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Pan C, Sun X, Song J, Yu C, Guo Y, Wang S, Gao R, Ning F, Pang Z, Chen Z, Li L. The Prospective Associations of Egg Consumption with the Risk of Total Cerebrovascular Disease Morbidity among Chinese Adults. Nutrients 2023; 15:nu15081808. [PMID: 37111029 PMCID: PMC10142563 DOI: 10.3390/nu15081808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/02/2023] [Accepted: 04/04/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Studies investigating the relationship between egg consumption and the risk of cerebrovascular disease (CED) have yielded inconsistent results. This study evaluated the association between egg consumption and the risk of CED among Chinese adults. METHODS Data were obtained from China Kadoorie Biobank, Qingdao. A computerised questionnaire was used to collect information regarding egg consumption frequency. CED events were tracked through linkage with the Disease Surveillance Point System and the new national health insurance databases. Cox proportional hazards regression analyses were used to evaluate associations between egg consumption and CED risk controlling for potential confounders. RESULTS After a median follow-up of 9.2 years, 865 and 1083 CED events among men and women, respectively, were documented. More than 50% of participants consumed eggs daily with an average age of 52.0 (10.4) years at baseline. No association between egg consumption and CED were identified in the whole cohort and women. However, a 28% lower risk of CED was observed in those who consumed eggs at a higher frequency (HR = 0.72, 95% CI: 0.55-0.95) and a significant trend for the association (p for trend = 0.012) in a multivariable model in men. CONCLUSION Higher frequency of egg consumption was associated with a lower risk of total CED events among men but not women in Chinese adults. The beneficial effect on women warrants further investigations.
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Affiliation(s)
- Chi Pan
- School of Public Health, Qingdao University, Qingdao 266071, China
| | - Xiaohui Sun
- Qingdao Municipality Center for Disease Control and Prevention, Qingdao 266033, China
- Qingdao Institute of Preventive Medicine, Qingdao 266033, China
| | - Jiahui Song
- School of Public Health, Qingdao University, Qingdao 266071, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Shaojie Wang
- Qingdao Municipality Center for Disease Control and Prevention, Qingdao 266033, China
- Qingdao Institute of Preventive Medicine, Qingdao 266033, China
| | - Ruqin Gao
- School of Public Health, Qingdao University, Qingdao 266071, China
| | - Feng Ning
- Qingdao Municipality Center for Disease Control and Prevention, Qingdao 266033, China
- Qingdao Institute of Preventive Medicine, Qingdao 266033, China
| | - Zengchang Pang
- Qingdao Municipality Center for Disease Control and Prevention, Qingdao 266033, China
- Qingdao Institute of Preventive Medicine, Qingdao 266033, China
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China
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2
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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: 30] [Impact Index Per Article: 15.0] [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.
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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
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3
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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.
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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.
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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.
