1
|
Niu PP, Zhang C, Li S, Li YS. Association between egg consumption and mortality risk in United States adults with established coronary heart disease or stroke: A cohort study using data from NHANES 1999-2018. Arch Gerontol Geriatr 2024; 124:105475. [PMID: 38733921 DOI: 10.1016/j.archger.2024.105475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/01/2024] [Accepted: 05/03/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND To investigate the relationship between egg consumption and mortality in individuals with pre-existing coronary heart disease or stroke. METHODS This study utilized data from the National Health and Nutrition Examination Survey conducted between 1999 and 2018. Egg consumption was evaluated through 24 h dietary recalls at baseline. Mortality status was tracked until December 31, 2019. Survey-weighted Cox proportional hazards models were utilized. RESULTS The study involved 3,975 participants aged 20 years or older with a median follow-up of 89.00 months. A total of 1,675 individuals died during follow-up. Compared to individuals who did not consume eggs, the consumption of 0-50 g/day (hazard ratio [HR] = 1.033, 95% confidence interval [CI] =0.878-1.214) was not found to have a significant association with all-cause mortality. However, consuming 50-100 g/day (HR = 1.281, 95% CI = 1.004-1.635) and >100 g/day (HR = 1.312, 95% CI =1.036-1.661) exhibited a significant association with an increased risk of all-cause mortality. We identified a non-liner relationship between egg consumption and cardiovascular mortality, where the risk was found to be lowest at an intake of about 50 g/day. For individuals consuming more than 50 g/day, each additional 50 g increment in egg consumption was significantly linked to an elevated risk of cardiovascular mortality (HR = 1.276, 95% CI = 1.009-1.614). CONCLUSION In U.S. adults with pre-existing cardiovascular disease, a significant positive association was found between consuming over 50 g of eggs per day and the risk of mortality, highlighting the importance of moderate intake.
Collapse
Affiliation(s)
- Peng-Peng Niu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. 450000; Henan Engineering Research Center of Neural Function Detection and Regulation, Zhengzhou, China. 450000.
| | - Chan Zhang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. 450000; Henan Engineering Research Center of Neural Function Detection and Regulation, Zhengzhou, China. 450000
| | - Shuo Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. 450000; Henan Engineering Research Center of Neural Function Detection and Regulation, Zhengzhou, China. 450000
| | - Yu-Sheng Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. 450000; Henan Engineering Research Center of Neural Function Detection and Regulation, Zhengzhou, China. 450000.
| |
Collapse
|
2
|
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
|
3
|
Chen Y, Gao Y, Chen Y, Wang Z, Xu H, Hu F, Cai Y. Association between Dietary Patterns and All-Cause Mortality in the Chinese Old: Analysis of the Chinese Longitudinal Healthy Longevity Survey Cohort. Nutrients 2024; 16:1605. [PMID: 38892538 PMCID: PMC11174105 DOI: 10.3390/nu16111605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/12/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
Diet is one of the most important ways to intervene and promote the health of older adults and reduce all-cause mortality. This study aimed to investigate the association between dietary patterns and all-cause mortality in the Chinese old. This study involved 11,958 subjects aged 65-116 years in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008 to 2018. Dietary patterns were derived from principal component analysis (PCA) with varimax rotation. Four dietary patterns were derived: the 'milk-egg-sugar pattern', 'carnivorous pattern', 'healthy pattern', and 'northeastern pattern'. Cox proportional hazard models were built for males and females separately to estimate the relationship between different dietary patterns and all-cause mortality. After adjusting for all covariates, the milk-egg-sugar pattern played a reverse role in mortality risk in males and females in different quartiles. In the carnivorous pattern, only males in the fourth quartile were observed to have a significantly reduced mortality risk (HR = 0.84 (95% CI: 0.77-0.93)). Both genders benefited from the healthy pattern, which consistently lowered mortality risk across all quartiles (males: HR = 0.87 (95% CI: 0.84-0.89); females: HR = 0.95 (95% CI: 0.92-0.97)). The northeastern pattern also showed an inverse association with all-cause mortality in males (HR = 0.94 (95% CI: 0.92-0.97)) and females (HR = 0.96 (95% CI: 0.93-0.98)). This study showed the association between dietary patterns and all-cause mortality in the Chinese old, which is significant for further quantitative studies.
Collapse
Affiliation(s)
- Yufei Chen
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (Y.C.); (Z.W.); (H.X.)
- Department of Public Health, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200050, China;
| | - Ying Gao
- Department of Public Health, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200050, China;
| | - Yexin Chen
- School of Management, Fudan University, Shanghai 200433, China;
| | - Zuxin Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (Y.C.); (Z.W.); (H.X.)
| | - Huifang Xu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; (Y.C.); (Z.W.); (H.X.)
| | - Fan Hu
- Department of Public Health, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200050, China;
| | - Yong Cai
- Department of Public Health, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200050, China;
| |
Collapse
|
4
|
Lee H, Park J, Kwon SH, Jeon JS, Noh H, Kim H. Dietary cholesterol intake is not associated with the development of chronic kidney disease: Results from two Korean cohort studies. Nutr Metab Cardiovasc Dis 2024; 34:1198-1206. [PMID: 38218709 DOI: 10.1016/j.numecd.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 11/30/2023] [Accepted: 12/14/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND AND AIMS Although dyslipidemia is a major risk factor for chronic kidney disease (CKD), the relationship between dietary cholesterol and CKD remains unknown. We investigated the association between cholesterol intake and CKD risk. METHODS AND RESULTS The Korea National Health and Nutrition Examination Survey (KNHANES) 2019-2021 (n = 13,769) and the Korean Genome and Epidemiology Study (KoGES) (n = 9225) data were used for this study. Cholesterol intake was assessed using a 24-h recall food frequency questionnaire, and participants were categorized into three groups (T1, T2, and T3) based on cholesterol intake. Primary outcomes were prevalence and incidence of CKD. Higher cholesterol intake was modestly associated with increased serum levels of total, low-density lipoprotein, and high-density lipoprotein cholesterol in the KNHANES. However, we found no significant association between cholesterol intake and CKD prevalence in the KNHANES, regardless of a history of hypercholesterolemia. In the KoGES, during a median follow-up of 11.4 years, cholesterol intake was not associated with incident CKD in participants without hypercholesterolemia (hazard ratio [HR] per 10 mg increase, 1.00; 95 % confidence interval [CI], 0.99-1.01) and in those with hypercholesterolemia (HR, 1.01; 95 % CI, 0.98-1.04). Egg consumption also showed no significant association with the risk of incident CKD. Additionally, cholesterol intake had no significant interaction on the relationships between serum cholesterol levels and incident CKD. CONCLUSION Although cholesterol intake was associated with increased serum cholesterol levels, it was not associated with CKD prevalence and incidence. Our findings suggest that reducing cholesterol intake alone may not be sufficient to prevent CKD.
Collapse
Affiliation(s)
- Haekyung Lee
- Division of Nephrology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul 04401, Republic of Korea; Hyonam Kidney Laboratory, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul 04401, Republic of Korea
| | - Joonbyung Park
- Division of Nephrology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul 04401, Republic of Korea
| | - Soon Hyo Kwon
- Division of Nephrology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul 04401, Republic of Korea; Hyonam Kidney Laboratory, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul 04401, Republic of Korea
| | - Jin Seok Jeon
- Division of Nephrology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul 04401, Republic of Korea; Hyonam Kidney Laboratory, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul 04401, Republic of Korea
| | - Hyunjin Noh
- Division of Nephrology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul 04401, Republic of Korea; Hyonam Kidney Laboratory, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul 04401, Republic of Korea
| | - Hyoungnae Kim
- Division of Nephrology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul 04401, Republic of Korea; Hyonam Kidney Laboratory, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul 04401, Republic of Korea.
| |
Collapse
|
5
|
Xue H, Qin R, Xi Q, Xiao S, Chen Y, Liu Y, Xu B, Han X, Lv H, Hu H, Hu L, Jiang T, Jiang Y, Ding Y, Du J, Ma H, Lin Y, Hu Z. Maternal Dietary Cholesterol and Egg Intake during Pregnancy and Large-for-Gestational-Age Infants: A Prospective Cohort Study. J Nutr 2024:S0022-3166(24)00180-9. [PMID: 38599384 DOI: 10.1016/j.tjnut.2024.04.011] [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: 12/27/2023] [Revised: 03/25/2024] [Accepted: 04/05/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Cholesterol plays a vital role in fetal growth and development during pregnancy. There remains controversy over whether pregnant females should limit their cholesterol intake. OBJECTIVES The objective of this study was to investigate the association between maternal dietary cholesterol intake during pregnancy and infant birth weight in a Chinese prospective cohort study. METHODS A total of 4146 mother-child pairs were included based on the Jiangsu Birth Cohort study. Maternal dietary information was assessed with a semiquantitative food-frequency questionnaire. Birth weight z-scores and large-for-gestational-age (LGA) infants were converted by the INTERGROWTH-21st neonatal weight-for-gestational-age standard. Poisson regression and generalized estimating equations were employed to examine the relationships between LGA and maternal dietary cholesterol across the entire pregnancy and trimester-specific cholesterol intake, respectively. RESULTS The median intake of maternal total dietary cholesterol during the entire pregnancy was 671.06 mg/d, with eggs being the main source. Maternal total dietary cholesterol and egg-sourced cholesterol were associated with an increase in birth weight z-score, with per standard deviation increase in maternal total and egg-sourced dietary cholesterol being associated with an increase of 0.16 [95% confidence interval (CI): 0.07, 0.25] and 0.06 (95% CI: 0.03, 0.09) in birth weight z-score, respectively. Egg-derived cholesterol intake in the first and third trimesters was positively linked to LGA, with an adjusted relative risk of 1.11 (95% CI: 1.04, 1.18) and 1.09 (95% CI: 1.00, 1.18). Compared with mothers consuming ≤7 eggs/wk in the third trimester, the adjusted relative risk for having an LGA newborn was 1.37 (95% CI: 1.09, 1.72) for consuming 8-10 eggs/wk and 1.45 (95% CI: 1.12, 1.86) for consuming >10 eggs/wk (P-trend = 0.015). CONCLUSIONS Maternal total dietary cholesterol intake, as well as consuming over 7 eggs/wk during pregnancy, displayed significant positive relationships with the incidence of LGA, suggesting that mothers should avoid excessive cholesterol intake during pregnancy to prevent adverse birth outcomes.
Collapse
Affiliation(s)
- Huixin Xue
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Rui Qin
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Scientific Research and Education, Changzhou Medical Center, Changzhou Maternity and Child Health Care Hospital, Nanjing Medical University, Changzhou, Jiangsu, China
| | - Qi Xi
- Department of Obstetrics, Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Shuxin Xiao
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Maternal, Child, and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yiyuan Chen
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yuxin Liu
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Bo Xu
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xiumei Han
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hong Lv
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine and Offspring Health (Suzhou Centre), Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Haiting Hu
- Department of Scientific Research and Education, Changzhou Medical Center, Changzhou Maternity and Child Health Care Hospital, Nanjing Medical University, Changzhou, Jiangsu, China
| | - Lingmin Hu
- Department of Reproduction, Changzhou Medical Center, Changzhou Maternity and Child Health Care Hospital, Nanjing Medical University, Changzhou, Jiangsu, China
| | - Tao Jiang
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yangqian Jiang
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Maternal, Child, and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Ye Ding
- Department of Maternal, Child, and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jiangbo Du
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine and Offspring Health (Suzhou Centre), Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Hongxia Ma
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine and Offspring Health (Suzhou Centre), Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Nanjing Medical University, Suzhou, Jiangsu, China
| | - Yuan Lin
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Maternal, Child, and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine and Offspring Health (Suzhou Centre), Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Nanjing Medical University, Suzhou, Jiangsu, China.
| | - Zhibin Hu
- State Key Laboratory of Reproductive Medicine and Offspring Health, Nanjing Medical University, Nanjing, Jiangsu, China; Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China; State Key Laboratory of Reproductive Medicine and Offspring Health (Suzhou Centre), Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Nanjing Medical University, Suzhou, Jiangsu, China.
| |
Collapse
|
6
|
Chopra AK. Dietary management of dyslipidemia. Indian Heart J 2024; 76 Suppl 1:S65-S72. [PMID: 38122980 PMCID: PMC11019336 DOI: 10.1016/j.ihj.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023] Open
Abstract
The rising burden of cardiovascular disease (CVD) has made the achievement of optimal lipoprotein levels a major public health priority. As nearly a fifth of global mortality is associated with dietary factors, and recommendations have been mired in controversy, a fresh look on the available data is attempted. Well established concepts regarding nutrition and cardiometabolic health, role of macronutrients, calories, and controversial foods are discussed followed by recommendations in the Indian context. A healthy dietary pattern rather than individual foods or nutrients is emphasized, and this is generally plant based with optional consumption of dairy, eggs, and meats within the suggested limits. Suggestions/recommendations are given for consumption of individual foods, remembering that choosing appropriate replacement foods is as important as restricting unhealthy foods.
