1
|
Lu Y, Hao YJ, Zhou X, Huang F, Li C, Wang J, Miao Z, Chen S, Zhang Y, Pan Z, Yin S, Li Y, Sun G. Effects of long-term intake of carotenoid-enriched eggs on healthy people: a randomized controlled study. Food Funct 2024; 15:7032-7045. [PMID: 38864191 DOI: 10.1039/d4fo00910j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
Red palm oil, a natural repository abundant in tocotrienols, tocopherols and carotenoids, is frequently employed as a pigment and nutritional enhancer in food products. The principal aim of this study is to explore the disparities in vitamin A levels, fatty acid profiles and gut microbiota among healthy adults who consume carotenoid-enriched eggs compared to those who consume normal eggs. A total of 200 hens were randomly assigned to either the red palm oil group or the soybean oil group, with the objective of producing carotenoid-enriched eggs and normal eggs. Throughout a six-month, double-blinded, randomized controlled trial, participants were instructed to consume one carotenoid-enriched or normal egg daily at a fixed time. Fecal and blood samples were collected from the participants at the start and conclusion of the six-month intervention period for further analysis. Our findings indicated that there was no significant change in the vitamin A level for daily supplementation with one carotenoid-enriched egg, but there were significant changes in some indicators of fatty acid profiles and gut microbiota compared to the control group of the population. Nonetheless, the consumption of eggs, regardless of carotenoid-enriched eggs or normal eggs, positively influenced dietary habits by reducing the intake of saturated fatty acids and enhancing the intake of monounsaturated and polyunsaturated fatty acids of the population.
Collapse
Affiliation(s)
- Yifei Lu
- Institute of Agro-product Processing, Jiangsu Academy of Agricultural Sciences, Nanjing, 210014, China.
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China.
| | - Yoong Jun Hao
- Malaysian Palm Oil Board, 6, Persiaran Institusi, Bandar Baru Bangi, 43000, Kajang, Selangor, Malaysia
| | - Xin Zhou
- Jintan District Center for Disease Control and Prevention, Changzhou City, Chang Zhou 213200, P.R. China
| | - Feilin Huang
- Jintan Jianchang Health Center, Changzhou City, Chang Zhou 213200, P.R. China
| | - Chao Li
- Jintan Jianchang Health Center, Changzhou City, Chang Zhou 213200, P.R. China
| | - Jiao Wang
- Jintan District Center for Disease Control and Prevention, Changzhou City, Chang Zhou 213200, P.R. China
| | - Zhiyue Miao
- Palm Oil Research and Technical Service Institute of Malaysian Palm Oil Board, Shanghai, 201108, P.R. China
| | - Shiqing Chen
- Palm Oil Research and Technical Service Institute of Malaysian Palm Oil Board, Shanghai, 201108, P.R. China
| | - Yihan Zhang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China.
| | - Zhenyu Pan
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China.
| | - Shiyu Yin
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China.
| | - Ying Li
- Institute of Agro-product Processing, Jiangsu Academy of Agricultural Sciences, Nanjing, 210014, China.
| | - Guiju Sun
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, China.
| |
Collapse
|
2
|
Kondo K, Miura K, Okamura T, Okayama A, Ueshima H. Dietary Factors, Dietary Patterns, and Cardiovascular Disease Risk in Representative Japanese Cohorts: NIPPON DATA80/90. J Atheroscler Thromb 2023; 30:207-219. [PMID: 36436878 PMCID: PMC9981349 DOI: 10.5551/jat.rv22001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Diet is one of the most important factors affecting healthy life expectancy through the onset of cardiovascular disease (CVD) risk as well as various chronic diseases. Because dietary habits and disease structure differ depending on the country, region, and/or race, evidence from each population is required. NIPPON DATA80/90 is a long-term cohort study of a representative Japanese population that participated in national nutrition surveys. Among the many findings of this cohort study, a dietary pattern with higher intake of fruits, vegetables, fish (n-3 polyunsaturated fatty acids), and dietary fiber and lower intake of salt as well as sodium-to-potassium ratio was found to be associated with a lower risk of CVD mortality. The results from our cohort study would be useful for effectively preventing CVD. This article reviews the published studies from the NIPPON DATA80/90 to highlight the significant findings that may be used to develop risk prevention strategies for CVD.