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5
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Izar MCDO, Giraldez VZR, Bertolami A, Santos Filho RDD, Lottenberg AM, Assad MHV, Saraiva JFK, Chacra APM, Martinez TLR, Bahia LR, Fonseca FAH, Faludi AA, Sposito AC, Chagas ACP, Jannes CE, Amaral CK, Araújo DBD, Cintra DE, Coutinho EDR, Cesena F, Xavier HT, Mota ICP, Giuliano IDCB, Faria Neto JR, Kato JT, Bertolami MC, Miname MH, Castelo MHCG, Lavrador MSF, Machado RM, Souza PGD, Alves RJ, Machado VA, Salgado Filho W. Update of the Brazilian Guideline for Familial Hypercholesterolemia - 2021. Arq Bras Cardiol 2021; 117:782-844. [PMID: 34709306 PMCID: PMC8528358 DOI: 10.36660/abc.20210788] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
| | - Viviane Zorzanelli Rocha Giraldez
- Instituto do Coração (InCor) da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
- Grupo Fleury, São Paulo, SP - Brasil
| | | | | | - Ana Maria Lottenberg
- Hospital Israelita Albert Einstein (HIAE) - Faculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE), São Paulo, SP - Brasil
- Faculdade de Medicina da Universidade de São Paulo, Laboratório de Lípides (LIM10), São Paulo, São Paulo, SP - Brasil
| | | | | | - Ana Paula M Chacra
- Instituto do Coração (InCor) da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | | | | | | | - Andrei C Sposito
- Universidade Estadual de Campinas (UNICAMP), Campinas, SP - Brasil
| | | | - Cinthia Elim Jannes
- Instituto do Coração (InCor) da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | | | | | | | | | - Fernando Cesena
- Hospital Israelita Albert Einstein (HIAE), São Paulo, SP - Brasil
| | | | | | | | | | | | | | - Marcio Hiroshi Miname
- Instituto do Coração (InCor) da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
| | - Maria Helane Costa Gurgel Castelo
- Universidade Federal do Ceará (UFC), Fortaleza, CE - Brasil
- Hospital do Coração de Messejana, Fortaleza, CE - Brasil
- Professora da Faculdade Unichristus, Fortaleza, CE - Brasil
| | - Maria Sílvia Ferrari Lavrador
- Hospital Israelita Albert Einstein (HIAE) - Faculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE), São Paulo, SP - Brasil
| | - Roberta Marcondes Machado
- Faculdade de Medicina da Universidade de São Paulo, Laboratório de Lípides (LIM10), São Paulo, São Paulo, SP - Brasil
| | - Patrícia Guedes de Souza
- Hospital Universitário Professor Edgard Santos da Universidade Federal da Bahia (UFBA), Salvador, BA - Brasil
| | | | | | - Wilson Salgado Filho
- Instituto do Coração (InCor) da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP - Brasil
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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.
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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.
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Hahn J, Dehghan M, Drouin-Chartier JP, Mentz RJ, Jneid H, Virani SS, Tang WHW, Krittanawong C. Egg Consumption and Risk of Cardiovascular Disease: a Critical Review. CURRENT EMERGENCY AND HOSPITAL MEDICINE REPORTS 2021. [DOI: 10.1007/s40138-021-00225-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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8
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Tang H, Cao Y, Yang X, Zhang Y. Egg Consumption and Stroke Risk: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies. Front Nutr 2020; 7:153. [PMID: 33015124 PMCID: PMC7506150 DOI: 10.3389/fnut.2020.00153] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 07/28/2020] [Indexed: 02/05/2023] Open
Abstract
Background: The present study was performed to systematically quantify the association between egg consumption and stroke risk as inconsistent results have been produced. Methods: Three electronic databases (PubMed, Embase, and Cochrane Library), previous reviews, meta-analyses, and bibliographies of relevant articles were retrieved from prospective cohort studies published before July 1, 2020. The random-effects model was employed to estimate summary relative risks (RRs) and 95% confidence intervals (CIs). A dose-response analysis was also performed when data were available. Results: Sixteen publications involving 24 prospective cohort studies were included in our final meta-analysis. No significant association between egg consumption and stroke risk was identified (RR = 0.92, 95% CI: 0.84–1.01) for the highest vs. the lowest quintiles of egg intake. Subgroup analysis indicated that geographic location significantly modified the effect of egg consumption on stroke risk. Higher egg consumption was attributed to a reduced probability of stroke in Asia (RR = 0.83, 95% CI: 0.73–0.94), but not in North America (RR = 0.95, 95% CI: 0.77–1.16) or Europe (RR = 1.02, 95% CI: 0.91–1.16). Dose-response analysis demonstrated a nearly J-shaped curve between egg consumption and risk of stroke. A decreased risk was observed for the intake of one to four eggs weekly and an increased risk for the intake of more than six eggs weekly. The results were significant at an intake of 10 eggs weekly. Conclusions: The evidence from this meta-analysis showed that a J-shaped association exists between egg consumption and stroke risk.