Collapse
|
7
|
Zhou X, Mott MM, Yiannakou I, Bradlee ML, Singer MR, Moore LL. Eggs and a Fiber-Rich Diet Are Beneficially Associated with Lipid Levels in Framingham Offspring Study Adults. Curr Dev Nutr 2024; 8:102062. [PMID: 38500805 PMCID: PMC10945122 DOI: 10.1016/j.cdnut.2023.102062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 11/21/2023] [Accepted: 12/07/2023] [Indexed: 03/20/2024] Open
Abstract
Background For many years, United States' dietary policy recommended limiting egg intake to no more than 3/wk in the belief that restricting dietary cholesterol would lower plasma cholesterol levels and thereby reduce the risk of cardiovascular disease. The evidence supporting these recommendations is controversial. Objectives To examine the impact of eggs, a major contributor to dietary cholesterol intake, on lipid levels and to determine whether these egg effects are modified by other healthy dietary factors in adults. Methods Males and females aged 30-64 y with available 3-d diet record data, without cardiovascular disease and not taking lipid- or glucose-lowering medications in the prospective Framingham Offspring cohort were included (n = 1852). Analysis of covariance models were used to compare mean follow-up lipid levels adjusting for age, sex, BMI, and dietary factors. Cox proportional hazard's models were used to estimate risk for elevated lipid levels. Results Consuming ≥5 eggs/wk was not adversely associated with lipid outcomes. Among men, consuming ≥5 (compared with <0.5) eggs/wk was associated with an 8.6 mg/dL lower total cholesterol level and a 5.9 mg/dL lower LDL cholesterol level, as well as lower triglycerides. Overall, higher egg intake combined with higher dietary fiber (compared with lower intakes of both) was associated with the lowest total cholesterol, LDL cholesterol, and LDL cholesterol-to-HDL cholesterol ratio. Finally, diets with higher (compared with lower) egg intakes in combination with higher total fish or fiber intakes, respectively, were associated with lower risks of developing elevated (>160 mg/dL) LDL cholesterol levels (hazard ratio: 0.61; 95% confidence interval: 0.44, 0.84; and HR: 0.70; 95% confidence interval: 0.49, 0.98, respectively). Conclusions Higher egg intakes were beneficially associated with serum lipids among healthy adults, particularly those who consumed more fish and dietary fiber.
Collapse
Affiliation(s)
- Xinyi Zhou
- Preventive Medicine and Epidemiology, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
| | - Melanie M Mott
- Preventive Medicine and Epidemiology, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
- DynaMed at Elton Bryson Stephens Company (EBSCO) Information Services, Ipswich, MA, United States
| | - Ioanna Yiannakou
- Preventive Medicine and Epidemiology, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
| | - M Loring Bradlee
- Preventive Medicine and Epidemiology, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
| | - Martha R Singer
- Preventive Medicine and Epidemiology, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
| | - Lynn L Moore
- Preventive Medicine and Epidemiology, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, United States
| |
Collapse
|
8
|
Galvis-Pérez Y, Pineda K, Zapata J, Aristizabal J, Estrada A, Fernández ML, Barona-Acevedo J. Annatto-Enriched Egg Improves the Perception of Satiety in Healthy Adults-Randomized Clinical Trial: EGGANT Study. Foods 2024; 13:731. [PMID: 38472844 DOI: 10.3390/foods13050731] [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: 11/29/2023] [Revised: 01/06/2024] [Accepted: 01/10/2024] [Indexed: 03/14/2024] Open
Abstract
Diet is one of the factors that prevents the development and death from cardiovascular diseases (CVD). It has been proposed that diets high in protein, which increase satiety, and with a high content of antioxidants, help reduce cardiovascular risk factors. The egg is one of the foods that produces greater satiety and provides antioxidants. In addition, due to its lipophilic matrix, it could improve the bioavailability of other dietary antioxidants such as Annatto. OBJECTIVE This study evaluated the effects of egg and annatto-enriched egg consumption on satiety markers and CVD risk factors in healthy adults from Colombia. METHODS A parallel randomized clinical trial was conducted, where one hundred and five (n = 105) men and women, divided into three groups, consumed daily for 8 weeks: (a) two eggs (egg group), or (b) two eggs with annatto (egg + annatto group), or (c) two egg whites (placebo group). RESULTS The three groups were similar in gender distribution. No significant changes were found over time (before vs. after) in any of the groups nor between the groups in anthropometric variables, physical activity, eating profile, and ghrelin as an objective marker of satiety. In the egg + annatto group, subjective satiety increased (effect size 0.431; p < 0.05) after consumption. CONCLUSIONS In healthy adults, the intake of two eggs, or two eggs with annatto daily for 8 weeks, did not result in significant changes in ghrelin; but eggs with annatto tend to increase the perception of satiety.
Collapse
Affiliation(s)
- Yeisson Galvis-Pérez
- Research Group of Toxinology, Food and Therapeutic Alternatives, Universidad de Antioquia UdeA, Medellín 050010, Colombia
- School of Microbiology, Universidad de Antioquia UdeA, Medellín 050010, Colombia
| | - Keilly Pineda
- Research Group of Toxinology, Food and Therapeutic Alternatives, Universidad de Antioquia UdeA, Medellín 050010, Colombia
| | - Juliana Zapata
- Research Group of Toxinology, Food and Therapeutic Alternatives, Universidad de Antioquia UdeA, Medellín 050010, Colombia
| | - Juan Aristizabal
- Physiology and Biochemistry Research Group-PHYSIS, Universidad de Antioquia UdeA, Medellín 050010, Colombia
- School of Nutrition and Dietetics, Universidad de Antioquia UdeA, Medellín 050010, Colombia
| | - Alejandro Estrada
- School of Nutrition and Dietetics, Universidad de Antioquia UdeA, Medellín 050010, Colombia
- Demography and Health Research Group, Universidad de Antioquia UdeA, Medellín 050010, Colombia
| | - María Luz Fernández
- School of Nutritional Sciences and Wellness, The University of Arizona, Tucson, AZ 85721, USA
| | - Jacqueline Barona-Acevedo
- Research Group of Toxinology, Food and Therapeutic Alternatives, Universidad de Antioquia UdeA, Medellín 050010, Colombia
- School of Microbiology, Universidad de Antioquia UdeA, Medellín 050010, Colombia
| |
Collapse
|
9
|
Li Y, Sun Y, Wu H, Yang P, Huang X, Zhang L, Yin L. Metabolic syndromes increase significantly with the accumulation of bad dietary habits. J Nutr Health Aging 2024; 28:100017. [PMID: 38388115 DOI: 10.1016/j.jnha.2023.100017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 11/30/2023] [Indexed: 02/24/2024]
Abstract
BACKGROUND The association between dietary habits and metabolic syndrome (MetS) has not been well documented, due to the complexity and individualization of dietary culture in the Chinese population. OBJECTIVE To construct a composite score from various bad dietary habits and to evaluate their comprehensive association with the prevalence of MetS and its components among Chinese men and women across various age groups. SETTING Serial cross-sectional studies. METHODS Twenty-three dietary habits were assessed through face-to-face interviews with 98,838 males and 83,099 females in health check-up programs from 2015 to 2021, among which eighteen bad dietary habits were observed to be associated independently with total MetS. The total score of bad dietary habits was composed of four categories via variable clustering analysis, including irregular dietary habits, unhealthy dietary flavors, unbalanced dietary structure, and high-fat diet. The 2016 Chinese guideline for the management of dyslipidemia in adults was used to define MetS. RESULTS Men had a higher score of bad dietary habits than women (9.63 ± 3.11 vs. 8.37 ± 3.23), which decreased significantly with increasing age in both males and females (Pinteraction<0.01). The prevalence of total MetS increased significantly with the cumulative score of bad dietary habits in both males (highest quintile vs. lowest quintile: OR, 1.90; 95% confidence interval [CI], 1.80-2.00; Plinear<0.01) and females (OR, 2.23; 95% CI, 2.02-2.46; Plinear<0.01) after adjusted for age, education, smoking status, alcohol consumption, and physical activities. These linear trends were also observed for each MetS component (all Plinear<0.01). The role of irregular dietary habits and high-fat diet on MetS prevalence are much higher in males than in females, while unhealthy dietary flavors and unbalanced dietary structure had a greater influence on females. CONCLUSIONS The accumulation of bad dietary habits contributes to the MetS developments. Thus, individualized lifestyle interventions are needed to correct bad dietary habits with regard to gender differences.
Collapse
Affiliation(s)
- Ying Li
- Health Management Center, Third Xiangya Hospital, Central South University, Changsha, China
| | - Yaya Sun
- Information Center, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China
| | - Hao Wu
- Health Management Center, Third Xiangya Hospital, Central South University, Changsha, China
| | - Pingting Yang
- Health Management Center, Third Xiangya Hospital, Central South University, Changsha, China
| | - Xin Huang
- Department of Epidemiology, School of Medicine, Hunan Normal University, Changsha, China
| | - Li Zhang
- Beijing Emergency Medical Center, Beijing, China.
| | - Lu Yin
- Information Center, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China.
| |
Collapse
|
10
|
Carter S, Hill AM, Yandell C, Buckley JD, Coates AM. Study protocol for a 15-week randomised controlled trial assessing the independent effects of high-cholesterol and high-saturated fat diets on LDL cholesterol. BMJ Open 2024; 14:e081664. [PMID: 38272555 PMCID: PMC10823933 DOI: 10.1136/bmjopen-2023-081664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
INTRODUCTION Previous research has associated high dietary cholesterol intake with raised low-density lipoprotein cholesterol (LDL-C) and thus increased risk for cardiovascular disease (CVD). Emerging research suggests that it is saturated fat, not dietary cholesterol, associated with increased CVD risk. Despite being high in cholesterol, eggs, low in saturated fat, are not adversely associated with blood lipids or CVD risk. This paper describes a randomised controlled counter-balanced, cross-over trial assessing the effects of a high-cholesterol/low-saturated fat (egg) diet and a low-cholesterol/high-saturated fat diet (egg free) on blood lipids and lipoproteins, while accounting for physical activity levels which can also influence these parameters. The primary aim is to demonstrate that high cholesterol intake (from eggs) within a healthy, low-saturated fat diet does not adversely affect blood lipid levels and lipoprotein profiles. Instead, we propose that adverse effects on these parameters are mediated by saturated fat intake. The secondary aim is to explore relationships between changes in blood lutein and zeaxanthin concentrations and alterations in physical activity, examining whether changes in physical activity mediate effects on blood lipids and lipoproteins. METHODS AND ANALYSIS Fifty-two adults aged 18-60 years with LDL-C less than 3.5 mmol/L will be randomly allocated to three isocaloric diets for 5 weeks each: a high-cholesterol (600 mg)/low-saturated fat (6%) (egg) diet, a low-cholesterol (300 mg)/high-saturated fat (12%) (egg free) diet and a control diet that is high in both cholesterol (600 mg) and saturated fat (12%). Lipid and lipoprotein levels, lipoprotein size and concentrations, blood pressure, blood glucose, physical activity levels, and plasma lutein and zeaxanthin concentrations will be measured. Treatment effects will be analysed using linear mixed effects models. ETHICS AND DISSEMINATION Ethics approval was obtained from the University of South Australia Human Research Ethics Committee no. 204 327. Results will be disseminated through peer-reviewed journals and national and international presentations. TRIAL REGISTRATION NUMBER NCT05267522.