Collapse
Affiliation(s)
- Keiko Kondo
- NCD Epidemiology Research Center, Shiga University of Medical Science, Shiga, Japan
| | - Katsuyuki Miura
- NCD Epidemiology Research Center, Shiga University of Medical Science, Shiga, Japan
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Tokyo, Japan
| | - Akira Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
| | - Hirotsugu Ueshima
- NCD Epidemiology Research Center, Shiga University of Medical Science, Shiga, Japan
| | | |
Collapse
|
3
|
Sugihara N, Shirai Y, Imai T, Sezaki A, Abe C, Kawase F, Miyamoto K, Inden A, Kato T, Sanada M, Shimokata H. The Global Association between Egg Intake and the Incidence and Mortality of Ischemic Heart Disease-An Ecological Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4138. [PMID: 36901143 PMCID: PMC10001696 DOI: 10.3390/ijerph20054138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
The relationship between egg consumption and ischemic heart disease (IHD) remains controversial as there is still no clear answer regarding the relationship, with research limited to a few geographical regions. In the current study, we conducted a longitudinal analysis of the association between egg intake and IHD incidence (IHDi) and mortality (IHDd) using 28 years of international data from 1990 to 2018. Egg intake (g/day/capita) by country was obtained from the Global Dietary Database. Age-standard IHDi and IHDd rates per 100,000 subjects in each country were obtained from the 2019 Global Burden of Disease database. The analysis included a total of 142 countries with populations of at least one million, for which all data were available from 1990 to 2018. Eggs are consumed worldwide, and regional differences in consumption are also shown. Utilizing IHDi and IHDd as objective variables and egg intake as an explanatory variable, the analysis was conducted using linear mixed models, which controlled for inter- and intra-country variation from year to year. The results showed a significant negative association between egg intake, and IHDi (-0.253 ± 0.117, p < 0.05) and IHDd (-0.359 ± 0.137, p < 0.05). The analysis was carried out using R 4.0.5. The results suggest that adequate egg intake might suppress IHDi and IHDd on a global scale.
Collapse
Affiliation(s)
- Norie Sugihara
- Faculty of Health and Social Services, Kanagawa University of Human Services, Yokosuka 238-8550, Japan
- Faculty of Core Research, Ochanomizu University, Tokyo 112-8610, Japan
| | - Yoshiro Shirai
- Department of Human Life and Environment, Kinjo Gakuin University, Nagoya 463-8521, Japan
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Nisshin 470-0196, Japan
| | - Tomoko Imai
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Nisshin 470-0196, Japan
- Department of Food Science and Nutrition, Doshisha Women’s College of Liberal Arts, Kyoto 602-0893, Japan
| | - Ayako Sezaki
- Department of Food Science and Human Nutrition, Ryukoku University, Otsu 520-2194, Japan
- Graduate School of Nutritional Sciences, Nagoya University of Arts and Sciences, Nisshin 470-0196, Japan
| | - Chisato Abe
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Nisshin 470-0196, Japan
- Department of Food and Nutrition, Tsu City College, Tsu 514-0112, Japan
| | - Fumiya Kawase
- Graduate School of Nutritional Sciences, Nagoya University of Arts and Sciences, Nisshin 470-0196, Japan
- Department of Nutrition, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Toyota 444-2351, Japan
| | - Keiko Miyamoto
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Nisshin 470-0196, Japan
- Department of Nursing, Nagoya University of Arts and Sciences, Nagoya 460-0001, Japan
| | - Ayaka Inden
- Graduate School of Nutritional Sciences, Nagoya University of Arts and Sciences, Nisshin 470-0196, Japan
- Clinical Nutrition Unit, Hamamatsu University Hospital, Hamamatsu 431-3192, Japan
| | - Takumi Kato
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Nisshin 470-0196, Japan
- Nutrition Division, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya 466-8650, Japan
| | - Masayo Sanada
- Department of Nursing, Heisei College of Health Sciences, Gifu 501-1131, Japan
| | - Hiroshi Shimokata
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Nisshin 470-0196, Japan
- Graduate School of Nutritional Sciences, Nagoya University of Arts and Sciences, Nisshin 470-0196, Japan
| |
Collapse
|
4
|
Wang K, Xiang Q, Hu L, Wang L, Zhang Y. Frequency of Egg Intake Associated with Mortality in Chinese Adults: An 8-Year Nationwide Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14777. [PMID: 36429496 PMCID: PMC9690384 DOI: 10.3390/ijerph192214777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/26/2022] [Accepted: 11/03/2022] [Indexed: 06/16/2023]
Abstract
Whether egg consumption plays a beneficial/detrimental role in affecting human health and longevity has been debated for decades. Large-scale cohort evidence from low- and middle-income populations are scarce. In this study, we aimed to assess the association of egg consumption with mortality in Chinese adults. A nationwide cohort of 30,835 participants ages 16-110 years were enrolled from 25 provincial regions in China's mainland. Dietary intake (e.g., egg, meat, vegetable) was assessed by a food-frequency questionnaire. Cox proportional hazards models were used to examine associations between egg consumption and mortality, adjusting for demographic characteristics, dietary factors and health status. Dose-response relationships were investigated using the smoothing function of restricted cubic splines. Several subgroup analyses were performed. A total of 1651 all-cause deaths occurred during a median follow-up of 8.1 years. Egg consumption was associated with lower risks of mortality, with the lowest risk occurring in the group of moderate egg intake (3-6 times/week). Compared with non-consumers, the hazard ratios (95% confidence intervals) for mortality were 0.84 (0.72-0.97) for 3-6 times/week and 0.82 (0.69-0.98) for ≥7 times/week, whereas no significant associations were observed among the lower egg intake group (1-2/week). An approximately inverted J-shaped association was observed in three models, while restricting our analysis in the multivariable model (model 3) did not identify a significant violation for the linear relationship (p for nonlinear = 0.122). There were no statistically significant effect modifications in the subgroup analyses. Egg consumption may be associated with lower risks of mortality in Chinese adults. Our findings found moderate-to-high egg consumption might be beneficial for improving long-term health and longevity.
