumption and Metabolic Disease. Korean J Food Sci Anim Resour 2018; 38:209-223. [PMID: 29805272 PMCID: PMC5960820 DOI: 10.5851/kosfa.2018.38.2.209] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 02/22/2018] [Accepted: 02/28/2018] [Indexed: 11/06/2022] Open
Abstract
The effect of high egg intake on metabolic syndrome (MetS), a major risk factor
for cardiovascular disease (CVD), has not been clearly elucidated. This study
was conducted to review the literature related to egg consumption and the risk
of metabolic disease as well as to examine the association between high egg
intake and MetS in Korean adults. A literature review was conducted using
published papers in PubMed and EMBASE through December 2017. We have reviewed 26
articles, which were associated with egg consumption and metabolic diseases, and
found that the results were controversial. Therefore, we analyzed data from
23,993 Korean adults aged 19 yrs and older. MetS was defined based on criteria
from the Adult Treatment Panel III. Egg consumption of 4-6 times/wk and 1
time/day were significantly associated with reduced prevalence of MetS (Odds
ratio (OR)=0.82; 95% Confidence interval (CI)=0.71-0.95 for 4-6 times/wk,
OR=0.83; 95% CI=0.69-0.99 for 1 time/day) compared to those who consumed eggs
less than once monthly. However, consuming two or more eggs per day was not
associated with MetS. As for the components of MetS, an egg intake of once daily
decreased the prevalence of abdominal obesity and an intake of 2-7 eggs weekly
was shown to prevent a reduction in the high-density lipoprotein cholesterol
levels. This study suggests that while consuming eggs 4-7 times weekly is
associated with a lower prevalence of MetS, consuming two or more eggs daily is
not associated with a reduced risk for MetS.
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Affiliation(s)
- Seon-Joo Park
- Department of Food and Nutrition, College of BioNano Technology, Gachon University, Seongnam 13120, Korea
| | - Ji-Hye Jung
- Institute for Clinical Nutrition, Inje University, Seoul 04551, Korea
| | - Sang-Woon Choi
- Chaum Life Center, CHA University School of Medicine, Seoul 06062, Korea.,Friedman School of Nutrition Science and Policy, Tufts University, Medford 02155, USA
| | - Hae-Jeung Lee
- Department of Food and Nutrition, College of BioNano Technology, Gachon University, Seongnam 13120, Korea
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27
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Egg consumption and the risk of cardiovascular disease and all-cause mortality: Guangzhou Biobank Cohort Study and meta-analyses. Eur J Nutr 2018; 58:785-796. [PMID: 29680985 DOI: 10.1007/s00394-018-1692-3] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 04/13/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE Eggs are highly nutritious but concerns over their cholesterol content have led to dietary avoidance among many. There are also important international differences in relevant dietary guidance. We conducted the first prospective study in China investigating the association of egg consumption, cardiovascular disease (CVD) mortality, and a meta-analysis. METHODS We included 28,024 participants without CVD at baseline (2003-8) in Guangzhou Biobank Cohort Study. All-cause and CVD mortality were identified through record linkage. We used Cox proportional hazards regression. We followed the Meta-analysis Of Observational Studies in Epidemiology reporting guidelines. RESULTS During 275,343 person-years follow-up (average 9.8 years), we found 2685 all-cause and 873 CVD deaths. We found no significant difference in all-cause mortality between higher (7+ eggs/week) and low consumption (< 1 egg/week) [adjusted hazard ratio (HR) 1.08, 95% confidence interval (CI) 0.93-1.24], and mortality from CVD (0.99, 95% CI 0.76-1.27), ischemic heart disease (IHD) (0.92, 95% CI 0.63-1.36), or stroke (0.88, 95% CI 0.57-1.35). The updated meta-analyses including our results showed that 7+ eggs/week was not associated with all-cause mortality (HR 1.09, 95% CI 0.997-1.200) or IHD (HR 0.97, 95% CI 0.90-1.05), but associated with a small reduction in stroke (HR 0.91. 95% CI 0.85-0.98). CONCLUSIONS Eating one egg daily is not associated with increase in CVD or all-cause mortality. The small observed reduction in stroke risk needs to be confirmed. Our findings support current guidelines recommending eggs as part of a healthy diet, and should be considered in other dietary recommendations.