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Affiliation(s)
- Hui Tang
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China.,Department of Neurosurgery, Nanchong Central Hospital, The Second Clinical Medical College, North Sichuan Medical College, Nanchong, China
| | - Yi Cao
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Xiang Yang
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yuekang Zhang
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
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9
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Abstract
There is a great debate regarding the association of cholesterol intake from egg consumption and the incidence of cardiovascular disease (CVD). Most studies show that moderate egg consumption is not associated with a significant increase in CVD, stroke, heart failure, and type 2 diabetes mellitus (T2DM), whereas others dispute this fact and state that there is an association with increased egg consumption, especially if they are consumed with saturated fats. In addition, the recent relaxation of cholesterol intake to greater than 300 mg/d by the American College of Cardiology/American Heart Association Nutritional Guidelines has fueled this debate. In order to get a current perspective on the significance of moderate egg consumption with the primary incidence of CVD, a focused Medline search of the English language literature was conducted between 2010 and March 2020 using the terms, cholesterol intake, egg consumption, coronary artery disease, CVD, and T2DM. Nineteen pertinent articles were retrieved, and these, together with collateral literature, will be discussed in this review article. The analysis of data from the articles retrieved indicated that several studies showed that moderate egg consumption (1 egg/d) is not associated with adverse cardiovascular effects in subjects free of CVD or T2DM, whereas other studies showed a positive association, especially in patients with preexisting CVD or T2DM. Therefore, at present, there is no unanimous agreement on this subject, and the controversy will continue until new confirmatory evidence becomes available.
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10
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Godos J, Micek A, Brzostek T, Toledo E, Iacoviello L, Astrup A, Franco OH, Galvano F, Martinez-Gonzalez MA, Grosso G. Egg consumption and cardiovascular risk: a dose-response meta-analysis of prospective cohort studies. Eur J Nutr 2020; 60:1833-1862. [PMID: 32865658 PMCID: PMC8137614 DOI: 10.1007/s00394-020-02345-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 07/21/2020] [Indexed: 12/11/2022]
Abstract
Purpose Cardiovascular disease (CVD) is a leading cause of mortality globally and is strongly influenced by dietary risk factors. The aim was to assess the association between egg consumption and risk of CVD risk/mortality, including coronary heart disease (CHD), stroke, and heart failure. Methods MEDLINE, Embase, and Web of Science databases were searched through April 2020 for prospective studies. Two independent reviewers screened and extracted the data through standardized methods. Size effects were calculated as summary relative risks (SRRs) in a dose–response fashion through random-effects meta-analyses. Results Thirty-nine studies including nearly 2 million individuals and 85,053 CHD, 25,103 stroke, 7536 heart failure, and 147,124 CVD cases were included. The summary analysis including 17 datasets from 14 studies conducted on CVD (incidence and/or mortality) showed that intake of up to six eggs per week is inversely associated with CVD events, when compared to no consumption [for four eggs per week, SRR = 0.95 (95% CI: 0.90; 1.00)]; a decreased risk of CVD incidence was observed for consumption of up to one egg per day [SRR = 0.94 (95% CI: 0.89; 0.99)]. The summary analysis for CHD incidence/mortality including 24 datasets from 16 studies showed a decreased risk up to two eggs per week [(SRR = 0.96 (95% CI: 0.91; 1.00)]. No associations were retrieved with risk of stroke. The summary analysis for heart failure risk including six datasets from four studies showed that intake of one egg per day was associated with increased risk raising for higher intakes compared to no consumption [for 1 egg per day, SRR = 1.15 (95% CI:1.02; 1.30)]. After considering GRADE criteria for strength of the evidence, it was rated low for all outcomes but stroke, for which it was moderate (yet referring to no risk). Conclusion There is no conclusive evidence on the role of egg in CVD risk, despite the fact that higher quality studies are warranted to obtain stronger evidence for a possible protection of CVD associated with moderate weekly egg consumption compared to no intake; equally, future studies may strengthen the evidence for increased heart failure risk associated with high regular egg consumption. Electronic supplementary material The online version of this article (10.1007/s00394-020-02345-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Agnieszka Micek
- Department of Nursing Management and Epidemiology Nursing, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland
| | - Tomasz Brzostek
- Department of Internal Medicine and Community Nursing, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland
| | - Estefania Toledo
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Navarre, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Navarra Institute for Health Research, IdiSNA, Pamplona, Navarre, Spain
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, IS, Italy.,Department of Medicine and Surgery, Research Centre in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy
| | - Arne Astrup
- Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Nørre Campus, Copenhagen, Denmark
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.,Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Fabio Galvano
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia 97, 95123, Catania, Italy
| | - Miguel A Martinez-Gonzalez
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Navarre, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Navarra Institute for Health Research, IdiSNA, Pamplona, Navarre, Spain.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Giuseppe Grosso
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia 97, 95123, Catania, Italy.