Collapse
Affiliation(s)
- Ke Wang
- Department of Nursing, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Qianqian Xiang
- Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
| | - Lan Hu
- Department of Nursing, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
- Department of Head and Neck Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, China
| | - Lu Wang
- School of Basic Medicine, Hubei University of Arts and Sciences, Xiangyang 441053, China
| | - Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan 430065, China
| |
Collapse
|
5
|
Ma W, Zhang Y, Pan L, Wang S, Xie K, Deng S, Wang R, Guo C, Qin P, Wu X, Wu Y, Zhao Y, Feng Y, Hu F. Association of Egg Consumption with Risk of All-Cause and Cardiovascular Disease Mortality: A Systematic Review and Dose-Response Meta-Analysis of Observational Studies. J Nutr 2022; 152:2227-2237. [PMID: 35524693 DOI: 10.1093/jn/nxac105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 12/18/2021] [Accepted: 05/05/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Recent studies have reported conflicting associations between egg consumption and the risk of all-cause or cardiovascular disease (CVD) mortality, including ischemic heart disease (IHD) mortality and stroke mortality. With accumulating evidence, up-to-date evidence about the association should be synthesized. OBJECTIVES We aimed to assess the association of the risk of all-cause and CVD mortality with egg consumption. METHODS We searched the PubMed, Embase, and Web of Science databases through 3 November, 2021 for observational studies conducted in participants ≥18 y of age and which provided ORs, RRs, or HRs and 95% CIs for ≥3 egg consumption categories or for increased intake of egg addressing the associations of interest. A random-effects model was used to pool the reported risk estimates. Restricted cubic splines were used to examine the dose-response association. RESULTS Twenty-four articles with 48 reports (25 for all-cause mortality, 11 for CVD mortality, 6 for IHD mortality, and 6 for stroke mortality) involving 11,890,695 participants were included. Intake of each 1-egg/d increment was associated with increased risk of all-cause mortality (RR: 1.06; 95% CI: 1.02, 1.10; P = 0.008), but the association was restricted to women, Americans, and studies with adjustments for hyperlipidemia. Egg consumption was linearly associated with CVD mortality only in participants >60 y of age, Americans, studies with follow-up duration ≥15 y, and studies with adjustments for hyperlipidemia (P ≤ 0.018). No significant association was found between egg consumption and IHD or stroke mortality (P ≥ 0.080). CONCLUSIONS Egg consumption was linearly associated with a modestly increased risk of all-cause mortality and, in older participants, Americans, and studies with longer follow-up or adjustments for hyperlipidemia, CVD mortality. These findings suggest that it may be prudent to avoid high egg consumption.