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28
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Matsuoka R, Kamachi K, Usuda M, Wang W, Masuda Y, Kunou M, Tanaka A, Utsunomiya K. Lactic-fermented egg white improves visceral fat obesity in Japanese subjects-double-blind, placebo-controlled study. Lipids Health Dis 2017; 16:237. [PMID: 29216922 PMCID: PMC5721610 DOI: 10.1186/s12944-017-0631-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 11/29/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It was reported that egg white protein (EWP) reduced body fat in rats. We developed a lactic-fermented egg white (LE) that facilitates the consumption of egg whites by fermenting them with lactobacillus, and were able to study their intake in humans. In this double-blind, placebo-controlled design, we evaluated the effect of LE on visceral fat area (VFA). METHODS Participants included 37 adult males and females aged ≥40 years (VFA at navel ≥100 cm2). They were divided into two groups: the control group and the LE group. The control and LE groups consumed drinks containing whey and LE, respectively, for 12 weeks (providing 8 g protein/day). VFA was measured at baseline and at week 12 of intake. Abdominal girth was measured at baseline and at weeks 6 and 12. RESULTS LE intake decreased VFA significantly compared with baseline (-8.89 cm2, p < 0.05), and VFA was significantly lower than that in the control group (+1.71 cm2, p < 0.05). The LE group showed significant improvement in the ratio of visceral to subcutaneous fat area compared with baseline and the control group (p < 0.05). CONCLUSIONS The results demonstrated that LE reduces VFA and improves the ratio of visceral to subcutaneous fat area. As other measurement items were not influenced, we concluded that LE improves visceral fat obesity. TRIAL REGISTRATION This clinical trial was retrospectively registered with the University hospital Medical Information Network (UMIN) Center, ( UMIN000026949 ; registered on 11/04/2017; http://www.umin.ac.jp /).
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Affiliation(s)
- Ryosuke Matsuoka
- R&D Division, Kewpie Corporation, 2-5-7 Sengawa Kewport, Sengawa-Cho, Chofu-Shi, Tokyo, 182-0002 Japan
| | - Keiko Kamachi
- Nutrition Clinic, Kagawa Nutrition University, 3-24-3, Komagome, Toshima-ku, Tokyo, 170-8481 Japan
| | - Mika Usuda
- R&D Division, Kewpie Corporation, 2-5-7 Sengawa Kewport, Sengawa-Cho, Chofu-Shi, Tokyo, 182-0002 Japan
| | - Wei Wang
- R&D Division, Kewpie Corporation, 2-5-7 Sengawa Kewport, Sengawa-Cho, Chofu-Shi, Tokyo, 182-0002 Japan
| | - Yasunobu Masuda
- R&D Division, Kewpie Corporation, 2-5-7 Sengawa Kewport, Sengawa-Cho, Chofu-Shi, Tokyo, 182-0002 Japan
| | - Masaaki Kunou
- R&D Division, Kewpie Corporation, 2-5-7 Sengawa Kewport, Sengawa-Cho, Chofu-Shi, Tokyo, 182-0002 Japan
| | - Akira Tanaka
- Nutrition Clinic, Kagawa Nutrition University, 3-24-3, Komagome, Toshima-ku, Tokyo, 170-8481 Japan
| | - Kazunori Utsunomiya
- Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461 Japan
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29
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Egg consumption, cardiovascular diseases and type 2 diabetes. Eur J Clin Nutr 2017; 72:44-56. [PMID: 28952608 DOI: 10.1038/ejcn.2017.153] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 08/07/2017] [Accepted: 08/15/2017] [Indexed: 01/05/2023]
Abstract
Eggs are rich in nutrients and a source of essential fatty- and amino acids, and the food item with highest cholesterol content. Since the 1970s dietary recommendations have advised limiting egg intake to 2-4 a week for the healthy population, and in those diagnosed with cardiovascular disease (CVD) and type 2 diabetes (T2D) an even more restricted consumption. The aim of the present paper was to assess the recommendation to lower the dietary intake of cholesterol and especially the intake of egg to reduce the risk of CVD and T2D. We performed three web-based literature searches on human studies (observational and interventional) published within the past 10 years during spring 2015. High-quality intervention studies have found nonsignificant effects of increasing the consumption of eggs on risk markers for CVD and T2D in healthy subjects and subjects with T2D. The risk associations found in the observational studies are more likely to be attributed to a dietary pattern often accompanying high egg intake and/or the cluster of other risk factors in people with high egg consumption. Dietary patterns, physical activity and genetics affect the predisposition of CVD and T2D more than a single food item as eggs. In conclusion, up to seven eggs per week can safely be consumed, but in patients with established CVD or T2D only with special emphasis on a healthy lifestyle.