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11
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Pasdar Y, Moradi S, Esfahani NH, Darbandi M, Niazi P. Intake of Animal Source Foods in Relation to Risk of Metabolic Syndrome. Prev Nutr Food Sci 2020; 25:133-139. [PMID: 32676463 PMCID: PMC7333013 DOI: 10.3746/pnf.2020.25.2.133] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 03/26/2020] [Indexed: 12/12/2022] Open
Abstract
Metabolic syndrome (MetS) is a prevalent disorder associated with diabetes and cardiovascular diseases. Lifestyle and occupation can increase the risk of developing MetS. Since dietary pattern is a major component of lifestyle, this study aimed to determine the relationship between consumption of animal source foods (ASFs) and MetS among food suppliers. This cross-sectional study was conducted on 112 male food suppliers. We measured anthropometric indices, body composition, and blood pressure of the participants. Blood biochemistry was determined using 5 mL fasting blood samples. MetS was defined based on the guidelines described by the International Diabetes Federation (IDF). ASF intake, including dairy products, eggs, red meat, poultry, and fish, was assessed using food frequency questionnaires. Overall, 46.4% of participants had MetS. Participants who consumed dairy 3∼5 times/d and more than 5 times/d had lower risk of MetS [odds ratios (OR): 0.18 (confidence interval (CI) 95%: 0.05∼0.62) and OR: 0.20 (CI 95%: 0.06∼0.67), respectively] compared with participants in the lowest tertile. The risk of hypertension was significantly decreased in participants who consumed dairy products >5 times/d [OR: 0.22 (CI 95%: 0.07∼0.67)]. Other ASFs were not associated against the risk of MetS in crude and adjusted models. Our findings indicated that adhering to dairy products can decrease the risk of MetS. Higher adherence to dairy products was also protective against hypertension in these participants.