Collapse
Affiliation(s)
- Sharayah Carter
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Alison M Hill
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Clinical Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Catherine Yandell
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Jonathan D Buckley
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Alison M Coates
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia
| |
Collapse
|
11
|
Zhang T, Wang Q, Cui XM, Zhang YY, Guo FX, Wu QF, Dong MH, Luo XT. Mediating effect of cumulative lipid profile burden on the effect of diet and obesity on hypertension incidence: a cohort study of people aged 35-65 in rural China. Eur J Clin Nutr 2024; 78:54-63. [PMID: 37816846 DOI: 10.1038/s41430-023-01348-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND AND OBJECTIVES Cumulative lipid profile burden is designed to dynamically measure lipid accumulation, and its effect on hypertension has been poorly studied. Our main purpose was to investigate the effect of cumulative lipid profile burden on the incidence of essential hypertension (EH) and to investigate whether cumulative lipid burden mediates the pathogenesis of the effects of diet and obesity on EH. SUBJECTS AND METHODS A total of 1295 participants were included in the study, which started in 2017. The average follow-up time was 2.98 years. A total of 240 EH patients occurred during the follow-up period. RESULTS The HR (95% CI) of the highest quartile in cumulative Total cholesterol (TC), triglyceride (TG) and high density lipoprotein (HDL) burden were 1.747 (1.145 - 2.664), 1.502 (1.038 - 2.173), 0.615 (0.413 - 0.917) for incidence of EH respectively, compared to the respective reference groups. Participants with EH consumed more red meat and refined grains, and red meat was positively associated with cumulative TC burden. BMI and Waist-To-Height Ratio (WHtR) increased the incidence of EH, and obesity was positively correlated with cumulative TG burden. Mediating analysis showed that cumulative TG had a partial mediating effect in the causal relationship between obesity and EH, and Mendelian randomization (MR) also proved this result. Diet was not found to influence EHn through cumulative lipid profile burden. CONCLUSIONS The cumulative TG burden partially mediates the effect of obesity on EH.
Collapse
Affiliation(s)
- Ting Zhang
- Key Laboratory of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University, Ganzhou, China
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Qi Wang
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Xiao-Mei Cui
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Yu-Ying Zhang
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Fang-Xi Guo
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Qing-Feng Wu
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Ming-Hua Dong
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Xiao-Ting Luo
- Key Laboratory of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University, Ganzhou, China.
- College of General Medicine, Gannan Medical University, Ganzhou, China.
| |
Collapse
|
12
|
Neuenschwander M, Stadelmaier J, Eble J, Grummich K, Szczerba E, Kiesswetter E, Schlesinger S, Schwingshackl L. Substitution of animal-based with plant-based foods on cardiometabolic health and all-cause mortality: a systematic review and meta-analysis of prospective studies. BMC Med 2023; 21:404. [PMID: 37968628 PMCID: PMC10652524 DOI: 10.1186/s12916-023-03093-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/25/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND There is growing evidence that substituting animal-based with plant-based foods is associated with a lower risk of cardiovascular diseases (CVD), type 2 diabetes (T2D), and all-cause mortality. Our aim was to summarize and evaluate the evidence for the substitution of any animal-based foods with plant-based foods on cardiometabolic health and all-cause mortality in a systematic review and meta-analysis. METHODS We systematically searched MEDLINE, Embase, and Web of Science to March 2023 for prospective studies investigating the substitution of animal-based with plant-based foods on CVD, T2D, and all-cause mortality. We calculated summary hazard ratios (SHRs) and 95% confidence intervals (95% CI) using random-effects meta-analyses. We assessed the certainty of evidence (CoE) using the GRADE approach. RESULTS In total, 37 publications based on 24 cohorts were included. There was moderate CoE for a lower risk of CVD when substituting processed meat with nuts [SHR (95% CI): 0.73 (0.59, 0.91), n = 8 cohorts], legumes [0.77 (0.68, 0.87), n = 8], and whole grains [0.64 (0.54, 0.75), n = 7], as well as eggs with nuts [0.83 (0.78, 0.89), n = 8] and butter with olive oil [0.96 (0.95, 0.98), n = 3]. Furthermore, we found moderate CoE for an inverse association with T2D incidence when substituting red meat with whole grains/cereals [0.90 (0.84, 0.96), n = 6] and red meat or processed meat with nuts [0.92 (0.90, 0.94), n = 6 or 0.78 (0.69, 0.88), n = 6], as well as for replacing poultry with whole grains [0.87 (0.83, 0.90), n = 2] and eggs with nuts or whole grains [0.82 (0.79, 0.86), n = 2 or 0.79 (0.76, 0.83), n = 2]. Moreover, replacing red meat for nuts [0.93 (0.91, 0.95), n = 9] and whole grains [0.96 (0.95, 0.98), n = 3], processed meat with nuts [0.79 (0.71, 0.88), n = 9] and legumes [0.91 (0.85, 0.98), n = 9], dairy with nuts [0.94 (0.91, 0.97), n = 3], and eggs with nuts [0.85 (0.82, 0.89), n = 8] and legumes [0.90 (0.89, 0.91), n = 7] was associated with a reduced risk of all-cause mortality. CONCLUSIONS Our findings indicate that a shift from animal-based (e.g., red and processed meat, eggs, dairy, poultry, butter) to plant-based (e.g., nuts, legumes, whole grains, olive oil) foods is beneficially associated with cardiometabolic health and all-cause mortality.
Collapse
Affiliation(s)
- Manuela Neuenschwander
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, Düsseldorf, Germany
| | - Julia Stadelmaier
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Julian Eble
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kathrin Grummich
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Edyta Szczerba
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, Düsseldorf, Germany
| | - Eva Kiesswetter
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sabrina Schlesinger
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany.
- German Center for Diabetes Research (DZD), Partner Düsseldorf, Düsseldorf, Germany.
| | - Lukas Schwingshackl
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| |
Collapse
|
13
|
Dimitriou M, Kalafati IP, Rallidis LS, Kolovou G, Dedoussis GV. A Posteriori Dietary Patterns and Coronary Artery Disease in a Greek Case-Control Study. Nutrients 2023; 15:4733. [PMID: 38004127 PMCID: PMC10675662 DOI: 10.3390/nu15224733] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
INTRODUCTION Diet is one of the most important modifiable risk factors associated with cardiovascular health (CH). Research identifying dietary patterns (DPs) through data-driven analysis and reporting associations between DPs and coronary artery disease (CAD) outcomes is rather limited. OBJECTIVE The aim of the present report was to generate DPs through factor analysis (FA) and to examine their association with CAD risk. METHODS Participants (n = 1017) consisted of cases diagnosed with CAD (n = 356) and controls (n = 661) drawn from the THISEAS study. Demographic, anthropometric and lifestyle data were collected. Dietary components were generated through FA. Logistic regression analysis was performed to estimate CAD relative risks. RESULTS FA generated seven dietary components, explaining 53.5% of the total variation in intake. The Western-type DP showed a modest significant association with CAD risk, after controlling for confounders (OR = 1.20; 95% CI = 1.09-1.32, p < 0.001). The vegetarian-type DP was not significantly associated with the likelihood of CAD (OR = 0.95; 95% CI = 0.84-1.04, p = 0.259). DISCUSSION The Western-type DP was positively associated with CAD risk and the odds were further increased after controlling for confounders. This finding is in concordance with previously reported positive associations between Western patterns and CAD risk. Limited data exist regarding a posteriori DPs and their effect on CAD risk.
Collapse
Affiliation(s)
- Maria Dimitriou
- Department of Nutritional Science and Dietetics, School of Health Sciences, University of Peloponnese, 24100 Kalamata, Greece
| | - Ioanna Panagiota Kalafati
- Department of Nutrition and Dietetics, School of Health and Education, Harokopio University of Athens, 17676 Athens, Greece; (I.P.K.)
| | - Loukianos S. Rallidis
- Second Department of Cardiology, Attikon Hospital, School of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Genovefa Kolovou
- First Cardiology Department, Onassis Cardiac Surgery, 17674 Athens, Greece;
| | - George V. Dedoussis
- Department of Nutrition and Dietetics, School of Health and Education, Harokopio University of Athens, 17676 Athens, Greece; (I.P.K.)
| |
Collapse
|
14
|
Xia X, Liu F, Huang K, Chen S, Li J, Cao J, Yang X, Liu X, Shen C, Yu L, Zhao Y, Zhao L, Li Y, Hu D, Huang J, Lu X, Gu D. Egg consumption and risk of coronary artery disease, potential amplification by high genetic susceptibility: a prospective cohort study. Am J Clin Nutr 2023; 118:773-781. [PMID: 37793743 DOI: 10.1016/j.ajcnut.2023.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/03/2023] [Accepted: 06/08/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Remarkable heterogeneity has been observed among population-based studies on egg consumption and risk of coronary artery disease (CAD). Whether genetic susceptibility serves as a potential explanation for this inconsistency remains unknown. OBJECTIVES We performed a prospective cohort study to investigate the association of egg consumption with incident CAD at different genetic susceptibilities. METHODS We included 34,111 participants without CAD at baseline from the project of Prediction for Atherosclerotic Cardiovascular Disease Risk in China. Egg consumption was assessed with food frequency questionnaires. Genetic susceptibility was quantified by a predefined polygenic risk score (PRS) with 540 genetic variants. The hazard ratio (HR) and 95% confidence interval (95% CI) of incident CAD associated with egg consumption and PRS were estimated using the Cox proportional hazards models. RESULTS Over a median 11.7 y of follow-up, 1,128 incident cases of CAD were recorded. Both higher egg consumption and increased PRS were related to higher risk of CAD. When stratified by genetic risk, each increment of 3 eggs/wk was associated with a 5% higher risk of CAD for participants at low to intermediate genetic risk (HR: 1.05; 95% CI: 1.01, 1.09), whereas risk increased to HR 1.10 (95% CI: 1.05, 1.16) for those at high genetic risk; a significant synergistic interaction was also indicated at both multiplicative (Pinteraction = 0.007) and additive (relative excess risk: 0.73; 95% CI: 0.24, 1.22) scales. When the joint effect was examined, in comparison with those at low to intermediate genetic risk and consuming <1 egg/wk, the HR (95% CI) was 2.95 (2.41, 3.62) for participants with high genetic risk and consumption of ≥10 eggs/wk, and the corresponding standardized 10-y CAD rates increased from 1.37% to 4.24%. CONCLUSIONS Genetic predisposition may synergistically interact with egg consumption in relation to increased CAD risk. PRS-stratified recommendations on egg consumption may help formulate personalized nutrition policies.
Collapse
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, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, China; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Fangchao Liu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, China
| | - Keyong Huang
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shufeng Chen
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianxin Li
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie Cao
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xueli Yang
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xiaoqing Liu
- Division of Epidemiology, Guangdong Provincial People's Hospital and Cardiovascular Institute, Guangzhou, China
| | - Chong Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Ling Yu
- Department of Cardiology, Fujian Provincial Hospital, Fuzhou, China
| | - Yingxin Zhao
- Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, China
| | - Liancheng Zhao
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ying Li
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China; Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, China
| | - Jiangfeng Huang
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiangfeng Lu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, China.
| | - Dongfeng Gu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, China; School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China.
| |
Collapse
|
15
|
Antoni R. Dietary saturated fat and cholesterol: cracking the myths around eggs and cardiovascular disease. J Nutr Sci 2023; 12:e97. [PMID: 37706071 PMCID: PMC10495817 DOI: 10.1017/jns.2023.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/27/2023] [Accepted: 08/11/2023] [Indexed: 09/15/2023] Open
Abstract
Whilst dietary cholesterol guidelines have waivered through the years with historic restrictions lifted for the majority of the general population, recommendations to reduce saturated fat intake have been the mainstay of dietary guidelines since the 1980s and were recently reinforced by the Scientific Advisory Committee on Nutrition (SACN). Cholesterol metabolism is complex, with saturated fat known to have a more significant contribution at raising levels of low-density lipoprotein (LDL) cholesterol, a well-established risk factor for cardiovascular disease (CVD). However, it is clear from metabolic research that hyper-responsiveness to both dietary cholesterol and saturated fat exists; hence, for specific subsets of the population, reductions in both nutrients may be indicated. With this in mind, the current article aims to provide an overview of the mechanisms underlying biological variation in responsiveness and introduces research currently underway which will hopefully identify simple biomarkers that can be used to predict responsiveness and permit tailored, personalised, dietary advice. Eggs are a well-known source of dietary cholesterol whilst being low in saturated fat. A common question encountered in clinical practice is must individuals limit intake to manage blood cholesterol levels. This article summarises key recent papers which confirm that eggs can be enjoyed as part of a healthy balanced diet, whilst highlighting the need for further research in certain population groups, e.g. in individuals with diabetes.