Collapse
Affiliation(s)
- Wancheng Ma
- Department of Non-communicable Disease Prevention and Control, Shenzhen Luohu Center for Chronic Disease Control, Shenzhen, China
| | - Yanyan Zhang
- Department of Non-communicable Disease Prevention and Control, Shenzhen Luohu Center for Chronic Disease Control, Shenzhen, China
| | - Li Pan
- Department of Comprehensive Ward, Shenzhen Luohu Hospital of Traditional Chinese Medicine, Shenzhen, China
| | - Sijia Wang
- Department of Non-communicable Disease Prevention and Control, Shenzhen Luohu Center for Chronic Disease Control, Shenzhen, China
| | - Kui Xie
- Department of Non-communicable Disease Prevention and Control, Shenzhen Luohu Center for Chronic Disease Control, Shenzhen, China
| | - Shan Deng
- Department of Non-communicable Disease Prevention and Control, Shenzhen Luohu Center for Chronic Disease Control, Shenzhen, China
| | - Rui Wang
- Department of Non-communicable Disease Prevention and Control, Shenzhen Luohu Center for Chronic Disease Control, Shenzhen, China
| | - Chunjiang Guo
- Department of Non-communicable Disease Prevention and Control, Shenzhen Luohu Center for Chronic Disease Control, Shenzhen, China
| | - Pei Qin
- Department of Medical Record Management, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Xiaoyan Wu
- Department of Cardiovascular and Cerebrovascular Disease Prevention and Control, Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Yuying Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, China
| | - Yifei Feng
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, China
| | - Fulan Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Shenzhen University Health Science Center, Shenzhen, China
| |
Collapse
|
6
|
Darooghegi Mofrad M, Naghshi S, Lotfi K, Beyene J, Hypponen E, Pirouzi A, Sadeghi O. Egg and Dietary Cholesterol Intake and Risk of All-Cause, Cardiovascular, and Cancer Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies. Front Nutr 2022; 9:878979. [PMID: 35711545 PMCID: PMC9195585 DOI: 10.3389/fnut.2022.878979] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/19/2022] [Indexed: 11/24/2022] Open
Abstract
Objective This systematic review and meta-analysis of prospective cohort studies examined the associations between egg and dietary cholesterol intake and the risk of mortality from all causes, including cardiovascular disease (CVD) and cancer. Methods We searched PubMed, Scopus, ISI Web of Knowledge, and Google Scholar until April 2021, as well as references to the relevant articles retrieved. Random-effects models were used to calculate summary relative risk (RR) and 95% confidence intervals (CIs) for the highest vs. lowest categories of egg and dietary cholesterol intake. Also, linear and non-linear dose–response analyses were conducted to examine the dose-response relationships. Results We included 55 studies, comprising data from 2,772,486 individuals with 228,425, 71,745, and 67,211 cases of all-cause, CVD, and cancer mortality, respectively. Intake of each additional egg per day was associated with a 7% higher risk of all-cause (1.07, 95% CI: 1.02–1.12, I2 = 84.8%) and a 13% higher risk of cancer mortality (1.13, 95% CI: 1.06–1.20, I2 = 54.2%), but was not associated with CVD mortality (1.00, 95% CI: 0.92–1.09, I2 = 81.5%). Non-linear analyses showed increased risks for egg consumption of more than 1.5 and 0.5 eggs/day, respectively. Each 100 mg/day increment in dietary cholesterol intake was associated with a 6% higher risk of all-cause mortality (1.06, 95% CI: 1.03–1.08, I2 = 34.5%) and a 6% higher risk of cancer mortality (1.06, 95% CI: 1.05–1.07, I2 = 0%), but was not associated with CVD mortality (1.04, 95% CI: 0.99–1.10, I2 = 85.9%). Non-linear analyses demonstrated elevated risks of CVD and cancer mortality for intakes more than 450 and 250 mg/day, respectively. Conclusions and Relevance High-dietary intake of eggs and cholesterol was associated with all-cause and cancer mortality. Little evidence for elevated risks was seen for intakes below 0.5 egg/day or 250 mg/day of dietary cholesterol. Our findings should be considered with caution because of small risk estimates and moderate between-study heterogeneity. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=252564, PROSPERO, identifier: CRD42021252564.