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Affiliation(s)
- Yahya Pasdar
- Department of Nutritional Sciences, Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
| | - Shima Moradi
- Department of Nutritional Sciences, Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
| | - Neda Hydarzadeh Esfahani
- Student Research Committee, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
| | - Mitra Darbandi
- Department of Nutritional Sciences, Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
| | - Parisa Niazi
- Department of Nutritional Sciences, Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
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12
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Shakoor H, Khan MI, Sahar A, Khan MKI, Faiz F, Basheer Ahmad H. Development of omega-3 rich eggs through dietary flaxseed and bio-evaluation in metabolic syndrome. Food Sci Nutr 2020; 8:2619-2626. [PMID: 32566179 PMCID: PMC7300047 DOI: 10.1002/fsn3.1522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 02/09/2020] [Accepted: 02/18/2020] [Indexed: 12/03/2022] Open
Abstract
An egg is a nutrient-dense food that contains protein, fats, vitamins, and minerals. It is proven that the consumption of eggs influences serum lipid concentration. Therefore, a study was conducted to investigate the effect of normal and omega-3 eggs on serum lipids profiles. Lipids were extracted from egg yolks and analyzed for fatty acids content. The present research is a crossover study design in which 20 participants were recruited randomly, and all subjects received three treatments: no eggs, omega-3 eggs, and normal eggs. However, fasting blood was drawn at baseline and the end of each diet period and analyzed for serum lipids, blood glucose, and insulin level. Omega-3 egg treatment showed reduction in the serum total cholesterol by 16.57 mg/dl (p < .001), triglyceride by 17.48 mg/dl, and increase in HDL cholesterol concentration by 0.48 mg/dl (p < .001) as compared to no-egg. A significant (p < .05) reduction in blood pressure by 8.34/8.67 mm/Hg and insulin level was observed due to omega-3 egg consumption which indicates that omega-3 fatty acids improve insulin sensitivity. On the other hand, regular egg intake elevates serum total cholesterol and triglycerides concentration but decreases blood pressure. It was concluded that omega-3-enriched egg consumption had a positive effect on the serum lipid profile and blood pressure of patients with metabolic syndrome as compared to normal eggs.
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Affiliation(s)
- Hira Shakoor
- National Institute of Food Science and TechnologyUniversity of Agriculture FaisalabadPakistanFaisalabad
| | - Muhammad Issa Khan
- National Institute of Food Science and TechnologyUniversity of Agriculture FaisalabadPakistanFaisalabad
| | - Amna Sahar
- National Institute of Food Science and TechnologyUniversity of Agriculture FaisalabadPakistanFaisalabad
| | | | - Furukh Faiz
- Department of Agriculture and Food TechnologyKarakoram International UniversityGilgitPakistan
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13
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Xia P, Pan X, Chen C, Wang Y, Ye Y, Pan A. Dietary Intakes of Eggs and Cholesterol in Relation to All-Cause and Heart Disease Mortality: A Prospective Cohort Study. J Am Heart Assoc 2020; 9:e015743. [PMID: 32400247 PMCID: PMC7660855 DOI: 10.1161/jaha.119.015743] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background The aim of this study was to identify associations between dietary intakes of eggs and cholesterol and all-cause and heart disease mortality in a US population. Methods and Results Data from the National Health and Nutrition Examination Survey 1999-2014 were used in this study, which included 37 121 participants ≥20 years of age. Dietary information was assessed via 24-hour dietary recalls at baseline. Mortality status was documented until December 31, 2015. Cox proportional hazards models were used to examine the associations between dietary intakes of eggs and cholesterol and all-cause and heart disease mortality. During a median follow-up of 7.8 years, 4991 deaths were documented, including 870 deaths from heart disease. No significant association was observed between additional daily consumption of half an egg and all-cause mortality (multivariable-adjusted hazard ratio, 1.04; 95% CI, 0.96-1.13), or heart disease mortality (0.96; 0.80-1.14). Each 50-mg/day increase of cholesterol intake was inversely associated with all-cause mortality among participants with daily intake <250 mg (0.87; 0.77-0.98), but positively associated with all-cause mortality among participants with daily intake ≥250 mg (1.07; 1.01-1.12). No significant association was found between dietary cholesterol intake and heart disease mortality. Conclusions No significant association was found between egg consumption and mortality in US adults. The association between dietary cholesterol intake and all-cause mortality depended on the baseline intake levels, with an inverse association in those with lower intake levels (<250 mg/day) but a positive association in those with higher intake levels (≥250 mg/day).