Collapse
Affiliation(s)
- Rona Antoni
- Department of Nutrition, Food and Exercise Sciences at University of Surrey, Guildford GU2 7WG, UK
| |
Collapse
|
16
|
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
|
17
|
Galvis Y, Pineda K, Zapata J, Aristizabal J, Estrada A, Fernandez ML, Barona-Acevedo J. Consumption of Eggs Alone or Enriched with Annatto ( Bixa orellana L.) Does Not Increase Cardiovascular Risk in Healthy Adults-A Randomized Clinical Trial, the Eggant Study. Nutrients 2023; 15:nu15020369. [PMID: 36678239 PMCID: PMC9865189 DOI: 10.3390/nu15020369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 01/13/2023] Open
Abstract
Most atherosclerotic cardiovascular diseases can be prevented by modifying lifestyles, including unhealthy diets. Eggs contain important carotenoids that may impact cardiovascular risk. The lipid nature of eggs can improve the bioavailability of other carotenoids, such as Annatto (Bixa orellana L.), with reported antioxidant properties. Although numerous studies have shown that there is no association between egg consumption and cardiovascular risk, there is still controversy. In addition, there is limited information about Annatto's effects on human health. This study evaluated the association between egg consumption and its enrichment with Annatto in lipid biomarkers of cardiovascular disease. In a parallel clinical trial, one hundred and five (n = 105) men and women were randomized by age, sex, and body mass index (BMI), and distributed into three groups. Subjects consumed daily, for 8 weeks, either two eggs, two eggs with Annatto, or two egg whites. Plasma lipids were measured by enzymatic colorimetric methods, plasma apolipoproteins and lipoprotein subfractions and size by nuclear magnetic resonance. There were no differences between groups in age, sex, and BMI. No significant changes were found over time or between groups in plasma triglycerides, LDL cholesterol, HDL cholesterol, apolipoprotein (apo) A1, apo B, or lipoprotein subfraction concentrations. In healthy adults, the intake of two eggs a day, or two eggs with Annatto for eight weeks, did not generate adverse changes in cardiovascular risk markers.
Collapse
Affiliation(s)
- Yeisson Galvis
- Research Group of Toxinology, Food and Therapeutic Alternatives, Universidad de Antioquia UdeA, Medellín 050010, Colombia
- School of Microbiology, Universidad de Antioquia UdeA, Medellín 050010, Colombia
| | - Keilly Pineda
- Research Group of Toxinology, Food and Therapeutic Alternatives, Universidad de Antioquia UdeA, Medellín 050010, Colombia
| | - Juliana Zapata
- Research Group of Toxinology, Food and Therapeutic Alternatives, Universidad de Antioquia UdeA, Medellín 050010, Colombia
| | - Juan Aristizabal
- School of Nutrition and Dietetics, Universidad de Antioquia UdeA, Medellín 050010, Colombia
- Physiology and Biochemistry Research Group-PHYSIS, Universidad de Antioquia UdeA, Medellín 050010, Colombia
| | - Alejandro Estrada
- School of Nutrition and Dietetics, Universidad de Antioquia UdeA, Medellín 050010, Colombia
| | - María Luz Fernandez
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, AZ 85721, USA
| | - Jacqueline Barona-Acevedo
- Research Group of Toxinology, Food and Therapeutic Alternatives, Universidad de Antioquia UdeA, Medellín 050010, Colombia
- School of Microbiology, Universidad de Antioquia UdeA, Medellín 050010, Colombia
- Correspondence:
| |
Collapse
|
18
|
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
|
19
|
Liu R, Zhao Y, Wang X, Fu H, Li Q, Dang S, Yan H. Association of Egg Consumption Frequency and Quantity with Dyslipidemia in Chinese Rural Adults. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2022:1-11. [PMID: 36301133 DOI: 10.1080/27697061.2022.2098202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 06/18/2022] [Accepted: 06/30/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE The aim was to estimate the association of egg consumption with dyslipidemia and its subtypes in Chinese adults. METHODS The cross-sectional health survey was conducted in Hanzhong city of Shaanxi province in 2010.Consumption of eggs (alone and mixed in foods) and nutrients were assessed using a semi-quantitative 81-item food frequency questionnaire (FFQ). Serum lipids and other physical measurements were measured by trained medical staff. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated from multivariable logistic regressions. Restricted cubic spline was used to visualize the possible non-linear association. RESULTS A total of 2241 participants (mean age, 48.0 years; 34.5% men) were included. The age- and gender- standardization dyslipidemia prevalence was 21.1% in men and 18.4% in women, respectively. Approximately 42.1% of individuals never or rarely consumed egg, while 9.4% consumed ≥2 times/week. The mean egg intake was 21.5 g/d in men and 17.4 in women. In women, after adjustment for demographics and lifestyle factors, the ORs (95%CI) for dyslipidemia and hypertriglyceridemia were 0.57(0.32-1.05) and 0.38 (0.17-0.85) for individuals consuming egg ≥2 times/week, compared with never or rarely consumers. When further adjustment of BMI and dietary factors, the inverse relation persisted for hypertriglyceridemia but attenuated to margin of significance for dyslipidemia (P-trend = 0.050). Increment of 25 g/d was associated with 15% (OR: 0.85, (0.71-1.00)) lower risk of dyslipidemia. Results from restricted cubic splines showed a substantial reduction of the risk within lower range of consumption, which reached the minimum risk around 20-50 g/d (P-nonlinearity = 0.069). No associations were observed in men. CONCLUSION Egg consumption was associated with decreased risk of dyslipidemia among Chinese women but not men. Additionally, the beneficial effect tended to be stronger at 20-50 g egg per day. Further study is warranted to validate these findings and clarify the causality.
Collapse
Affiliation(s)
- Ruru Liu
- Department of Disinfection and Infection Control, Xi'an Center for Disease Control and Prevention, Xi'an, Shaanxi Province, China
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, China
| | - Yaling Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, China
| | - Xin Wang
- Department of Disinfection and Infection Control, Xi'an Center for Disease Control and Prevention, Xi'an, Shaanxi Province, China
| | - Han Fu
- Department of Disinfection and Infection Control, Xi'an Center for Disease Control and Prevention, Xi'an, Shaanxi Province, China
| | - Qiang Li
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, China
| | - Shaonong Dang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, China
| | - Hong Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi Province, China
| |
Collapse
|
20
|
Mesas AE, Garrido-Miguel M, Fernández-Rodríguez R, Fernández-Franco S, Lugones-Sánchez C, García-Ortiz L, Martínez-Vizcaíno V. The association of egg consumption with blood pressure levels and glycated hemoglobin in Spanish adults according to body mass index. Sci Rep 2022; 12:17465. [PMID: 36261679 PMCID: PMC9582218 DOI: 10.1038/s41598-022-21772-6] [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] [Received: 05/13/2022] [Accepted: 09/30/2022] [Indexed: 01/12/2023] Open
Abstract
The objective of this study was to evaluate the association of egg consumption with blood pressure (BP) and glycated hemoglobin (HbA1c). In addition, it was assessed whether this association changes according to body weight status. This cross-sectional study is based on multicenter data from Spanish adult participants in the EVIDENT II trial. Egg consumption was assessed with a Food Frequency Questionnaire, and data on BP and HbA1c were collected using standardized procedures. Linear regression and ANCOVA models adjusted for the main confounders were performed. The analyses were stratified by body weight status. A total of 668 participants were analyzed (mean age 52.4 ± 11.8 years, 62.3% women). Compared with lower consumption, higher egg consumption was associated with lower systolic (ß = - 6.15 ± 1.74; p-for-trend = 0.017), diastolic (ß = - 4.41 ± 1.03; p-for-trend = 0.002), and mean arterial pressure (ß = - 4.99 ± 1.17; p-for-trend = 0.003) and with lower HbA1c (ß = - 0.19 ± 0.06; p-for-trend = 0.019) levels. These associations lost statistical significance in the adjusted analyses. The results did not vary by body weight status. In conclusion, consumption of up to 1 egg per day is not associated with BP or HbA1c, even in overweight or obese individuals. Our findings suggested that this frequency of egg consumption is safe as part of a healthy diet and lifestyle for cardiometabolic risk.
Collapse
Affiliation(s)
- Arthur Eumann Mesas
- grid.8048.40000 0001 2194 2329Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain ,grid.411400.00000 0001 2193 3537Universidade Estadual de Londrina, Londrina, Paraná 86057-970 Brazil
| | - Miriam Garrido-Miguel
- grid.8048.40000 0001 2194 2329Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain ,grid.8048.40000 0001 2194 2329Faculty of Nursing, Universidad de Castilla-La Mancha, C/ Campus Universitario , s/n (Edificio Benjamín Palencia), 02006 Albacete, Spain
| | - Rubén Fernández-Rodríguez
- grid.8048.40000 0001 2194 2329Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain
| | | | - Cristina Lugones-Sánchez
- grid.452531.4Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Instituto de Investigación Biomédica de Salamanca (IBSAL), 37005 Salamanca, Spain
| | - Luis García-Ortiz
- grid.452531.4Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Instituto de Investigación Biomédica de Salamanca (IBSAL), 37005 Salamanca, Spain ,grid.11762.330000 0001 2180 1817Departamento de Ciencias Biomédicas y del Diagnóstico, Universidad de Salamanca, 37007 Salamanca, Spain ,RedIAPP: Red Española de Investigación Para Actividades Preventivas y Promoción de la Salud en Atención Primaria, Barcelona, Spain
| | - Vicente Martínez-Vizcaíno
- grid.8048.40000 0001 2194 2329Health and Social Research Center, Universidad de Castilla-La Mancha, 16071 Cuenca, Spain ,RedIAPP: Red Española de Investigación Para Actividades Preventivas y Promoción de la Salud en Atención Primaria, Barcelona, Spain ,grid.441837.d0000 0001 0765 9762Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, 1101 Talca, Chile
| |
Collapse
|
21
|
Huang X, Hui H, Zhu W, Chen N, Wei Y, Wang Z, Shi J. Effect of the interaction between alcohol and meat consumption on the hyperlipidaemia risk among elderly individuals: Evidence from Shanghai, China. Front Nutr 2022; 9:982626. [PMID: 36324622 PMCID: PMC9618893 DOI: 10.3389/fnut.2022.982626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 09/22/2022] [Indexed: 11/14/2022] Open
Abstract
Background Diet and other lifestyle habits may have an increased effect on blood lipids in older people. This study aimed to examine the associations between diet (meat, fish, and egg), alcohol consumption and blood lipids. Methods Surveillance data on chronic diseases and their risk factors were collected from Shanghai during 2017–2018. A Kish table was used for sampling 438 older adults, of whom 71 consumed alcohol. Logistic regression was used to test the relationships between diet, alcohol consumption and blood lipid levels in elderly individuals, and the marginal effects (MEs) were estimated. Results Dyslipidaemia was more common among drinkers than among nondrinkers (P < 0.01). Alcohol consumption was associated with dyslipidaemia (OR = 2.667, P < 0.01 for TC; OR = 1.919, P < 0.05 for LDL; OR = 3.412, P < 0.01 for TG), and consumption of more than 50 g of meat per day showed similar associations (OR = 3.227, P < 0.01 for TC; OR = 3.263, P < 0.01, for LDL; OR = 2.329, P < 0.01 for TG). The MEs of alcohol drinking and excessive meat consumption on the rate of dyslipidaemia were 0.324 for TC (P < 0.01), 0.255 for LDL (P < 0.05), and 0.174 for TG (P < 0.01). Discussion The risk of hyperlipidaemia was increased among elderly individuals with excessive meat and alcohol consumption, which also had an interactive effect.