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30
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Fuller NR, Markovic TP, Sainsbury A, Caterson ID. Eggs and type 2 diabetes: Current evidence suggests no cause for concern in the short-term. NUTR BULL 2017. [DOI: 10.1111/nbu.12246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- N. R. Fuller
- The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders; University of Sydney; Sydney NSW Australia
| | - T. P. Markovic
- The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders; University of Sydney; Sydney NSW Australia
- Metabolism and Obesity Services; Royal Prince Alfred Hospital; Camperdown NSW Australia
| | - A. Sainsbury
- The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders; University of Sydney; Sydney NSW Australia
| | - I. D. Caterson
- The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders; University of Sydney; Sydney NSW Australia
- Metabolism and Obesity Services; Royal Prince Alfred Hospital; Camperdown NSW Australia
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31
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DiMarco DM, Missimer A, Murillo AG, Lemos BS, Malysheva OV, Caudill MA, Blesso CN, Fernandez ML. Intake of up to 3 Eggs/Day Increases HDL Cholesterol and Plasma Choline While Plasma Trimethylamine-N-oxide is Unchanged in a Healthy Population. Lipids 2017; 52:255-263. [PMID: 28091798 DOI: 10.1007/s11745-017-4230-9] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 12/20/2016] [Indexed: 12/22/2022]
Abstract
Eggs are a source of cholesterol and choline and may impact plasma lipids and trimethylamine-N-oxide (TMAO) concentrations, which are biomarkers for cardiovascular disease (CVD) risk. Therefore, the effects of increasing egg intake (0, 1, 2, and 3 eggs/day) on these and other CVD risk biomarkers were evaluated in a young, healthy population. Thirty-eight subjects [19 men/19 women, 24.1 ± 2.2 years, body mass index (BMI) 24.3 ± 2.5 kg/m2] participated in this 14-week crossover intervention. Participants underwent a 2-week washout with no egg consumption, followed by intake of 1, 2, and 3 eggs/day for 4 weeks each. Anthropometric data, blood pressure (BP), dietary records, and plasma biomarkers (lipids, glucose, choline, and TMAO) were measured during each intervention phase. BMI, waist circumference, systolic BP, plasma glucose, and plasma triacylglycerol did not change throughout the intervention. Diastolic BP decreased with egg intake (P < 0.05). Compared to 0 eggs/day, intake of 1 egg/day increased HDL cholesterol (HDL-c) (P < 0.05), and decreased LDL cholesterol (LDL-c) (P < 0.05) and the LDL-c/HDL-c ratio (P < 0.01). With intake of 2-3 eggs/day, these changes were maintained. Plasma choline increased dose-dependently with egg intake (P < 0.0001) while fasting plasma TMAO was unchanged. These results indicate that in a healthy population, consuming up to 3 eggs/day results in an overall beneficial effect on biomarkers associated with CVD risk, as documented by increased HDL-c, a reduced LDL-c/HDL-c ratio, and increased plasma choline in combination with no change in plasma LDL-c or TMAO concentrations.
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Affiliation(s)
- Diana M DiMarco
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Amanda Missimer
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Ana Gabriela Murillo
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Bruno S Lemos
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Olga V Malysheva
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, 14850, USA
| | - Marie A Caudill
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, 14850, USA
| | - Christopher N Blesso
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Maria Luz Fernandez
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT, 06269, USA.
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32
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Effect of dietary pomegranate seed oil on laying hen performance and physicochemical properties of eggs. Food Chem 2016; 221:1096-1103. [PMID: 27979064 DOI: 10.1016/j.foodchem.2016.11.051] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 11/08/2016] [Accepted: 11/10/2016] [Indexed: 11/21/2022]
Abstract
The objective of the study was to determine the effects of pomegranate seed oil, used as a source of punicic acid (CLnA) in the diets of laying hens, on the physicochemical properties of eggs. Forty Isa Brown laying hens (26weeks old) were equally subjected to 4 dietary treatments (n=10) and fed a commercial layer diet supplying 2.5% sunflower oil (control) or three levels (0.5, 1.0 and 1.5%) of punicic acid in the diets. After 12weeks of feeding the hens, eggs collection began. Sixty eggs - randomly selected from each group - were analysed for physicochemical properties. Eggs naturally enriched with CLnA preserve their composition and conventional properties in most of the analysed parameters (including chemical composition, physical as well as organoleptic properties). Dietary CLnA had positive impact on the colour of the eggs' yolk, whereas the hardness of hard-boiled egg yolks was not affected. Additionally, increasing dietary CLnA led to an increase not only the CLnA concentrations, but also CLA in egg-yolk lipids.