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Affiliation(s)
- Peng‐Fei Xia
- Department of Epidemiology and BiostatisticsMinistry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - Xiong‐Fei Pan
- Department of Epidemiology and BiostatisticsMinistry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
- Division of EpidemiologyDepartment of MedicineVanderbilt University Medical CenterNashvilleTN
| | - Chen Chen
- Department of Epidemiology and BiostatisticsMinistry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - Yi Wang
- Department of Epidemiology and BiostatisticsMinistry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - Yi Ye
- Department of Epidemiology and BiostatisticsMinistry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - An Pan
- Department of Epidemiology and BiostatisticsMinistry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
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14
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Drouin-Chartier JP, Chen S, Li Y, Schwab AL, Stampfer MJ, Sacks FM, Rosner B, Willett WC, Hu FB, Bhupathiraju SN. Egg consumption and risk of cardiovascular disease: three large prospective US cohort studies, systematic review, and updated meta-analysis. BMJ 2020; 368:m513. [PMID: 32132002 PMCID: PMC7190072 DOI: 10.1136/bmj.m513] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To evaluate the association between egg intake and cardiovascular disease risk among women and men in the United States, and to conduct a meta-analysis of prospective cohort studies. DESIGN Prospective cohort study, and a systematic review and meta-analysis of prospective cohort studies. SETTING Nurses' Health Study (NHS, 1980-2012), NHS II (1991-2013), Health Professionals' Follow-Up Study (HPFS, 1986-2012). PARTICIPANTS Cohort analyses included 83 349 women from NHS, 90 214 women from NHS II, and 42 055 men from HPFS who were free of cardiovascular disease, type 2 diabetes, and cancer at baseline. MAIN OUTCOME MEASURES Incident cardiovascular disease, which included non-fatal myocardial infarction, fatal coronary heart disease, and stroke. RESULTS Over up to 32 years of follow-up (>5.54 million person years), 14 806 participants with incident cardiovascular disease were identified in the three cohorts. Participants with a higher egg intake had a higher body mass index, were less likely to be treated with statins, and consumed more red meats. Most people consumed between one and less than five eggs per week. In the pooled multivariable analysis, consumption of at least one egg per day was not associated with incident cardiovascular disease risk after adjustment for updated lifestyle and dietary factors associated with egg intake (hazard ratio for at least one egg per day v less than one egg per month 0.93, 95% confidence interval 0.82 to 1.05). In the updated meta-analysis of prospective cohort studies (33 risk estimates, 1 720 108 participants, 139 195 cardiovascular disease events), an increase of one egg per day was not associated with cardiovascular disease risk (pooled relative risk 0.98, 95% confidence interval 0.93 to 1.03, I2=62.3%). Results were similar for coronary heart disease (21 risk estimates, 1 411 261 participants, 59 713 coronary heart disease events; 0.96, 0.91 to 1.03, I2=38.2%), and stroke (22 risk estimates, 1 059 315 participants, 53 617 stroke events; 0.99, 0.91 to 1.07, I2=71.5%). In analyses stratified by geographical location (P for interaction=0.07), no association was found between egg consumption and cardiovascular disease risk among US cohorts (1.01, 0.96 to 1.06, I2=30.8%) or European cohorts (1.05, 0.92 to 1.19, I2=64.7%), but an inverse association was seen in Asian cohorts (0.92, 0.85 to 0.99, I2=44.8%). CONCLUSIONS Results from the three cohorts and from the updated meta-analysis show that moderate egg consumption (up to one egg per day) is not associated with cardiovascular disease risk overall, and is associated with potentially lower cardiovascular disease risk in Asian populations. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019129650.