Collapse
Affiliation(s)
- Xiaojing Huang
- School of Management, Xuzhou Medical University, Xuzhou, China
| | - Hong Hui
- General Department, Shanghai Baoshan District Gucun Town Community Health Service Center, Shanghai, China
| | - Wenqing Zhu
- Executive Office, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Ning Chen
- School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yan Wei
- Key Lab of Health Technology Assessment (National Health Commission), School of Public Health, Fudan University, Shanghai, China
- *Correspondence: Yan Wei
| | - Zhaoxin Wang
- Health Management Center, First Affiliated Hospital of Hainan Medical University, Hainan, China
- School of Management, Hainan Medical University, Hainan, China
- Zhaoxin Wang
| | - Jianwei Shi
- Department of General Practice, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China
- Department of Social Medicine and Health Management, School of Public Health, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Jianwei Shi
| |
Collapse
|
22
|
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
|
23
|
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: 5] [Impact Index Per Article: 2.5] [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
|
24
|
Lorkowski S. [Long known and mostly unused: lifestyle measures to support lipid-lowering therapy]. Dtsch Med Wochenschr 2022; 147:796-806. [PMID: 35672026 DOI: 10.1055/a-1516-2581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Dyslipidemias are common metabolic disorders in Western industrialized countries. Lifestyle measures such as increasing physical activity and improving diet were for many years the only measure for their treatment. Because of their health-promoting effects, guidelines for the treatment of dyslipidemias consider lifestyle measures to be the basis of any drug therapy. Due to the numerous efficient options for intensive lipid-lowering medication, lifestyle measures are recommended by responsible physicians, but their implementation is usually not intensively pursued due to the large time commitment; in contrast to sustained recommendations for increasing physical activity and normalizing body weight, nutritional therapists are too rarely consulted as specialists despite the significant effects our diet has on cardiovascular risk factors such as LDL-cholesterol, triglycerides and blood pressure. In this review, the principles of nutritional therapy of dyslipidemias are described, and it is outlined how recent studies support the plausibility and evidence of the individual measures.
Collapse
|
25
|
Pan L, Chen L, Lv J, Pang Y, Guo Y, Pei P, Du H, Yang L, Millwood IY, Walters RG, Chen Y, Gong W, Chen J, Yu C, Chen Z, Li L. Association of egg consumption, metabolic markers, and risk of cardiovascular diseases: A nested case-control study. eLife 2022; 11:72909. [PMID: 35607895 PMCID: PMC9129873 DOI: 10.7554/elife.72909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 04/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background Few studies have assessed the role of individual plasma cholesterol levels in the association between egg consumption and the risk of cardiovascular diseases. This research aims to simultaneously explore the associations of self-reported egg consumption with plasma metabolic markers and these markers with the risk of cardiovascular disease (CVD). Methods Totally 4778 participants (3401 CVD cases subdivided into subtypes and 1377 controls) aged 30-79 were selected based on the China Kadoorie Biobank. Targeted nuclear magnetic resonance was used to quantify 225 metabolites in baseline plasma samples. Linear regression was conducted to assess associations between self-reported egg consumption and metabolic markers, which were further compared with associations between metabolic markers and CVD risk. Results Egg consumption was associated with 24 out of 225 markers, including positive associations for apolipoprotein A1, acetate, mean HDL diameter, and lipid profiles of very large and large HDL, and inverse associations for total cholesterol and cholesterol esters in small VLDL. Among these 24 markers, 14 were associated with CVD risk. In general, the associations of egg consumption with metabolic markers and of these markers with CVD risk showed opposite patterns. Conclusions In the Chinese population, egg consumption is associated with several metabolic markers, which may partially explain the protective effect of moderate egg consumption on CVD. Funding This work was supported by the National Natural Science Foundation of China (81973125, 81941018, 91846303, 91843302). The CKB baseline survey and the first re-survey were supported by a grant from the Kadoorie Charitable Foundation in Hong Kong. The long-term follow-up is supported by grants (2016YFC0900500, 2016YFC0900501, 2016YFC0900504, 2016YFC1303904) from the National Key R&D Program of China, National Natural Science Foundation of China (81390540, 81390541, 81390544), and Chinese Ministry of Science and Technology (2011BAI09B01). The funders had no role in the study design, data collection, data analysis and interpretation, writing of the report, or the decision to submit the article for publication.
Collapse
Affiliation(s)
- Lang Pan
- Department of Epidemiology and Biostatistics, Peking UniversityBeijingChina
| | - Lu Chen
- Department of Epidemiology and Biostatistics, Peking UniversityBeijingChina
| | - Jun Lv
- Department of Epidemiology and Biostatistics, Peking UniversityBeijingChina
- Peking University Center for Public Health and Epidemic Preparedness & ResponseBeijingChina
- Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of EducationBeijingChina
| | - Yuanjie Pang
- Department of Epidemiology and Biostatistics, Peking UniversityBeijingChina
| | - Yu Guo
- Fuwai Hospital Chinese Academy of Medical Sciences, National Center for Cardiovascular DiseasesBeijingChina
| | - Pei Pei
- Chinese Academy of Medical SciencesBeijingChina
| | - Huaidong Du
- Medical Research Council Population Health Research Unit at the University of OxfordOxfordUnited Kingdom
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of OxfordOxfordUnited Kingdom
| | - Ling Yang
- Medical Research Council Population Health Research Unit at the University of OxfordOxfordUnited Kingdom
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of OxfordOxfordUnited Kingdom
| | - Iona Y Millwood
- Medical Research Council Population Health Research Unit at the University of OxfordOxfordUnited Kingdom
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of OxfordOxfordUnited Kingdom
| | - Robin G Walters
- Medical Research Council Population Health Research Unit at the University of OxfordOxfordUnited Kingdom
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of OxfordOxfordUnited Kingdom
| | - Yiping Chen
- Medical Research Council Population Health Research Unit at the University of OxfordOxfordUnited Kingdom
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of OxfordOxfordUnited Kingdom
| | - Weiwei Gong
- NCDs Prevention and Control Department, Zhejiang CDCHangzhouChina
| | - Junshi Chen
- China National Center for Food Safety Risk AssessmentBeijingChina
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, Peking UniversityBeijingChina
- Peking University Center for Public Health and Epidemic Preparedness & ResponseBeijingChina
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of OxfordOxfordUnited Kingdom
| | - Liming Li
- Department of Epidemiology and Biostatistics, Peking UniversityBeijingChina
- Peking University Center for Public Health and Epidemic Preparedness & ResponseBeijingChina
| |
Collapse
|
26
|
Fernandez ML, Murillo AG. Is There a Correlation between Dietary and Blood Cholesterol? Evidence from Epidemiological Data and Clinical Interventions. Nutrients 2022; 14:nu14102168. [PMID: 35631308 PMCID: PMC9143438 DOI: 10.3390/nu14102168] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 05/18/2022] [Accepted: 05/20/2022] [Indexed: 11/25/2022] Open
Abstract
Dietary cholesterol has been a topic of debate since the 1960s when the first dietary guidelines that limited cholesterol intake to no more than 300 mg/day were set. These recommendations were followed for several years, and it was not until the late 1990s when they were finally challenged by the newer information derived from epidemiological studies and meta-analysis, which confirmed the lack of correlation between dietary and blood cholesterol. Further, dietary interventions in which challenges of cholesterol intake were evaluated in diverse populations not only confirmed these findings but also reported beneficial effects on plasma lipoprotein subfractions and size as well as increases in HDL cholesterol and in the functionality of HDL. In this review, we evaluate the evidence from recent epidemiological analysis and meta-analysis as well as clinical trials to have a better understanding of the lack of correlation between dietary and blood cholesterol.
Collapse
Affiliation(s)
- Maria Luz Fernandez
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06268, USA
- Correspondence:
| | - Ana Gabriela Murillo
- Department of Biochemistry, University of Costa Rica, San Jose 11501-2060, Costa Rica;
| |
Collapse
|
27
|
Thomas MS, Puglisi M, Malysheva O, Caudill MA, Sholola M, Cooperstone JL, Fernandez ML. Eggs Improve Plasma Biomarkers in Patients with Metabolic Syndrome Following a Plant-Based Diet-A Randomized Crossover Study. Nutrients 2022; 14:nu14102138. [PMID: 35631279 PMCID: PMC9147178 DOI: 10.3390/nu14102138] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/16/2022] [Accepted: 05/18/2022] [Indexed: 12/12/2022] Open
Abstract
Plant-based (PB) diets are considered a healthy dietary pattern; however, eggs are not always included in this dietary regime. We hypothesized that the addition of two eggs per day would increase HDL cholesterol as well as plasma lutein, zeaxanthin and choline in individuals with metabolic syndrome (MetS). In this randomized controlled crossover intervention, we recruited 30 participants (49.3 ± 8 y) with MetS who followed a PB diet for 13 weeks. A registered dietitian advised all subjects on food selection and followed them through the intervention to ensure compliance. Participants underwent a 2-week washout with no eggs or spinach (a source of dietary lutein and zeaxanthin) and were randomly allocated to consume spinach (70 g) with either two eggs (EGG) or the equivalent amount of egg substitute (SUB) for breakfast for 4 weeks. After a 3-week washout, they were allocated the alternate breakfast. A total of 24 participants (13 women/11 men) finished the intervention. Plasma lipids, glucose, insulin, anthropometrics, plasma lutein, zeaxanthin, choline and trimethylamine oxide (TMAO) were assessed at baseline and the end of each intervention. When we compared individuals consuming the EGG versus the SUB breakfast, we observed a lower body weight (p < 0.02) and a higher HDL cholesterol (p < 0.025) after the EGG diet. There were no differences in plasma LDL cholesterol, triglycerides, glucose, insulin, or blood pressure. The number of large HDL particles measured by NMR was higher after EGG (p < 0.01) as compared to SUB. Plasma choline was higher in both treatments (p < 0.01) compared to baseline (8.3 ± 2.1 μmol/L). However, plasma choline values were higher in EGG (10.54 ± 2.8 μmol/L) compared to SUB (9.47 ± 2.7 μmol/L) p < 0.025. Both breakfasts increased plasma lutein compared to baseline (p < 0.01), while plasma zeaxanthin was only increased in the egg intervention (p < 0.01). These results indicate that consuming a plant-based diet in combination with whole eggs increases plasma HDL cholesterol, choline and zeaxanthin, important biomarkers in subjects with MetS.
Collapse
Affiliation(s)
- Minu S. Thomas
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA; (M.S.T.); (M.P.)
| | - Michael Puglisi
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA; (M.S.T.); (M.P.)
| | - Olga Malysheva
- Department of Human Nutrition, Division of Nutritional Science, Cornell University, Ithaca, NY 14860, USA; (O.M.); (M.A.C.)
| | - Marie A. Caudill
- Department of Human Nutrition, Division of Nutritional Science, Cornell University, Ithaca, NY 14860, USA; (O.M.); (M.A.C.)
| | - Maria Sholola
- Department of Food Science and Technology, The Ohio State University, Columbus, OH 43210, USA; (M.S.); (J.L.C.)
| | - Jessica L. Cooperstone
- Department of Food Science and Technology, The Ohio State University, Columbus, OH 43210, USA; (M.S.); (J.L.C.)
- Department of Horticulture and Crop Science, The Ohio State University, Columbus, OH 43210, USA
| | - Maria Luz Fernandez
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA; (M.S.T.); (M.P.)
- Correspondence:
| |
Collapse
|
28
|
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: 28] [Impact Index Per Article: 14.0] [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
|
29
|
Quintão ECR. Does eating eggs matter? ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2022; 66:152-156. [PMID: 35420270 PMCID: PMC9832897 DOI: 10.20945/2359-3997000000464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Dietary cholesterol is absorbed in proportion to the amount ingested, blocking its hepatic synthesis, increasing its biliary excretion, only slightly increasing production of bile acids while potentially raising the serum concentration of the atherogenic low-density lipoprotein. Humans lie midway between rats and rabbits that respond to dietary cholesterol, respectively, with high and low capacity to produce bile acids, and low or high capacity to raise blood cholesterol. There are regular studies exonerating as well as blaming dietary cholesterol as a cardiovascular risk factor, particularly in genetic hypercholesterolemic individuals. We then resorted at reviewing all meta-analyses on the subject but failed to reach at a clear conclusion useful in medical practice. Nevertheless, ingestion of the same amount of cholesterol results in wide variation in the amounts absorbed and in plasma lipoprotein profiles depending on poorly understood genetic factors. Several genetic conditions are capable of interfering with the absorption and synthesis of cholesterol. Hyperabsorption of dietary cholesterol elicits the accumulation of cholesterol in the liver and in plasma. In this regard, most cases of familial hypercholesterolemia that have a case of intestinal hyperabsorption of cholesterol also demonstrate the same defect. A practical useful suggestion is to measure for a few weeks the total serum cholesterol and its fractions at least three times before and during the intake of eggs that the candidate wishes to maintain in his usual dietary practice as an efficient procedure to identify those who respond with undesirable increases in serum cholesterol.