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33
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Alexander DD, Miller PE, Vargas AJ, Weed DL, Cohen SS. Meta-analysis of Egg Consumption and Risk of Coronary Heart Disease and Stroke. J Am Coll Nutr 2016; 35:704-716. [DOI: 10.1080/07315724.2016.1152928] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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34
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Woo HW, Choi BY, Kim MK. Cross-Sectional and Longitudinal Associations between Egg Consumption and Metabolic Syndrome in Adults ≥ 40 Years Old: The Yangpyeong Cohort of the Korean Genome and Epidemiology Study (KoGES_Yangpyeong). PLoS One 2016; 11:e0147729. [PMID: 26808174 PMCID: PMC4726710 DOI: 10.1371/journal.pone.0147729] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 01/07/2016] [Indexed: 12/31/2022] Open
Abstract
Since the 1970s, the public has been advised to limit egg consumption even though there is little evidence of any harmful effect of eggs on blood cholesterol. The purpose of this cross-sectional and prospective study was to evaluate the potential association between egg consumption and metabolic syndrome (MetS) and MetS components in adults ≥ 40 years in KoGES_Yangpyeong. Yangpyeong is a rural area in South Korea. A total of 2,887 subjects (men 1,115, women 1,772) were recruited from 2005 to 2009, based on a physical examination and questionnaires administered using standardized protocol. After excluding subjects who had MetS at baseline, 1,663 subjects (675 men, 958 women) were followed for 3.20 years (range: 0.34–8.70). During the follow-up period, MetS occurred in 289 subjects. More than 3 eggs per week was significantly associated with decreased risk of MetS in both men (RR = 0.46, 95% CI, 0.26–0.82, P for trend = 0.1093) and women (RR = 0.54, 95% CI, 0.31–0.93, P for trend 0.0325) compared to non-users. There was a cross-sectional inverse relationship between egg consumption and abdominal obesity in men and women. Also, prospectively, higher egg consumption in men was associated with a decreased risk of high fasting blood glucose (RR = 0.39, 95% CI, 0.22–0.67, P for trend = 0.0042) and high triglycerides (RR = 0.42, 95% CI, 0.22–0.80, P for trend = 0.1080). In conclusion, our findings suggest that higher egg consumption may reduce the risk of MetS both in men and women, and the risk of high fasting blood glucose and high triglycerides in men. Current guidelines regarding egg consumption may need to be re-visited for healthy middle-aged and elderly people.
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Affiliation(s)
- Hye Won Woo
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, Korea
- Institute for Health and Society, Hanyang University, Seoul, Korea
| | - Bo Youl Choi
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, Korea
- Institute for Health and Society, Hanyang University, Seoul, Korea
| | - Mi Kyung Kim
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, Korea
- Institute for Health and Society, Hanyang University, Seoul, Korea
- * E-mail:
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35
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McNamara DJ. The Fifty Year Rehabilitation of the Egg. Nutrients 2015; 7:8716-22. [PMID: 26506379 PMCID: PMC4632449 DOI: 10.3390/nu7105429] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 09/17/2015] [Accepted: 10/15/2015] [Indexed: 12/13/2022] Open
Abstract
The 1968 American Heart Association announced a dietary recommendation that all individuals consume less than 300 mg of dietary cholesterol per day and no more than three whole eggs per week. This recommendation has not only significantly impacted the dietary patterns of the population, but also resulted in the public limiting a highly nutritious and affordable source of high quality nutrients, including choline which was limited in the diets of most individuals. The egg industry addressed the egg issue with research documenting the minimal effect of egg intake on plasma lipoprotein levels, as well as research verifying the importance of egg nutrients in a variety of issues related to health promotion. In 2015 dietary cholesterol and egg restrictions have been dropped by most health promotion agencies worldwide and recommended to be dropped from the 2015 Dietary Guidelines for Americans.
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Affiliation(s)
- Donald J McNamara
- Eggs for Health Consulting, 5905 Cozumel Pl., Las Vegas, NV 89131, USA.
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Zhang M, Zhu Y, Li P, Chang H, Wang X, Liu W, Zhang Y, Huang G. Associations between Dietary Patterns and Impaired Fasting Glucose in Chinese Men: A Cross-Sectional Study. Nutrients 2015; 7:8072-89. [PMID: 26402695 PMCID: PMC4586577 DOI: 10.3390/nu7095382] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 09/12/2015] [Accepted: 09/15/2015] [Indexed: 12/15/2022] Open
Abstract
Few studies have examined the association between Asian dietary pattern and prediabetes, in particular, the Chinese diet. We conducted a cross-sectional study to identify dietary patterns associated with impaired fasting glucose (IFG) which considered a state of prediabetes in Chinese men. The study included 1495 Chinese men aged 20 to 75 years. Information about diet was obtained using an 81-item food frequency questionnaire (FFQ), and 21 predefined food groups were considered in a factor analysis. Three dietary patterns were generated by factor analysis: (1) a vegetables-fruits pattern; (2) an animal offal-dessert pattern; and (3) a white rice-red meat pattern. The multivariate-adjusted odds ratio (OR) of IFG for the highest tertile of the animal offal-dessert pattern in comparison with the lowest tertile was 3.15 (95% confidence intervals (CI): 1.87-5.30). The vegetables-fruits dietary pattern was negatively associated with the risk of IFG, but a significant association was observed only in the third tertile. There was no significant association between IFG and the white rice-red meat pattern. Our findings indicated that the vegetables-fruits dietary pattern was inversely associated with IFG, whereas the animal offal-dessert pattern was associated with an increased risk of IFG in Chinese men. Further prospective studies are needed to elucidate the diet-prediabetes relationships.
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Affiliation(s)
- Meilin Zhang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China.
| | - Yufeng Zhu
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China.
| | - Ping Li
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China.
| | - Hong Chang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China.