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Affiliation(s)
| | - Siyu Chen
- Department of Nutrition, Harvard T H Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Yanping Li
- Department of Nutrition, Harvard T H Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Amanda L Schwab
- Department of Nutrition, Harvard T H Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Meir J Stampfer
- Department of Nutrition, Harvard T H Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Frank M Sacks
- Department of Nutrition, Harvard T H Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Bernard Rosner
- Department of Nutrition, Harvard T H Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Biostatistics, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Walter C Willett
- Department of Nutrition, Harvard T H Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Frank B Hu
- Department of Nutrition, Harvard T H Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Shilpa N Bhupathiraju
- Department of Nutrition, Harvard T H Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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15
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Takagi H, Hari Y, Nakashima K, Kuno T, Ando T. Egg Consumption and Coronary Artery Disease: A Nice Knockdown Argument. Angiology 2020; 71:589-601. [PMID: 32000503 DOI: 10.1177/0003319719897493] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
To identify prospective cohort studies enrolling adults and investigating an association of egg consumption with incidence and mortality of coronary artery disease (CAD), PubMed and Web of Science were searched through June 2019. Adjusted hazard ratios (HRs) of CAD incidence/mortality for more versus the least frequent egg consumption were extracted from each study. Study-specific estimates were pooled in the random-effects model. Sixteen eligible studies with a total of 1 285 505 participants were identified and included in the present meta-analysis. The primary meta-analysis pooling all HRs for the most versus least frequent egg consumption demonstrated that egg consumption was associated with significantly low CAD incidence/mortality (pooled HR: 0.93; 95% confidence interval: 0.89-0.98; I 2 = 9%). In the secondary meta-analyses (separately combining HRs for the third vs first tertile, the fourth vs first quartile, the third vs first quartile, the fifth vs first quintile, the fourth vs first quintile, and the third vs first quintile egg consumption), the fifth (vs first) quintile egg consumption was only associated with significantly low CAD incidence/mortality. In conclusion, egg consumption is independently associated with low incidence/mortality of CAD, which may be derived from the comparisons of the fifth versus first quintile egg consumption.
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Affiliation(s)
- Hisato Takagi
- Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.,Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yosuke Hari
- Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.,Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Kouki Nakashima
- Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.,Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Toshiki Kuno
- Department of Medicine, Mount Sinai Beth Israel Medical Center, New York, NY, USA
| | - Tomo Ando
- Division of Interventional Cardiology, Department of Cardiology, New York Presbyterian Hospital/Columbia University Medical Center, New York, NY, USA
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16
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Carson JAS, Lichtenstein AH, Anderson CA, Appel LJ, Kris-Etherton PM, Meyer KA, Petersen K, Polonsky T, Van Horn L. Dietary Cholesterol and Cardiovascular Risk: A Science Advisory From the American Heart Association. Circulation 2020; 141:e39-e53. [DOI: 10.1161/cir.0000000000000743] [Citation(s) in RCA: 90] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The elimination of specific dietary cholesterol target recommendations in recent guidelines has raised questions about its role with respect to cardiovascular disease. This advisory was developed after a review of human studies on the relationship of dietary cholesterol with blood lipids, lipoproteins, and cardiovascular disease risk to address questions about the relevance of dietary cholesterol guidance for heart health. Evidence from observational studies conducted in several countries generally does not indicate a significant association with cardiovascular disease risk. Although meta-analyses of intervention studies differ in their findings, most associate intakes of cholesterol that exceed current average levels with elevated total or low-density lipoprotein cholesterol concentrations. Dietary guidance should focus on healthy dietary patterns (eg, Mediterranean-style and DASH [Dietary Approaches to Stop Hypertension]–style diets) that are inherently relatively low in cholesterol with typical levels similar to the current US intake. These patterns emphasize fruits, vegetables, whole grains, low-fat or fat-free dairy products, lean protein sources, nuts, seeds, and liquid vegetable oils. A recommendation that gives a specific dietary cholesterol target within the context of food-based advice is challenging for clinicians and consumers to implement; hence, guidance focused on dietary patterns is more likely to improve diet quality and to promote cardiovascular health.