Collapse
|
30
|
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
|
31
|
Wang K, Wang L, Liu L, Zhou P, Mo S, Luo S, Zhang Y, Wang K, Yuan Y, Yin Z, Zhang Y. Longitudinal association of egg intake frequency with cardiovascular disease in Chinese adults. Nutr Metab Cardiovasc Dis 2022; 32:908-917. [PMID: 35168825 DOI: 10.1016/j.numecd.2022.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 12/17/2021] [Accepted: 01/04/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Reducing dietary cholesterol is generally acceptable for the prevention of cardiovascular disease (CVD). Eggs are nutrient-dense and common food items across the world, while rich in cholesterol. The potential effects of egg intake on cardiovascular health remain uncertainty and have been under debate in past decades. METHODS AND RESULTS A nationwide cohort of 20,688 participants aged 16-110 years without CVD at baseline were derived from the China Family Panel Studies. Egg consumption was assessed by a semi-quantitative food frequency questionnaire. We adopted stratified Cox proportional hazards model with random intercepts for provinces to evaluate associations of egg intake with CVD incidence. During a median follow-up of 6.0 years, we identified 2395 total CVD incidence and mean egg consumption was 3 times/week. Egg intakes were associated lower risks of CVD incidence in the multivariate-adjusted model. Compared with the non-consumers, the corresponding HRs (95% confidence interval) for total CVD events were 0.84 (0.74-0.94) for 1-2 times per week, 0.78 (0.69-0.88) for 3-6/week, and 0.83 (0.72-0.95) for ≥7/week. Similar relationships were found in hypertension. Approximately non-linear relationships were observed between egg consumption with total CVD and hypertension incidence, identifying the lowest risk in 3-6 times/week. Subgroup analyses estimated lower risks of total CVD and hypertension in females only, with significant effect modification by sex (P for interaction = 0.008 and 0.020). CONCLUSION Egg consumption may be associated with lower risks of CVD incidence among Chinese adults. Our findings could have implications in CVD prevention and might be considered in the development of dietary guidelines.
Collapse
Affiliation(s)
- Ke Wang
- Department of Nursing, Medical College, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Lu Wang
- Department of Nursing, Medical College, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Linjiong Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Peixuan Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Shaocai Mo
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Siqi Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Yuanyuan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Kai Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Yang Yuan
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Zhouxin Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, 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
|
32
|
Egg consumption and risk of cardiovascular events among Iranians: results from Isfahan Cohort Study (ICS). Eur J Clin Nutr 2022; 76:1409-1414. [DOI: 10.1038/s41430-022-01118-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/26/2022] [Accepted: 03/10/2022] [Indexed: 11/09/2022]
|
33
|
Lim CGY, Tai ES, van Dam RM. Replacing dietary carbohydrates and refined grains with different alternatives and risk of cardiovascular diseases in a multi-ethnic Asian population. Am J Clin Nutr 2022; 115:854-863. [PMID: 34996115 DOI: 10.1093/ajcn/nqab403] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 11/29/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cardiovascular diseases (CVDs) are a major cause of deaths worldwide, but prospective data on dietary risk factors for CVD in South and Southeast Asian populations are sparse. OBJECTIVE We aimed to evaluate the relation between macronutrient and food intakes and incidence of major adverse cardiovascular events (MACEs) in a multi-ethnic Asian population. METHODS We used data from the Singapore Multi-Ethnic Cohort (n = 12,408), a prospective cohort of ethnic Chinese, Malay, and Indian adults aged 21‒65 y recruited between 2004 and 2010. Dietary intakes were assessed using a validated food-frequency questionnaire, and the incidence of MACEs was ascertained through data linkage with national registries. A Cox proportional hazards model was used to evaluate the associations between dietary intakes and MACE risk. RESULTS Over a mean (SD) follow-up of 10.1 (2.3) y, 746 incident cases of MACEs were documented. We observed a direct association between carbohydrate intake and MACE risk (highest vs. lowest quartile, HR: 1.35; 95% CI: 1.07, 1.71; P-trend = 0.001). Replacing 5% of energy from carbohydrate with polyunsaturated fat (HR: 0.79; 95% CI: 0.69, 0.91) but not saturated fat (HR: 0.95; 95% CI: 0.84, 1.09) was significantly associated with a lower MACE risk. In terms of food groups, replacing 1 serving/d of refined grains with fruit (HR: 0.93; 95% CI: 0.87, 0.99), vegetables (HR: 0.92; 95% CI: 0.85, 1.00), and dairy (HR: 0.90; 95% CI: 0.82, 0.98) was associated with lower MACE risk. Cholesterol intake was associated with a higher MACE risk in ethnic Indians (highest vs. lowest quartile, HR: 2.40; 95% CI: 1.53, 3.75; P-trend < 0.001) but not in ethnic Malay or Chinese (P-interaction = 0.015). CONCLUSIONS Moderating carbohydrate intakes by increasing polyunsaturated fat intake and replacing refined grains with fruits, vegetables, and dairy was associated with lower MACE risk in Asian populations.
Collapse
Affiliation(s)
- Charlie G Y Lim
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - E Shyong Tai
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Division of Endocrinology, National University Hospital, Singapore.,Duke-NUS Medical School, Singapore
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| |
Collapse
|
34
|
Mesas AE, Garrido-Miguel M, Fernández-Rodríguez R, Fernández Franco S, Lugones-Sánchez C, García-Ortiz L, Martínez-Vizcaíno V. Egg Consumption and Blood Lipid Parameters According to the Presence of Chronic Metabolic Disorders: The EVIDENT II Study. J Clin Endocrinol Metab 2022; 107:e963-e972. [PMID: 34734262 PMCID: PMC8851934 DOI: 10.1210/clinem/dgab802] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Egg consumption is one of the main dietary sources of cholesterol, but whether individuals who eat more eggs have a worse blood lipid profile remains controversial. OBJECTIVE We examined the relationship between egg consumption and lipid parameters and explored whether this relationship changes according to the presence of chronic metabolic disorders. METHODS A multicenter cross-sectional study was conducted with adult participants in the EVIDENT II trial. Adjusted linear regression models were stratified by the main chronic metabolic disorders. RESULTS Among the 728 participants (61.9% women, mean age 52.1 ± 11.9 years), the mean egg consumption was equivalent to 5 to 6 eggs per week for a 70-kg individual. In the fully adjusted analysis, no association was found of egg consumption with total and high-density lipoprotein cholesterol (HDL-c), and triglyceride levels. Furthermore, compared with the first quartile of consumption, the fourth quartile was associated with lower low-density lipoprotein cholesterol (LDL-c) levels (coefficient -7.01; 95% CI -13.39, -0.62) and a lower LDL-c/HDL-c ratio (coefficient -0.24, 95% CI -0.41, -0.06). In the analyses stratified by chronic metabolic diseases, higher egg consumption was not associated with lipid profile in those with obesity, hypertension, type 2 diabetes, dyslipidemia, or treated with hypolipidemic drugs, and was associated with a better lipid profile in participants without these conditions. CONCLUSION Higher egg consumption was not associated with blood lipids in individuals with chronic metabolic disorders. In individuals without such conditions, the lipid profile was better among those who consumed more eggs. Our findings support current guidelines recommending eggs as part of a healthy diet.
Collapse
Affiliation(s)
- Arthur Eumann Mesas
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, 16071, Spain
- Universidade Estadual de Londrina, Londrina, Paraná, 86057-970, Brazil
| | - Miriam Garrido-Miguel
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, 16071, Spain
- Universidad de Castilla-La Mancha, Faculty of Nursing, Albacete, 02006, Spain
- Correspondence: Miriam Garrido-Miguel, C/ Santa Teresa Jornet, sin número, 16071, Cuenca, Spain.
| | | | | | - Cristina Lugones-Sánchez
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Instituto de investigación Biomédica de Salamanca (IBSAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Salamanca, 37005, Spain
| | - Luis García-Ortiz
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Instituto de investigación Biomédica de Salamanca (IBSAL), Gerencia de Atención Primaria de Salamanca, Gerencia Regional de Salud de Castilla y León (SACyL), Salamanca, 37005, Spain
- Universidad de Salamanca, Departamento de Ciencias Biomédicas y del Diagnóstico, Salamanca, 37007, Spain
- Investigadores grupo EVIDENT, redIAPP: Red Española de Investigación para Actividades Preventivas y Promoción de la Salud en Atención Primaria
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, 16071, Spain
- Investigadores grupo EVIDENT, redIAPP: Red Española de Investigación para Actividades Preventivas y Promoción de la Salud en Atención Primaria
- Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, 1101, Chile
| |
Collapse
|
35
|
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
|
36
|
Liu X, Shao Y, Sun J, Tu J, Wang Z, Tao J, Chen J. Egg consumption improves vascular and gut microbiota function without increasing inflammatory, metabolic, and oxidative stress markers. Food Sci Nutr 2022; 10:295-304. [PMID: 35035930 PMCID: PMC8751450 DOI: 10.1002/fsn3.2671] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/02/2021] [Accepted: 11/05/2021] [Indexed: 12/11/2022] Open
Abstract
Egg consumption is one of the many inconsistencies in evidence linking dietary cholesterol to cardiovascular disease (CVD). In addition, the gut microbiota and its metabolite, trimethylamine-N-oxide (TMAO), have been shown to play a crucial role in the development of CVD. The fact that egg is rich in choline suggests that excessive egg consumption may increase TMAO production by altering the gut microbiota. However, the effects of egg consumption on vascular function and gut microbiota remain unclear. Here, the diet of nine young male subjects was supplemented with two boiled eggs daily for 2 weeks. Changes in vascular function, inflammation, metabolism, oxidative stress, and gut microbiota were examined. We found that egg consumption increased flow-mediated dilation and decreased brachial-ankle pulse wave velocity. Furthermore, egg consumption positively modulated the gut microbiota function but had no effects on the levels of C-reactive protein, glucose, lipid profile, malondialdehyde, superoxide dismutase, or TMAO. The current study provides evidence that egg consumption improves vascular function, which may be related to the alterations seen in the gut microbiota. Therefore, moderate egg consumption may help to improve vascular and intestinal function in individuals at low risk of developing CVD and other metabolic disorders.
Collapse
Affiliation(s)
- Xiang Liu
- Department of Cardiac SurgeryGuangdong Cardiovascular InstituteGuangdong Provincial People’s HospitalGuangdong Academy of Medical SciencesGuangzhouChina
- Guangdong Provincial Key Laboratory of South China Structural Heart DiseaseGuangzhouChina
- School of MedicineSouth China University of TechnologyGuangzhouChina
| | - Yijia Shao
- Department of Hypertension and Vascular DiseasesThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina
- NHC Key Laboratory of Assisted Circulation (Sun Yat‐sen University)GuangzhouChina
| | - Jiapan Sun
- Department of GeriatricsPeking University Shenzhen HospitalShenzhen Peking University‐The Hong Kong University of Science and Technology Medical CenterShenzhenChina
| | - Jiazichao Tu
- Department of Cardiac SurgeryGuangdong Cardiovascular InstituteGuangdong Provincial People’s HospitalGuangdong Academy of Medical SciencesGuangzhouChina
- Guangdong Provincial Key Laboratory of South China Structural Heart DiseaseGuangzhouChina
- School of MedicineSouth China University of TechnologyGuangzhouChina
| | - Zhichao Wang
- Department of Hypertension and Vascular DiseasesThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina
- NHC Key Laboratory of Assisted Circulation (Sun Yat‐sen University)GuangzhouChina
| | - Jun Tao
- Department of Hypertension and Vascular DiseasesThe First Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina
- NHC Key Laboratory of Assisted Circulation (Sun Yat‐sen University)GuangzhouChina
| | - Jimei Chen
- Department of Cardiac SurgeryGuangdong Cardiovascular InstituteGuangdong Provincial People’s HospitalGuangdong Academy of Medical SciencesGuangzhouChina
- Guangdong Provincial Key Laboratory of South China Structural Heart DiseaseGuangzhouChina
- School of MedicineSouth China University of TechnologyGuangzhouChina
| |
Collapse
|
37
|
Njike VY, Treu JA, Kela GCM, Ayettey RG, Comerford BP, Siddiqui WT. Egg Consumption in the Context of Plant-Based Diets and Cardiometabolic Risk Factors in Adults at Risk of Type 2 Diabetes. J Nutr 2021; 151:3651-3660. [PMID: 34494112 DOI: 10.1093/jn/nxab283] [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] [Received: 06/18/2021] [Revised: 07/27/2021] [Accepted: 08/04/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Plant-based diets (PBDs) are typically recommended to those at risk of type 2 diabetes mellitus (T2DM). OBJECTIVES We examined how including eggs, compared with excluding them from PBDs, affected cardiometabolic risk factors in adults at risk of T2DM. METHODS This was a randomized, controlled, single-blind, crossover trial of 35 adults (mean age: 60.7 y; 25 women, 10 men) at risk of T2DM assigned to 1 of 2 sequence permutations of 2 dietary treatments (plant-based plus eggs, and exclusively plant-based), with a 4-wk washout period. A dietitian counseled participants to exclude or include 2 eggs daily in the context of PBDs for a 6-wk interval. Our primary outcome measure was endothelial function (EF) measured as flow-mediated dilatation. Secondary outcome measures included lipid profile, blood pressure, insulin sensitivity, anthropometry, and dietary intake. Data were analyzed using generalized linear models. RESULTS Compared with egg exclusion, egg inclusion in the context of PBDs did not adversely affect EF (-1.7% ± 6.5% compared with -1.8% ± 7.5%; P = 0.9805). Likewise, egg inclusion, compared with egg exclusion, did not adversely affect (P = 0.1096-0.9781) lipid profile, blood pressure, insulin sensitivity, or anthropometry. Egg inclusion, compared with egg exclusion, improved reported intakes of selenium (23.1 ± 30.3 μg/d compared with 2.3 ± 34.9 μg/d; P = 0.0124) and choline (172.0 ± 96.0 mg/d compared with -3.4 ± 68.1 mg/d; P < 0.0001). CONCLUSIONS Consuming 2 eggs daily in the context of PBDs does not adversely affect cardiometabolic risk factors among adults at risk of T2DM. Eggs could be used as an adjuvant to enhance PBDs that are typically recommended for those at risk of T2DM.This trial was registered at clinicaltrials.gov as NCT04316429.