Collapse
Affiliation(s)
- Manije Darooghegi Mofrad
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Sina Naghshi
- Department of Clinical Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Keyhan Lotfi
- Department of Community Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Joseph Beyene
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.,Chanchlani Research Centre, McMaster University, Hamilton, ON, Canada
| | - Elina Hypponen
- Australian Centre for Precision Health, Unit of Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia.,South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Aliyar Pirouzi
- Cellular and Molecular Department, Gerash University of Medical Sciences, Gerash, Iran
| | - Omid Sadeghi
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
7
|
Zhao B, Gan L, Graubard BI, Männistö S, Albanes D, Huang J. Associations of Dietary Cholesterol, Serum Cholesterol, and Egg Consumption With Overall and Cause-Specific Mortality: Systematic Review and Updated Meta-Analysis. Circulation 2022; 145:1506-1520. [PMID: 35360933 PMCID: PMC9134263 DOI: 10.1161/circulationaha.121.057642] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Despite substantial research highlighting the importance of exogenous dietary cholesterol intake and endogenous serum cholesterol level in human health, a thorough evaluation of the associations is lacking. Our study objective was to examine overall and cause-specific mortality in relation to dietary and serum cholesterol, as well as egg consumption, and conduct an updated meta-regression analysis of cohort studies. METHODS We conducted a prospective analysis of 27 078 men in the ATBC Study (Alpha-Tocopherol, Beta-Carotene Cancer Prevention). Multivariable-controlled cause-specific Cox proportional hazards regression models were used to calculate hazard ratios and 31-year absolute mortality risk differences. A systematic review and meta-analysis of cohort studies was also performed (PROSPERO [URL: https://www.crd.york.ac.uk/prospero/; Unique identifier: CRD42021272756]). RESULTS Based on 482 316 person-years of follow-up, we identified 22 035 deaths, including 9110 deaths from cardiovascular disease (CVD). Greater dietary cholesterol and egg consumption were associated with increased risk of overall and CVD-related mortality. Hazard ratios for each additional 300 mg cholesterol intake per day were 1.10 and 1.13 for overall and CVD-related mortality, respectively; for each additional 50-g egg consumed daily, hazard ratios were 1.06 and 1.09, respectively, for overall and CVD-related mortality (all P values<0.0001). After multivariable adjustment, higher serum total cholesterol concentrations were associated with increased risk of CVD-related mortality (hazard ratios per 1 SD increment, 1.14; P<0.0001). The observed associations were generally similar across cohort subgroups. The updated meta-analysis of cohort studies on the basis of 49 risk estimates, 3 601 401 participants, and 255 479 events showed consumption of 1 additional 50-g egg daily was associated with significantly increased CVD risk (pooled relative risk, 1.04 [95% CI, 1.00-1.08]; I2=80.1%). In the subgroup analysis of geographic regions (Pinteraction=0.02), an increase of 50-g egg consumed daily was associated with a higher risk of CVD in US cohorts (pooled relative risk, 1.08 [95% CI, 1.02-1.14]) and appeared related to a higher CVD risk in European cohorts with borderline significance (pooled relative risk, 1.05), but was not associated with CVD risk in Asian cohorts. CONCLUSIONS In this prospective cohort study and updated meta-analysis, greater dietary cholesterol and egg consumption were associated with increased risk of overall and CVD-related mortality. Our findings support restricted consumption of dietary cholesterol as a means to improve long-term health and longevity.
Collapse
Affiliation(s)
- Bin Zhao
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Lu Gan
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Barry I. Graubard
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Bethesda, MD, USA
| | - Satu Männistö
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Bethesda, MD, USA
| | - Jiaqi Huang
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China,Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Bethesda, MD, USA
| |
Collapse
|
8
|
Shirota M, Watanabe N, Suzuki M, Kobori M. Japanese-Style Diet and Cardiovascular Disease Mortality: A Systematic Review and Meta-Analysis of Prospective Cohort Studies. Nutrients 2022; 14:nu14102008. [PMID: 35631146 PMCID: PMC9147868 DOI: 10.3390/nu14102008] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/27/2022] [Accepted: 05/07/2022] [Indexed: 02/05/2023] Open
Abstract
This systematic review and meta-analysis elucidate the effects of the Japanese-style diet and characteristic Japanese foods on the mortality risk of cardiovascular disease (CVD), cerebrovascular disease (stroke), and heart disease (HD). This review article followed the PRISMA guidelines. A systematic search in PubMed, The Cochrane Library, JDreamIII, and ICHUSHI Web identified prospective cohort studies on Japanese people published till July 2020. The meta-analysis used a random-effects model, and heterogeneity and publication bias were evaluated with I2 statistic and Egger’s test, respectively. Based on inclusion criteria, we extracted 58 articles, including 9 on the Japanese-style diet (n = 469,190) and 49 (n = 2,668,238) on characteristic Japanese foods. With higher adherence to the Japanese-style diet, the pooled risk ratios (RRs) for CVD, stroke, heart disease/ischemic heart disease combined (HD/IHD) mortality were 0.83 (95% CI, 0.77–0.89, I2 = 58%, Egger’s test: p = 0.625, n = 9 studies), 0.80 (95% CI, 0.69–0.93, I2 = 66%, Egger’s test: p = 0.602, n = 6 studies), and 0.81 (95% CI, 0.75–0.88, I2 = 0%, Egger’s test: p = 0.544, n = 6 studies), respectively. Increased consumption of vegetables, fruits, fish, green tea, and milk and dairy products decreased the RR for CVD, stroke, or HD mortality. Increased salt consumption elevated the RR for CVD and stroke mortality. Increased consumption of dietary fiber and plant-derived protein decreased the RR for CVD, stroke, and HD/IHD mortality. The Japanese-style diet and characteristic Japanese foods may reduce CVD mortality. Most studies conducted diet surveys between 1980 and the 1990s. This meta-analysis used articles that evaluated the same cohort study by a different method. A new large-scale cohort study matching the current Japanese dietary habits is needed to confirm these findings.