- Department of Rehabilitation and Sports Medicine, Tianjin Medical University, 22 Qixiangtai Road, Heping District,Tianjin 300070, China.
| | - Xuan Wang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China.
| | - Weiqiao Liu
- Health Education and Guidance Center of Heping District, 97 Hualong Road, Heping District, Tianjin 300040, China.
| | - Yuwen Zhang
- Health Education and Guidance Center of Heping District, 97 Hualong Road, Heping District, Tianjin 300040, China.
| | - Guowei Huang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin 300070, China.
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Egg Consumption and Human Cardio-Metabolic Health in People with and without Diabetes. Nutrients 2015; 7:7399-420. [PMID: 26404366 PMCID: PMC4586539 DOI: 10.3390/nu7095344] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Revised: 08/20/2015] [Accepted: 08/26/2015] [Indexed: 12/15/2022] Open
Abstract
The guidelines for dietary cholesterol and/or egg intake for both the general population and those at higher risk of cardiovascular disease (for example, people with type 2 diabetes mellitus (T2DM)) differ between countries, and even for different specialist societies in a country. The disparity between these guidelines is at least in part related to the conflicting evidence as to the effects of eggs in the general population and in those with T2DM. This review addresses the effect of eggs on cardiovascular disease (CVD) risk from both epidemiological research and controlled prospective studies, in people with and without cardio-metabolic disease. It also examines the nutritional qualities of eggs and whether they may offer protection against chronic disease. The evidence suggests that a diet including more eggs than is recommended (at least in some countries) may be used safely as part of a healthy diet in both the general population and for those at high risk of cardiovascular disease, those with established coronary heart disease, and those with T2DM. In conclusion, an approach focused on a person's entire dietary intake as opposed to specific foods or nutrients should be the heart of population nutrition guidelines.
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Choi Y, Chang Y, Lee JE, Chun S, Cho J, Sung E, Suh BS, Rampal S, Zhao D, Zhang Y, Pastor-Barriuso R, Lima JA, Shin H, Ryu S, Guallar E. Egg consumption and coronary artery calcification in asymptomatic men and women. Atherosclerosis 2015; 241:305-12. [DOI: 10.1016/j.atherosclerosis.2015.05.036] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Revised: 05/21/2015] [Accepted: 05/22/2015] [Indexed: 10/23/2022]
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Egg phospholipids and cardiovascular health. Nutrients 2015; 7:2731-47. [PMID: 25871489 PMCID: PMC4425170 DOI: 10.3390/nu7042731] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 03/25/2015] [Accepted: 04/03/2015] [Indexed: 01/20/2023] Open
Abstract
Eggs are a major source of phospholipids (PL) in the Western diet. Dietary PL have emerged as a potential source of bioactive lipids that may have widespread effects on pathways related to inflammation, cholesterol metabolism, and high-density lipoprotein (HDL) function. Based on pre-clinical studies, egg phosphatidylcholine (PC) and sphingomyelin appear to regulate cholesterol absorption and inflammation. In clinical studies, egg PL intake is associated with beneficial changes in biomarkers related to HDL reverse cholesterol transport. Recently, egg PC was shown to be a substrate for the generation of trimethylamine N-oxide (TMAO), a gut microbe-dependent metabolite associated with increased cardiovascular disease (CVD) risk. More research is warranted to examine potential serum TMAO responses with chronic egg ingestion and in different populations, such as diabetics. In this review, the recent basic science, clinical, and epidemiological findings examining egg PL intake and risk of CVD are summarized.
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Miranda JM, Anton X, Redondo-Valbuena C, Roca-Saavedra P, Rodriguez JA, Lamas A, Franco CM, Cepeda A. Egg and egg-derived foods: effects on human health and use as functional foods. Nutrients 2015; 7:706-29. [PMID: 25608941 PMCID: PMC4303863 DOI: 10.3390/nu7010706] [Citation(s) in RCA: 144] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 12/26/2014] [Accepted: 01/15/2015] [Indexed: 01/22/2023] Open
Abstract
Eggs are sources of protein, fats and micronutrients that play an important role in basic nutrition. However, eggs are traditionally associated with adverse factors in human health, mainly due to their cholesterol content. Nowadays, however, it is known that the response of cholesterol in human serum levels to dietary cholesterol consumption depends on several factors, such as ethnicity, genetic makeup, hormonal factors and the nutritional status of the consumer. Additionally, in recent decades, there has been an increasing demand for functional foods, which is expected to continue to increase in the future, owing to their capacity to decrease the risks of some diseases and socio-demographic factors such as the increase in life expectancy. This work offers a brief overview of the advantages and disadvantages of egg consumption and the potential market of functional eggs, and it explores the possibilities of the development of functional eggs by technological methods.