Collapse
Affiliation(s)
- Valentine Y Njike
- Yale-Griffin Prevention Research Center, Derby, CT, USA.,Griffin Hospital Medical Education, Derby, CT, USA
| | - Judith A Treu
- Yale-Griffin Prevention Research Center, Derby, CT, USA
| | | | | | | | | |
Collapse
|
38
|
The Effect of Whole Egg Intake on Muscle Mass: Are the Yolk and Its Nutrients Important? Int J Sport Nutr Exerc Metab 2021; 31:514-521. [PMID: 34504041 DOI: 10.1123/ijsnem.2021-0086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 11/18/2022]
Abstract
Whole egg may have potential benefits for enhancing muscle mass, independent of its protein content. The yolk comprises ∼40% of the total protein in an egg, as well as containing several nonprotein nutrients that could possess anabolic properties (e.g., microRNAs, vitamins, minerals, lipids, phosphatidic acid and other phospholipids). Therefore, the purpose of this narrative review is to discuss the current evidence as to the possible effects of egg yolk compounds on skeletal muscle accretion beyond those of egg whites alone. The intake of whole egg seems to promote greater myofibrillar protein synthesis than egg white intake in young men. However, limited evidence shows no difference in muscle hypertrophy when comparing the consumption of whole egg versus an isonitrogenous quantity of egg white in young men performing resistance training. Although egg yolk intake seems to promote additional acute increases on myofibrillar protein synthesis, it does not seem to further enhance muscle mass when compared to egg whites when consumed as part of a high-protein dietary patterns, at least in young men. This conclusion is based on very limited evidence and more studies are needed to evaluate the effects of egg yolk (or whole eggs) intake on muscle mass not only in young men, but also in other populations such as women, older adults, and individuals with muscle wasting diseases.
Collapse
|
39
|
Ji N, Huang Z, Zhang X, Sun Y, Ye S, Chen S, Tucker KL, Wu S, Gao X. Association between egg consumption and arterial stiffness: a longitudinal study. Nutr J 2021; 20:67. [PMID: 34256749 PMCID: PMC8278728 DOI: 10.1186/s12937-021-00720-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 06/15/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Inconsistent associations between egg consumption and cardiovascular disease (CVD) risk have been observed in previous studies. This study aims to longitudinally investigate the association between egg consumption and altered risk of arterial stiffness, a major pre-clinical pathogenic change of CVD, which was assessed by brachial-ankle pulse wave velocity (baPWV). METHODS A total of 7315 Chinese participants from the Kailuan Study, free of CVD and cancer were included in this study. Egg consumption was assessed by a semi-quantitative validated food frequency questionnaire in 2014. baPWV was repeatedly measured at baseline and during follow-up (mean follow-up: 3.41 years). General linear regression was used to calculate means of baPWV change rate across different egg consumption groups, adjusting for age, sex, baseline baPWV, healthy eating index, total energy, social-economic status, blood pressure, obesity, smoking, lipid profiles, and fasting glucose concentrations. RESULTS Compared to the annual baPWV change rate in participants with 0-1.9 eggs/wk. (adjusted mean: 35.9 ± 11.2 cm/s/y), those consuming 3-3.9 eggs/wk. (adjusted mean: 0.2 ± 11.4 cm/s/y) had the lowest increase in baPWV during follow-up (P-difference = 0.002). Individuals with low (0-1.9 eggs/wk) vs. high (5+ eggs /wk) egg intake showed similar changes in baPWV. CONCLUSIONS In this large-scale longitudinal analysis, we did not find a significant difference in arterial stiffness, as assessed by baPWV level, between low and high egg consumption groups. However, moderate egg consumption (3-3.9 eggs/wk) appeared to have beneficial effects on arterial stiffness.
Collapse
Affiliation(s)
- Naiwen Ji
- Department of Nutritional Sciences, The Pennsylvania State University, 109 Chandlee Lab, University Park, State College, PA, 16802, USA
| | - Zhe Huang
- Department of Cardiology, Kailuan General Hospital, Tangshan, People's Republic of China
| | - Xinyuan Zhang
- Department of Nutritional Sciences, The Pennsylvania State University, 109 Chandlee Lab, University Park, State College, PA, 16802, USA
| | - Yuanyuan Sun
- Department of Epidemiology and Biostatistics, Peking Union Medical College, Beijing, China
| | - Shumao Ye
- Cardiovascular Nutrition Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, USA
| | - Shuohua Chen
- Health Care Center, Kailuan General Hospital, Tangshan, China
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts, Lowell, MA, USA
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, People's Republic of China.
| | - Xiang Gao
- Department of Nutritional Sciences, The Pennsylvania State University, 109 Chandlee Lab, University Park, State College, PA, 16802, USA.
| |
Collapse
|
40
|
Pan XF, Yang JJ, Lipworth LP, Shu XO, Cai H, Steinwandel MD, Blot WJ, Zheng W, Yu D. Cholesterol and Egg Intakes with Cardiometabolic and All-Cause Mortality among Chinese and Low-Income Black and White Americans. Nutrients 2021; 13:nu13062094. [PMID: 34205293 PMCID: PMC8234137 DOI: 10.3390/nu13062094] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/04/2021] [Accepted: 06/14/2021] [Indexed: 02/02/2023] Open
Abstract
We examined the associations of dietary cholesterol and egg intakes with cardiometabolic and all-cause mortality among Chinese and low-income Black and White Americans. Included were 47,789 Blacks, 20,360 Whites, and 134,280 Chinese aged 40–79 years at enrollment. Multivariable Cox models with restricted cubic splines were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality outcomes using intakes of 150 mg cholesterol/day and 1 egg/week as the references. Cholesterol intake showed a nonlinear association with increased all-cause mortality and a linear association with increased cardiometabolic mortality among Black Americans: HRs (95% CIs) associated with 300 and 600 mg/day vs. 150 mg/day were 1.07 (1.03–1.11) and 1.13 (1.05–1.21) for all-cause mortality (P-linearity = 0.04, P-nonlinearity = 0.002, and P-overall < 0.001) and 1.10 (1.03–1.16) and 1.21 (1.08–1.36) for cardiometabolic mortality (P-linearity = 0.007, P-nonlinearity = 0.07, and P-overall = 0.005). Null associations with all-cause or cardiometabolic mortality were noted for White Americans (P-linearity ≥ 0.13, P-nonlinearity ≥ 0.06, and P-overall ≥ 0.05 for both). Nonlinear inverse associations were observed among Chinese: HR (95% CI) for 300 vs. 150 mg/day was 0.94 (0.92–0.97) for all-cause mortality and 0.91 (0.87–0.95) for cardiometabolic mortality, but the inverse associations disappeared with cholesterol intake > 500 mg/day (P-linearity ≥ 0.12; P-nonlinearity ≤ 0.001; P-overall < 0.001 for both). Similarly, we observed a positive association of egg intake with all-cause mortality in Black Americans, but a null association in White Americans and a nonlinear inverse association in Chinese. In conclusion, the associations of cholesterol and egg intakes with cardiometabolic and all-cause mortality may differ across ethnicities who have different dietary patterns and cardiometabolic risk profiles. However, residual confounding remains possible.
Collapse
Affiliation(s)
- Xiong-Fei Pan
- Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Department of Medicine, Division of Epidemiology, Nashville, TN 37203, USA; (X.-F.P.); (J.-J.Y.); (L.P.L.); (X.-O.S.); (H.C.); (W.J.B.); (W.Z.)
| | - Jae-Jeong Yang
- Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Department of Medicine, Division of Epidemiology, Nashville, TN 37203, USA; (X.-F.P.); (J.-J.Y.); (L.P.L.); (X.-O.S.); (H.C.); (W.J.B.); (W.Z.)
| | - Loren P. Lipworth
- Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Department of Medicine, Division of Epidemiology, Nashville, TN 37203, USA; (X.-F.P.); (J.-J.Y.); (L.P.L.); (X.-O.S.); (H.C.); (W.J.B.); (W.Z.)
| | - Xiao-Ou Shu
- Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Department of Medicine, Division of Epidemiology, Nashville, TN 37203, USA; (X.-F.P.); (J.-J.Y.); (L.P.L.); (X.-O.S.); (H.C.); (W.J.B.); (W.Z.)
| | - Hui Cai
- Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Department of Medicine, Division of Epidemiology, Nashville, TN 37203, USA; (X.-F.P.); (J.-J.Y.); (L.P.L.); (X.-O.S.); (H.C.); (W.J.B.); (W.Z.)
| | - Mark D. Steinwandel
- International Epidemiology Field Station, Vanderbilt University Medical Center, Nashville, TN 37203, USA;
| | - William J. Blot
- Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Department of Medicine, Division of Epidemiology, Nashville, TN 37203, USA; (X.-F.P.); (J.-J.Y.); (L.P.L.); (X.-O.S.); (H.C.); (W.J.B.); (W.Z.)
- International Epidemiology Field Station, Vanderbilt University Medical Center, Nashville, TN 37203, USA;
| | - Wei Zheng
- Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Department of Medicine, Division of Epidemiology, Nashville, TN 37203, USA; (X.-F.P.); (J.-J.Y.); (L.P.L.); (X.-O.S.); (H.C.); (W.J.B.); (W.Z.)
| | - Danxia Yu
- Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Department of Medicine, Division of Epidemiology, Nashville, TN 37203, USA; (X.-F.P.); (J.-J.Y.); (L.P.L.); (X.-O.S.); (H.C.); (W.J.B.); (W.Z.)
- Correspondence: ; Tel.: +1-615-936-7389; Fax: +1-615-343-5938
| |
Collapse
|
41
|
Longitudinal association of egg consumption habits with blood lipids among Chinese adults: results from the Prediction for Atherosclerotic Cardiovascular Disease Risk in China project. Chin Med J (Engl) 2021; 135:747-749. [PMID: 34133357 PMCID: PMC9276296 DOI: 10.1097/cm9.0000000000001555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Indexed: 11/26/2022] Open
|
42
|
Bries AE, Webb JL, Vogel B, Carrillo C, Day TA, Kimber MJ, Valentine RJ, Rowling MJ, Clark S, Schalinske KL, McNeill EM. RNA Sequencing Reveals Key Metabolic Pathways Are Modified by Short-Term Whole Egg Consumption. Front Nutr 2021; 8:652192. [PMID: 34041258 PMCID: PMC8141817 DOI: 10.3389/fnut.2021.652192] [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] [Received: 01/11/2021] [Accepted: 04/06/2021] [Indexed: 11/13/2022] Open
Abstract
Eggs are protein-rich, nutrient-dense, and contain bioactive ingredients that have been shown to modify gene expression and impact health. To understand the effects of egg consumption on tissue-specific mRNA and microRNA expression, we examined the role of whole egg consumption (20% protein, w/w) on differentially expressed genes (DEGs) between rat (n = 12) transcriptomes in the prefrontal cortex (PFC), liver, kidney, and visceral adipose tissue (VAT). Principal component analysis with hierarchical clustering was used to examine transcriptome profiles between dietary treatment groups. We performed Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis as well as genetic network and disease enrichment analysis to examine which metabolic pathways were the most predominantly altered in each tissue. Overall, our data demonstrates that whole egg consumption for 2 weeks modified the expression of 52 genes in the PFC, 22 genes in VAT, and two genes in the liver (adj p < 0.05). Additionally, 16 miRNAs were found to be differentially regulated in the PFC, VAT, and liver, but none survived multiple testing correction. The main pathways influenced by WE consumption were glutathione metabolism in VAT and cholesterol biosynthesis in the PFC. These data highlight key pathways that may be involved in diseases and are impacted by acute consumption of a diet containing whole eggs.