Collapse
Affiliation(s)
- Masayuki Shirota
- Institute of Food Research, National Agriculture and Food Research Organization, 2-1-2 Kannondai, Tsukuba-shi 305-8642, Ibaraki, Japan;
| | - Norikazu Watanabe
- Yakujihou Marketing Jimusho Inc., Level 3, Sanno Park Tower, 2-11-1 Nagata-cho, Chiyoda-ku, Tokyo 100-6162, Japan; (N.W.); (M.S.)
| | - Masataka Suzuki
- Yakujihou Marketing Jimusho Inc., Level 3, Sanno Park Tower, 2-11-1 Nagata-cho, Chiyoda-ku, Tokyo 100-6162, Japan; (N.W.); (M.S.)
| | - Masuko Kobori
- Institute of Food Research, National Agriculture and Food Research Organization, 2-1-2 Kannondai, Tsukuba-shi 305-8642, Ibaraki, Japan;
- Correspondence: ; Tel.: +81-29-838-8011
| |
Collapse
|
9
|
Mousavi SM, Zargarzadeh N, Rigi S, Persad E, Pizarro AB, Hasani-Ranjbar S, Larijani B, Willett WC, Esmaillzadeh A. Egg Consumption and Risk of All-Cause and Cause-Specific Mortality: A Systematic Review and Dose-Response Meta-analysis of Prospective Studies. Adv Nutr 2022; 13:1762-1773. [PMID: 35396834 PMCID: PMC9526855 DOI: 10.1093/advances/nmac040] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/09/2022] [Accepted: 04/07/2022] [Indexed: 01/28/2023] Open
Abstract
The association between egg consumption and mortality is extremely debatable. This study aimed to investigate the potential dose-response association of egg consumption with risk of mortality from all causes and cause-specific in the general population. The primary comprehensive literature search was conducted in PubMed/Medline, Scopus, ISI Web of Science, and Embase up to March 2021, as well as reference lists of relevant original papers and key journals. We calculated summary RRs and their 95% CIs for the highest and lowest categories, as well as the linear trend estimation of egg intake, using the random-effects model. Thirty-three (32 publications) cohort studies were included. These studies enrolled 2,216,720 participants and recorded 232,408 deaths from all causes. Comparing highest versus lowest egg intake categories was not associated with the risk of mortality from all causes (RR: 1.02; 95% CI: 0.94, 1.11; n = 25), cardiovascular disease (CVD) (RR: 1.04; 95% CI: 0.87, 1.23, n = 11), coronary heart disease (CHD) (RR: 0.98; 95% CI: 0.84, 1.16; n = 10), stroke (RR: 0.81; 95% CI: 0.64, 1.02; n = 9), and respiratory disease (RR: 0.96; 95% CI: 0.53, 1.71; n = 3); however, it was associated with a higher risk of cancer mortality (RR: 1.20; 95% CI: 1.04, 1.39; n = 13). In the linear dose-response analysis, an additional intake of 1 egg per week was associated with a 2% and 4% increased risk of all-cause and cancer mortality, respectively, and a 4% decreased risk of stroke mortality. The certainty of the evidence was rated as low to moderate. Higher egg consumption was not associated with an increased risk of mortality from all causes, CVD, CHD, stroke, or respiratory disease, whereas an elevated risk was observed for cancer mortality. These findings suggest that eggs be consumed in low to moderate amounts (≤1 egg/d) as part of a healthy diet.
Collapse
Affiliation(s)
- Seyed Mohammad Mousavi
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran,Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Nikan Zargarzadeh
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Somaye Rigi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Emma Persad
- Department for Evidence-based Medicine and Evaluation, Danube University Krems, Krems, Austria
| | | | - Shirin Hasani-Ranjbar
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Walter C Willett
- Departments of Nutrition and Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA,Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | | |
Collapse
|
10
|
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
| |
Collapse
|
11
|
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.