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Affiliation(s)
- Jose M Miranda
- Laboratorio de Higiene Inspección y Control de Alimentos, Dpto. de Química Analítica, Nutrición y Bromatología, Universidad de Santiago de Compostela, 27002 Lugo, Spain.
| | - Xaquin Anton
- Clavo congelados, S. A. Caldas de Reis, 36650 Pontevedra, Spain.
| | - Celia Redondo-Valbuena
- Laboratorio de Higiene Inspección y Control de Alimentos, Dpto. de Química Analítica, Nutrición y Bromatología, Universidad de Santiago de Compostela, 27002 Lugo, Spain.
| | - Paula Roca-Saavedra
- Laboratorio de Higiene Inspección y Control de Alimentos, Dpto. de Química Analítica, Nutrición y Bromatología, Universidad de Santiago de Compostela, 27002 Lugo, Spain.
| | - Jose A Rodriguez
- Centro de Investigaciones Químicas, Universidad Autónoma del Estado de Hidalgo, Carr. Pachuca-Tulancingo Km. 4.5, 42076 Pachuca, Hidalgo, Mexico.
| | - Alexandre Lamas
- Laboratorio de Higiene Inspección y Control de Alimentos, Dpto. de Química Analítica, Nutrición y Bromatología, Universidad de Santiago de Compostela, 27002 Lugo, Spain.
| | - Carlos M Franco
- Laboratorio de Higiene Inspección y Control de Alimentos, Dpto. de Química Analítica, Nutrición y Bromatología, Universidad de Santiago de Compostela, 27002 Lugo, Spain.
| | - Alberto Cepeda
- Laboratorio de Higiene Inspección y Control de Alimentos, Dpto. de Química Analítica, Nutrición y Bromatología, Universidad de Santiago de Compostela, 27002 Lugo, Spain.
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Abstract
In the 1960s, the thesis that dietary cholesterol contributes to blood cholesterol and heart disease risk was a rational conclusion based on the available science at that time. Fifty years later the research evidence no longer supports this hypothesis yet changing the dietary recommendation to limit dietary cholesterol has been a slow and at times contentious process. The preponderance of the clinical and epidemiological data accumulated since the original dietary cholesterol restrictions were formulated indicate that: (1) dietary cholesterol has a small effect on the plasma cholesterol levels with an increase in the cholesterol content of the LDL particle and an increase in HDL cholesterol, with little effect on the LDL:HDL ratio, a significant indicator of heart disease risk, and (2) the lack of a significant relationship between cholesterol intake and heart disease incidence reported from numerous epidemiological surveys. Over the last decade, many countries and health promotion groups have modified their dietary recommendations to reflect the current evidence and to address a now recognised negative consequence of ineffective dietary cholesterol restrictions (such as inadequate choline intake). In contrast, health promotion groups in some countries appear to suffer from cognitive dissonance and continue to promote an outdated and potentially hazardous dietary recommendation based on an invalidated hypothesis. This review evaluates the evidence for and against dietary cholesterol restrictions and the potential consequences of such restrictions.
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Effects of carbohydrate restriction and dietary cholesterol provided by eggs on clinical risk factors in metabolic syndrome. J Clin Lipidol 2013; 7:463-71. [DOI: 10.1016/j.jacl.2013.03.008] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2012] [Revised: 01/16/2013] [Accepted: 03/14/2013] [Indexed: 11/21/2022]
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Shin JY, Xun P, Nakamura Y, He K. Egg consumption in relation to risk of cardiovascular disease and diabetes: a systematic review and meta-analysis. Am J Clin Nutr 2013; 98:146-59. [PMID: 23676423 PMCID: PMC3683816 DOI: 10.3945/ajcn.112.051318] [Citation(s) in RCA: 196] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The associations of egg consumption with cardiovascular disease (CVD) and diabetes are still unclear. OBJECTIVE We aimed to quantitatively summarize the literature on egg consumption and risk of CVD, cardiac mortality, and type 2 diabetes by conducting a meta-analysis of prospective cohort studies. DESIGN A systematic literature review was conducted for published studies in PubMed and EMBASE through March 2012. Additional information was retrieved through Google or a hand review of the reference from relevant articles. Studies were included if they had a prospective study design, were published in English-language journals, and provided HRs and 95% CIs for the associations of interest. Data were independently extracted by 2 investigators, and the weighted HRs and 95% CIs for the associations of interest were estimated by using a random-effects model. RESULTS A total of 22 independent cohorts from 16 studies were identified, including participants ranging in number from 1600 to 90,735 and in follow-up time from 5.8 to 20.0 y. Comparison of the highest category (≥1 egg/d) of egg consumption with the lowest (<1 egg/wk or never) resulted in a pooled HR (95% CI) of 0.96 (0.88, 1.05) for overall CVD, 0.97 (0.86, 1.09) for ischemic heart disease, 0.93 (0.81, 1.07) for stroke, 0.98 (0.77, 1.24) for ischemic heart disease mortality, 0.92 (0.56, 1.50) for stroke mortality, and 1.42 (1.09, 1.86) for type 2 diabetes. Of the studies conducted in diabetic patients, the pooled HR (95% CI) was 1.69 (1.09, 2.62) for overall CVD. CONCLUSIONS This meta-analysis suggests that egg consumption is not associated with the risk of CVD and cardiac mortality in the general population. However, egg consumption may be associated with an increased incidence of type 2 diabetes among the general population and CVD comorbidity among diabetic patients.