Collapse
Affiliation(s)
- Amanda E Bries
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, United States.,Interdepartmental Graduate Program in Nutritional Sciences, Iowa State University, Ames, IA, United States
| | - Joe L Webb
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, United States.,Interdepartmental Graduate Program in Nutritional Sciences, Iowa State University, Ames, IA, United States
| | - Brooke Vogel
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, United States
| | - Claudia Carrillo
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, United States
| | - Timothy A Day
- Department of Biomedical Sciences, Iowa State University College of Veterinary Medicine, Ames, IA, United States
| | - Michael J Kimber
- Department of Biomedical Sciences, Iowa State University College of Veterinary Medicine, Ames, IA, United States
| | - Rudy J Valentine
- Interdepartmental Graduate Program in Nutritional Sciences, Iowa State University, Ames, IA, United States.,Department of Kinesiology, Iowa State University, Ames, IA, United States
| | - Matthew J Rowling
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, United States.,Interdepartmental Graduate Program in Nutritional Sciences, Iowa State University, Ames, IA, United States
| | - Stephanie Clark
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, United States
| | - Kevin L Schalinske
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, United States.,Interdepartmental Graduate Program in Nutritional Sciences, Iowa State University, Ames, IA, United States
| | - Elizabeth M McNeill
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, United States.,Interdepartmental Graduate Program in Nutritional Sciences, Iowa State University, Ames, IA, United States
| |
Collapse
|
43
|
Nestel PJ, Sullivan DR, Mori TA. Dietary management of cardiovascular risk including type 2 diabetes. Curr Opin Endocrinol Diabetes Obes 2021; 28:134-141. [PMID: 33186195 DOI: 10.1097/med.0000000000000589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Recent changes or confirmations linking patterns of eating and specific dietary interventions in the management of cardiovascular risk factors including associations with prevalent and incident type 2 diabetes. RECENT FINDINGS Recently published guidance for dietary management of cardiovascular risk and type 2 diabetes have mostly common features. Major findings include a trend to replace strict quantitative advice on nutrients with qualitative advice on food consumption with exceptions for diabetes, global advice to increase intake of plant foods, confirmation to substitute mono and polyunsaturated oils for saturated and trans fats, new advisory on supplemental omega-3 intake, less limitation on dairy foods and fermented dairy foods encouraged, reduced emphasis on specific cholesterol-rich foods allowing greater consumption of eggs except for people with diabetes, processed meat consumption limited allowing modest intake of lean red meat, distinguishing between 'healthy' and 'unhealthy' carbohydrates including sugars, and maintaining advice on healthy bodyweight, reducing salt intake and encouraging water as preferred beverage. SUMMARY The new guidance for healthier patterns of food consumption supported by evidence is more readily understood by health practitioners and translatable to consumers and patients.
Collapse
Affiliation(s)
| | - David R Sullivan
- Department of Chemical Pathology, Royal Prince Alfred Hospital, NSW Health Pathology, Camperdown
| | - Trevor A Mori
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
| |
Collapse
|
44
|
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
|
45
|
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]
|
46
|
Khatun T, Hoque A, Anwar KS, Sarker MR, Ara F, Maqbool D. Dietary habits of patients with coronary artery disease in a tertiary-care hospital of Bangladesh: a case-controlled study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2021; 40:3. [PMID: 33648595 PMCID: PMC7919298 DOI: 10.1186/s41043-021-00226-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 02/14/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND AND OBJECTIVES Globally, coronary artery disease (CAD) remains one of the leading causes of death, both in developed and less economically developed countries (LEDC) including Bangladesh. Diet plays a key role in the pathogenesis processes of atherosclerosis and coronary artery disease (CAD). The purpose of this study was to assess the dietary habit of heart disease cases that had CAD against matched controls. METHODOLOGY Complying Helsinki ethical norms, with written consent, this case-control study was performed among 210 subjects: 105 CAD-hospitalized patients (selected from Lab Aid Cardiac and Specialized Hospitals) and 105 healthy subjects from local urban communities having their body mass index (BMI: ranging between ≥18.5 and 27 socio-demographic status, detailed-dietary patterns and blood pressure levels were recorded, anthropometric indices measured, and serum biochemistry (complete lipid profile) tested/analyzed for both the cases and controls. All visually re-checked data were analyzed using appropriate statistical tools (t test/conditional-logistic regressions) on SPS/Windows V.21.0. RESULT Almost half (45%) CAD patients had hypertriglyceridemia and higher levels of low-density lipoprotein, significantly higher BMA (p=0.001), waist circumference, and waist to hip ratio in male patients (p=0.005 and p=0.020, respectively) than their peer controls. Serum lipid profiles, sugar concentrations, and blood pressure levels of CAD patients revealed higher levels than clinically defined cut-off values as established risk factors for CAD. Odds ratios (CI 95%) as risk factors for consuming junk food {OR=5.49 (2.25-13.38)}, chicken {OR=4.54 (1.89-10.9) was the most, followed by beef {OR=2.68 (1.19-4.98)}, eggs {OR=2.38 (1.14-10.92)}, fish {OR=2.81 (1.31-6.04)}, and vegetables {0R=.968 (0.510-1.839)}. However, fat-free milk, ghee/butter oil, curd/yogurt, and fruits had lower ORs revealing no or less risks for CAD. CONCLUSION Food habits of CAD patients (with higher BMI level and biochemical indicators of the blood) statistically revealed that consuming junk food, meat, and eggs being riskier, fruits, fat-free milk, yogurt, and vegetable remains have protective effects on CAD.
Collapse
Affiliation(s)
- Taslima Khatun
- Department of Public Health, College of Medicine, National Cheng Kung University (NCKU), Taiwan City, Taiwan
- Department of Community Nutrition, Faculty of Public Health, Bangladesh University of Health Sciences (BUHS), 125/1, Darus Salam, Mirpur, Dhaka, 1 Bangladesh
| | - Asirul Hoque
- Department of Community Nutrition, Faculty of Public Health, Bangladesh University of Health Sciences (BUHS), 125/1, Darus Salam, Mirpur, Dhaka 1, Bangladesh
| | - Kazi Selim Anwar
- Infectious Diseases Department, International University of Health & Welfare (IUHW), Narita, Japan
| | - Manika Rani Sarker
- Department of Community Nutrition, Faculty of Public Health, Bangladesh University of Health Sciences (BUHS), 125/1, Darus Salam, Mirpur, Dhaka 1, Bangladesh
| | - Ferdous Ara
- Department of Food and Nutrition, AkijCollege of Home Economics, Road 9/A (New), House118, Dhanmondi, Dhaka, 1209 Bangladesh
| | - Dilara Maqbool
- Nutrition Officer, LabAid Cardiac Hospital, Dhaka, 1205 Bangladesh
| |
Collapse
|
47
|
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
|
48
|
Yuan S, Ming-Wei L, Qi-Qiang H, Larsson SC. Egg, cholesterol and protein intake and incident type 2 diabetes mellitus: Results of repeated measurements from a prospective cohort study. Clin Nutr 2021; 40:4180-4186. [PMID: 33593662 DOI: 10.1016/j.clnu.2021.01.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 12/15/2020] [Accepted: 01/28/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND & AIMS Epidemiological evidence on the associations of egg, cholesterol and protein intake with risk of type 2 diabetes is inconsistent. Therefore, we conducted this study to explore these associations among Chinese adults. METHODS Data from 4 waves (2004, 2006, 2009 and 2011) of the China Health and Nutrition Survey were used. A multistage random-cluster sampling method was employed to recruit the participants in both rural and urban areas. We included individuals who participated in 2004 and any waves afterwards. Those 1) below 18 years of age; 2) with diabetes at baseline; or 3) with extreme energy intake (men: <800 kcal or >6000 kcal; women: <600 kcal or >4000 kcal) were excluded. Respondents were classified into four groups according to quartiles of egg, cholesterol and protein intake per day. Numbers of eggs per day were calculated by dividing egg intake in grams by 50 g. Diagnosis of type 2 diabetes was self-reported. Logistic generalized estimation equation models were employed. RESULTS There were 7312 individuals included in 2004, 6390 in 2006, 4826 in 2009 and 4963 in 2011. The mean age of participants at baseline was 48.3 years and 47.2% were men. Over an average of 5.8-y follow-up, 209 developed type 2 diabetes. After adjustment for demographic, lifestyle and dietary confounders, the odds ratio of type 2 diabetes for those in the highest compared with the lowest protein intake quartile was 2.38 (95% CI: 1.43, 3.98). The odds ratio of individuals with ≥3 eggs/day versus none was 3.76 (95% CI, 2.05, 6.90). Cholesterol intake was not associated with type 2 diabetes. CONCLUSIONS Individuals with the highest protein intake had over a 2-fold increased risk of type 2 diabetes compared with those with the lowest protein intake. A high intake of egg, but not dietary cholesterol, was associated with type 2 diabetes. This association warrants further investigation.
Collapse
Affiliation(s)
- Shuai Yuan
- School of Health Sciences, Wuhan University, Donghu Rd. 115, Wuhan City, Hubei Province, Wuhan, PR China; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
| | - Liu Ming-Wei
- School of Health Sciences, Wuhan University, Donghu Rd. 115, Wuhan City, Hubei Province, Wuhan, PR China.
| | - He Qi-Qiang
- School of Health Sciences, Wuhan University, Donghu Rd. 115, Wuhan City, Hubei Province, Wuhan, PR China.
| | - Susanna C Larsson
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
| |
Collapse
|
49
|
Yong ST, Tan HY, Samat N, Wong HK. The effect of high monacolin K red yeast rice supplement on performance, egg quality, egg yolk cholesterol, plasma lipids and enzyme profile of laying hens. ANIMAL PRODUCTION SCIENCE 2021. [DOI: 10.1071/an20585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Context
Reducing egg cholesterol has been a major goal of many researchers over four decades. Monacolin K, a 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitor, identical to the active ingredient in the prescription statin drug lovastatin, could be a promising feed supplement for layers.
Aims
To determine the effects of high monacolin K red yeast rice (RYR) supplement on feed intake, egg production, egg cholesterol content, plasma lipid and enzyme metabolites in laying hens.
Methods
Hyline brown layers were fed RYR supplement at 0, 0.2, 0.4, 0.8 and 1.6% of the diet for 6 weeks. Total and daily feed intake, egg production, egg weights and feed conversion ratio between the RYR treated groups and the control were compiled. Egg cholesterol and egg quality at the 3rd and 6th week of the feeding trial were analysed. Plasma lipids and enzymes were sampled towards the end of the trial.
Key results
Egg cholesterol were significantly lower (P < 0.05) in the 0.8 and 1.6% RYR supplemented group. Supplementation with 0.8% RYR resulted in 11.16% reduction in egg cholesterol at the 3rd week with no further improvements with longer feeding. There were no significant differences (P > 0.05) in total and daily feed intake, egg production, egg weights and feed conversion ratio (FCR) between the RYR treated and control group. Total plasma cholesterol and triglycerides were significantly lower (P < 0.05) in the 0.8 and 1.6% RYR supplemented group when compared with the control group. RYR supplementation exert no significant differences (P > 0.05) in plasma enzyme levels.
Conclusions
The present study suggests that RYR supplementation of 0.8% resulted in egg cholesterol reduction by 11.16% with no adverse effects on laying hens.
Implications
The feeding trial showed that RYR supplement can be used as a feed additive in layer diets to lower egg cholesterol, plasma cholesterol and triglycerides with no adverse effects on layer egg production and plasma enzymes over the feeding period.
Collapse
|
50
|
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.
Collapse
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
| |
Collapse
|