Collapse
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
| |
Collapse
|
12
|
Ruggiero E, Di Castelnuovo A, Costanzo S, Persichillo M, De Curtis A, Cerletti C, Donati MB, de Gaetano G, Iacoviello L, Bonaccio M. Egg consumption and risk of all-cause and cause-specific mortality in an Italian adult population. Eur J Nutr 2021; 60:3691-3702. [PMID: 33763719 PMCID: PMC8437843 DOI: 10.1007/s00394-021-02536-w] [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: 11/02/2020] [Accepted: 03/06/2021] [Indexed: 02/06/2023]
Abstract
Purpose Dietary guidelines recommend to limit egg consumption to 4 servings per week but the relation between egg intake and health outcomes is still controversial. To evaluate the association of egg consumption and mortality risk in Italian adults and to investigate nutritional factors and serum lipids as potentially explaining such associations. Methods Longitudinal analysis on 20,562 men and women aged ≥ 35y, free from cardiovascular disease (CVD) and cancer belonging to the Moli-sani Study cohort (enrolled 2005–2010) followed up for a median of 8.2 years. Results In multivariable-adjusted analysis as compared to low intake (> 0 ≤ 1 egg/week), eating > 4 eggs/week led to an increased risk of all-cause (Hazard ratio [HR] = 1.50; 95%CI 1.13–1.99), CVD (HR = 1.75; 1.07–2.87) and cancer mortality (HR = 1.52; 0.99–2.33). Similarly, an intake of 2–4 eggs/week was associated with higher all-cause (HR = 1.22; 1.01–1.46) and CVD mortality risk (HR = 1.43; 1.03–1.97). An increase of 1 egg per week was associated with higher mortality risk among high-risk individuals, such as those with hypertension and hyperlipidaemia. Dietary cholesterol explained about 43.0% and 39.3% (p values < 0.0001) of the association of eggs with all-cause and CVD mortality, respectively, while serum lipids (e.g., total cholesterol) accounted for a small proportion of egg-mortality relation. Conclusions Among Italian adults, high egg consumption leads to an increased risk of all-cause and CVD mortality, with the risk being evident even at the recommended intake of 2–4 eggs per week. A substantial part of this association was likely due to the egg contribution to dietary cholesterol. Our findings suggest limiting the consumption of eggs in the diet and these results should be considered in the development of dietary guidelines and updates. Supplementary Information The online version contains supplementary material available at 10.1007/s00394-021-02536-w.
Collapse
Affiliation(s)
- Emilia Ruggiero
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via dell'Elettronica, 86077, Pozzilli, IS, Italy
| | | | - Simona Costanzo
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via dell'Elettronica, 86077, Pozzilli, IS, Italy
| | - Mariarosaria Persichillo
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via dell'Elettronica, 86077, Pozzilli, IS, Italy
| | - Amalia De Curtis
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via dell'Elettronica, 86077, Pozzilli, IS, Italy
| | - Chiara Cerletti
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via dell'Elettronica, 86077, Pozzilli, IS, Italy
| | - Maria Benedetta Donati
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via dell'Elettronica, 86077, Pozzilli, IS, Italy
| | - Giovanni de Gaetano
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via dell'Elettronica, 86077, Pozzilli, IS, Italy
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via dell'Elettronica, 86077, Pozzilli, IS, Italy. .,Research Centre in Epidemiology and Preventive Medicine (EPIMED), Department of Medicine and Surgery, University of Insubria, Varese-Como, Italy.
| | - Marialaura Bonaccio
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Via dell'Elettronica, 86077, Pozzilli, IS, Italy
| | | |
Collapse
|
13
|
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]
|
14
|
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.
Collapse
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
| | | |
Collapse
|
15
|
Xia P, Pan X, Chen C, Wang Y, Ye Y, Pan A. Dietary Intakes of Eggs and Cholesterol in Relation to All-Cause and Heart Disease Mortality: A Prospective Cohort Study. J Am Heart Assoc 2020; 9:e015743. [PMID: 32400247 PMCID: PMC7660855 DOI: 10.1161/jaha.119.015743] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background The aim of this study was to identify associations between dietary intakes of eggs and cholesterol and all-cause and heart disease mortality in a US population. Methods and Results Data from the National Health and Nutrition Examination Survey 1999-2014 were used in this study, which included 37 121 participants ≥20 years of age. Dietary information was assessed via 24-hour dietary recalls at baseline. Mortality status was documented until December 31, 2015. Cox proportional hazards models were used to examine the associations between dietary intakes of eggs and cholesterol and all-cause and heart disease mortality. During a median follow-up of 7.8 years, 4991 deaths were documented, including 870 deaths from heart disease. No significant association was observed between additional daily consumption of half an egg and all-cause mortality (multivariable-adjusted hazard ratio, 1.04; 95% CI, 0.96-1.13), or heart disease mortality (0.96; 0.80-1.14). Each 50-mg/day increase of cholesterol intake was inversely associated with all-cause mortality among participants with daily intake <250 mg (0.87; 0.77-0.98), but positively associated with all-cause mortality among participants with daily intake ≥250 mg (1.07; 1.01-1.12). No significant association was found between dietary cholesterol intake and heart disease mortality. Conclusions No significant association was found between egg consumption and mortality in US adults. The association between dietary cholesterol intake and all-cause mortality depended on the baseline intake levels, with an inverse association in those with lower intake levels (<250 mg/day) but a positive association in those with higher intake levels (≥250 mg/day).