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Affiliation(s)
- Jang Yel Shin
- Department of Nutrition, Gillings Schools of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Li Y, Zhou C, Zhou X, Li L. Egg consumption and risk of cardiovascular diseases and diabetes: a meta-analysis. Atherosclerosis 2013; 229:524-30. [PMID: 23643053 DOI: 10.1016/j.atherosclerosis.2013.04.003] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 03/09/2013] [Accepted: 04/02/2013] [Indexed: 01/14/2023]
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.
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Affiliation(s)
- Yuehua Li
- 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
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Rong Y, Chen L, Zhu T, Song Y, Yu M, Shan Z, Sands A, Hu FB, Liu L. Egg consumption and risk of coronary heart disease and stroke: dose-response meta-analysis of prospective cohort studies. BMJ 2013; 346:e8539. [PMID: 23295181 PMCID: PMC3538567 DOI: 10.1136/bmj.e8539] [Citation(s) in RCA: 242] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To investigate and quantify the potential dose-response association between egg consumption and risk of coronary heart disease and stroke. DESIGN Dose-response meta-analysis of prospective cohort studies. DATA SOURCES PubMed and Embase prior to June 2012 and references of relevant original papers and review articles. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Prospective cohort studies with relative risks and 95% confidence intervals of coronary heart disease or stroke for three or more categories of egg consumption. RESULTS Eight articles with 17 reports (nine for coronary heart disease, eight for stroke) were eligible for inclusion in the meta-analysis (3,081,269 person years and 5847 incident cases for coronary heart disease, and 4,148,095 person years and 7579 incident cases for stroke). No evidence of a curve linear association was seen between egg consumption and risk of coronary heart disease or stroke (P=0.67 and P=0.27 for non-linearity, respectively). The summary relative risk of coronary heart disease for an increase of one egg consumed per day was 0.99 (95% confidence interval 0.85 to 1.15; P=0.88 for linear trend) without heterogeneity among studies (P=0.97, I(2)=0%). For stroke, the combined relative risk for an increase of one egg consumed per day was 0.91 (0.81 to 1.02; P=0.10 for linear trend) without heterogeneity among studies (P=0.46, I(2)=0%). In a subgroup analysis of diabetic populations, the relative risk of coronary heart disease comparing the highest with the lowest egg consumption was 1.54 (1.14 to 2.09; P=0.01). In addition, people with higher egg consumption had a 25% (0.57 to 0.99; P=0.04) lower risk of developing hemorrhagic stroke. CONCLUSIONS Higher consumption of eggs (up to one egg per day) is not associated with increased risk of coronary heart disease or stroke. The increased risk of coronary heart disease among diabetic patients and reduced risk of hemorrhagic stroke associated with higher egg consumption in subgroup analyses warrant further studies.
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Affiliation(s)
- Ying Rong
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of Science and Technology, 430030 Wuhan, PR China
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Ueno M, Izumi Y, Kawaguchi Y, Ikeda A, Iso H, Inoue M, Tsugane S. Prediagnostic plasma antibody levels to periodontopathic bacteria and risk of coronary heart disease. Int Heart J 2012; 53:209-14. [PMID: 22878796 DOI: 10.1536/ihj.53.209] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Many epidemiological studies have indicated that periodontitis is an important risk factor for coronary heart disease (CHD). We examined whether plasma antibody levels to 3 major periodontal pathogens, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Prevotella intermedia predicted the risk of CHD events. A nested case-control research design (case: n = 191, control: n = 382), by matching gender, age, study area, date of blood collection, and time since last meal at blood collection, was employed in a large cohort of Japanese community residents.Antibody levels of periodontopathic bacteria were associated with risk of CHD after adjusting for BMI, smoking status, alcohol intake, history of hypertension, history of diabetes mellitus, exercise during leisure time, and perceived mental stress. The association was different by age subgroup. For subjects aged 40-55 years, the medium (31.7-184.9 U/mL) or high tertile plasma antibody level (> 184.9 U/mL) of A. actinomycetemcomitans showed higher risk of CHD (medium: OR = 3.72; 95% CI = 1.20-11.56, high: OR = 4.64; 95% CI = 1.52-14.18) than the low tertile level (< 31.7 U/mL). The ORs of CHD incidence became higher with an increase in IgG level of A. actinomycetemcomitans (P for trend = 0.007). For subjects aged 56-69 years, the high tertile level (> 414.1 U/mL) of P. intermedia was associated with higher risk of CHD (OR = 2.65; 95% CI = 1.18-5.94) in a dose-response fashion (P for trend = 0.007). The possible role of periodontopathic bacteria as a risk factor for CHD incidence was suggested by the results of this study by the elevated antibody level to these bacteria with the increased risk of CHD.
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Affiliation(s)
- Masayuki Ueno
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
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Kanter MM, Kris-Etherton PM, Fernandez ML, Vickers KC, Katz DL. Exploring the factors that affect blood cholesterol and heart disease risk: is dietary cholesterol as bad for you as history leads us to believe? Adv Nutr 2012; 3:711-7. [PMID: 22983850 PMCID: PMC3648753 DOI: 10.3945/an.111.001321] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
This paper summarizes presentations given at the 2011 Experimental Biology meetings about the latest research and a paleoanthropological perspective pertaining to the relationship between dietary cholesterol intake and cardiovascular disease risk. For much of the past 50 years, a great deal of the scientific literature regarding dietary fat and cholesterol intake has indicated a strong positive correlation with heart disease. In recent years, however, there have been a number of epidemiological studies that did not support a relationship between cholesterol intake and cardiovascular disease. Further, a number of recent clinical trials that looked at the effects of long-term egg consumption (as a vehicle for dietary cholesterol) reported no negative impact on various indices of cardiovascular health and disease. Coupled with data indicating that the impact of lowering dietary cholesterol intake on serum LDL levels is small compared with other dietary and lifestyle factors, there is a need to consider how otherwise healthy foods can be incorporated in the diet to meet current dietary cholesterol recommendations. Because eggs are a healthful food, it is particularly important that sensible strategies be recommended for inclusions of eggs in a healthy diet.
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Affiliation(s)
- Mitchell M. Kanter
- Egg Nutrition Center, Park Ridge, IL,To whom correspondence should be addressed. E-mail:
| | | | | | | | - David L. Katz
- Yale University Prevention Research Center, New Haven, CT
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The Effect of Egg Consumption in Hyperlipidemic Subjects during Treatment with Lipid-Lowering Drugs. J Lipids 2012; 2012:672720. [PMID: 22778967 PMCID: PMC3388582 DOI: 10.1155/2012/672720] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Revised: 04/18/2012] [Accepted: 05/02/2012] [Indexed: 01/08/2023] Open
Abstract
Background. Limiting egg consumption to avoid high cholesterolemia is recommended to reduce risk of cardiovascular disease. However, recent evidences suggest that cholesterol from diet has limited influence on serum cholesterol. Objective. To assess the effect of egg consumption on lipid profiles in hyperlipidemic adults treated with lipid-lowering drugs. Material and Method. Sixty hyperlipidemic subjects, mean age of 61 years, who had been treated with lipid-lowering drugs. Every subject was assigned to consume additional 3 eggs per day with their regular diet for 12 weeks. Measurements for lipid profiles and body compositions were performed. Results. An additional consumption of 3 eggs per day for 12 weeks increased HDL-cholesterol by 2.46 ± 6.81 mg/dL (P < 0.01) and decreased LDL-cholesterol to HDL-cholesterol ratio by 0.13 ± 0.46 (P < 0.05). No significant changes were found in other lipid profiles. Body weight and body mass index were significantly increased at 12th week by 0.52 ± 1.83 kg and 0.31 ± 0.99 kg/m2, respectively (P < 0.05). Conclusion. In hyperlipidemic adults who were treated with lipid-lowering drugs, the consumption of additional 3 eggs per day to their regular diet will increase the level of HDL-cholesterol and decrease the ratio of LDL-cholesterol to HDL-cholesterol.
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Abstract
PURPOSE OF REVIEW The perceived notion that dietary cholesterol is associated with increased risk for coronary heart disease (CHD) has led to dietary recommendations of no more than 300 mg/day for healthy populations in the USA. This study will review the recent evidence that challenges the current dietary restrictions regarding cholesterol while it presents some beneficial effects of eggs (an icon for dietary cholesterol) in healthy individuals. RECENT FINDINGS The European countries, Australia, Canada, New Zealand, Korea and India among others do not have an upper limit for cholesterol intake in their dietary guidelines. Further, existing epidemiological data have clearly demonstrated that dietary cholesterol is not correlated with increased risk for CHD. Although numerous clinical studies have shown that dietary cholesterol challenges may increase plasma LDL cholesterol in certain individuals, who are more sensitive to dietary cholesterol (about one-quarter of the population), HDL cholesterol also rises resulting in the maintenance of the LDL/HDL cholesterol ratio, a key marker of CHD risk. SUMMARY The lines of evidence coming from current epidemiological studies and from clinical interventions utilizing different types of cholesterol challenges support the notion that the recommendations limiting dietary cholesterol should be reconsidered.
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Affiliation(s)
- Maria L Fernandez
- Department of Nutritional Sciences, University of Connecticut, Storrs, Connecticut 06269, USA.
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Minai J, Tanaka T, Okamura T, Fukuhara S, Suzukamo Y, Ueshima H, Yamagata Z. Relationship changes in lifestyle, cardiovascular risk factors, and mental health in Japanese workers: A four-year follow up with high-risk and population strategies of the occupational health promotion (HIPOP-OHP) study. Health (London) 2012. [DOI: 10.4236/health.2012.411161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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