Collapse
Affiliation(s)
- Peng‐Fei Xia
- Department of Epidemiology and BiostatisticsMinistry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - Xiong‐Fei Pan
- Department of Epidemiology and BiostatisticsMinistry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
- Division of EpidemiologyDepartment of MedicineVanderbilt University Medical CenterNashvilleTN
| | - Chen Chen
- Department of Epidemiology and BiostatisticsMinistry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - Yi Wang
- Department of Epidemiology and BiostatisticsMinistry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - Yi Ye
- Department of Epidemiology and BiostatisticsMinistry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - An Pan
- Department of Epidemiology and BiostatisticsMinistry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| |
Collapse
|
16
|
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.
Collapse
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
| |
Collapse
|
17
|
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.
Collapse
|
18
|
Sugano M. Egg and Health: Focused on the Cholesterol Issue. J JPN SOC FOOD SCI 2019. [DOI: 10.3136/nskkk.66.362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Michihiro Sugano
- Professor Emeritus, Kyushu University and Prefectural University of Kumamoto and Chair, The Japan Egg Science Society
| |
Collapse
|
19
|
Mazidi M, Katsiki N, Mikhailidis DP, Pencina MJ, Banach M. Egg Consumption and Risk of Total and Cause-Specific Mortality: An Individual-Based Cohort Study and Pooling Prospective Studies on Behalf of the Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group. J Am Coll Nutr 2019; 38:552-563. [PMID: 31173548 DOI: 10.1080/07315724.2018.1534620] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Mohsen Mazidi
- Key State Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Chaoyang, Beijing, China
| | - Niki Katsiki
- Institute of Genetics and Developmental Biology, International College, University of Chinese Academy of Science (IC-UCAS), West Beichen Road, Chaoyang, China
| | - Dimitri P. Mikhailidis
- Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London, London, UK
| | - Michael J. Pencina
- Department of Biostatistics and Bioinformatics, Duke Clinical Research Institute, Durham, North Carolina
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland
- Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
- Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
| |
Collapse
|
20
|
van den Brandt PA. Red meat, processed meat, and other dietary protein sources and risk of overall and cause-specific mortality in The Netherlands Cohort Study. Eur J Epidemiol 2019; 34:351-369. [PMID: 30673923 PMCID: PMC6451725 DOI: 10.1007/s10654-019-00483-9] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 01/11/2019] [Indexed: 11/15/2022]
Abstract
Processed meat and red meat have been associated with increased mortality, but studies are inconsistent and few have investigated substitution by other protein sources. The relationship of overall and causes-specific mortality with red meat, processed meat, and other dietary protein sources was investigated in The Netherlands Cohort Study. In 1986, 120,852 men and women aged 55-69 years provided information on dietary and lifestyle habits. Mortality follow-up until 1996 consisted of linkage to statistics Netherlands. Multivariable case-cohort analyses were based on 8823 deaths and 3202 subcohort members with complete data on diet and confounders. Red meat (unprocessed) intake was not associated with overall and cause-specific mortality. Processed meat intake was significantly positively related to overall mortality: HR (95% CI) comparing highest versus lowest quintile, 1.21 (1.02-1.44) with Ptrend = 0.049. Significant associations were observed for cardiovascular [HR Q5 vs. Q1, 1.26 (1.01-1.26)] and respiratory [HR = 1.79 (1.19-2.67)], but not cancer mortality [HR = 1.16 (0.97-1.39)]. Adjustment for nitrite intake attenuated these associations which became nonsignificant: HRs Q5 versus Q1 (95% CI) were: 1.10 (0.77-1.55) for total, 1.09 (0.71-1.67) for cardiovascular, 1.44 (0.68-3.05) for respiratory, and 1.11 (0.78-1.58) for cancer mortality. Nitrite was significantly associated with overall, CVD and respiratory mortality. Poultry intake was significantly inversely related to cancer and overall mortality. While fish intake showed positive associations, nut intake showed inverse associations with all endpoints. Replacing processed meat with a combination of poultry, eggs, fish, pulses, nuts and low-fat dairy was associated with lower risks of overall, cardiovascular and respiratory mortality. Processed meat was related to increased overall, CVD and respiratory mortality, potentially due to nitrite. Substituting processed meat with other protein sources was associated with lower mortality risks.
Collapse
Affiliation(s)
- Piet A van den Brandt
- Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
- Department of Epidemiology, CAPHRI-School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, The Netherlands.
| |
Collapse
|