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17
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The efficacy and safety of edoxaban versus warfarin in preventing clinical events in atrial fibrillation: A systematic review and meta-analysis. Anatol J Cardiol 2020; 25:77-88. [PMID: 33583814 DOI: 10.14744/anatoljcardiol.2020.18049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Atrial fibrillation (AF) is the most common type of arrhythmia. Warfarin reduces the incidence and mortality of strokes in patients with AF. Edoxaban reduces the bleeding risk in patients with AF. This study evaluates the efficacy and safety of edoxaban versus warfarin in preventing clinical events in patients with AF through a meta-analysis of randomized controlled trials (RCTs). RCTs were retrieved from medical literature databases. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated to compare the primary and safety endpoints. In total, five articles (10 trial comparisons) containing 24,836 patients were retrieved. Of these patients, 16,268 (65.5%) received edoxaban and 8,568 (34.5%) received warfarin. Compared with warfarin, edoxaban significantly reduced the incidence of cardiovascular death (CVD), major bleeding, and non-major bleeding (RR: 0.86, 95% CI: 0.80-0.93, I2 : 0.0%; RR: 0.65, 95% CI: 0.59-0.71, I2 : 75.6%; and RR: 0.80, 95% CI: 0.77-0.84, I2 : 79.3%, respectively). Edoxaban did not increase the incidence of stroke, systemic embolic events, myocardial infarction, and adverse events compared with warfarin (RR: 1.00, 95% CI: 0.90-1.11, I2 : 42.8%; RR: 1.00, 95% CI: 0.67-1.49, I2 : 0.0%; RR: 1.08, 95% CI: 0.93-1.27, I2 : 0.0%; RR: 1.00, 95% CI: 0.91-1.10, I2: 46.4%, respectively). This meta-analysis indicated that compared with warfarin, edoxaban can significantly reduce the incidence of CVD and major and non-major bleeding. The anticoagulant effect and safety of edoxaban may be better than those of warfarin.
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18
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The effect of egg consumption on cardiometabolic health outcomes: an umbrella review. Public Health Nutr 2019; 23:935-955. [DOI: 10.1017/s1368980019002441] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjective:This umbrella review provides an overview of the consistency and gaps in the evidence base on eggs and cardiometabolic health.Design:PubMed, Web of Science, Cochrane Library, the Nutrition Evidence Systematic Review and Agency for Healthcare Research and Quality databases were screened for evidence-based reviews in English that assessed human studies on egg consumption and cardiometabolic outcomes.Results:Seven systematic reviews and fifteen meta-analyses were identified, with eighteen of these published since 2015. Overall, the systematic reviews were of low quality, while meta-analyses were of moderate- to high-quality. No association of increased egg intake and risks of heart disease or stroke in the general population were found in the meta-analyses. Increased risk of heart failure was noted in two meta-analyses that analysed the same three cohort studies. Five recent meta-analyses reported no increased risk of type 2 diabetes mellitus (T2DM) in the general population, although increased risk in US-based populations only has been reported. Older (<2013) meta-analyses reported increased risks of cardiovascular disease (CVD) or heart disease in T2DM populations, and no recent evidence-based reviews were identified. Finally, only one meta-analysis reported intervention studies specifically on eggs and biomarkers (i.e. lipids), and the results contradicted those from observation studies.Conclusions:Recent evidence-based reviews conclude that increased egg consumption is not associated with CVD risk in the general population. More research is needed on the positive associations between egg consumption and heart failure and T2DM risk, as well as CVD risk in diabetics, before firm conclusions can be made.
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19
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Saande CJ, Webb JL, Curry PE, Rowling MJ, Schalinske KL. Dietary Whole Egg Reduces Body Weight Gain in a Dose-Dependent Manner in Zucker Diabetic Fatty Rats. J Nutr 2019; 149:1766-1775. [PMID: 31254347 DOI: 10.1093/jn/nxz143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 05/22/2019] [Accepted: 06/04/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND We previously reported that a whole-egg-based diet attenuated weight gain in rats with type 2 diabetes (T2D) and more effectively maintained vitamin D status than an equivalent amount of supplemental cholecalciferol. OBJECTIVES The objective of this study was to determine the lowest dose of whole egg effective at maintaining vitamin D homeostasis and attenuating the obese phenotype in T2D rats. METHODS Zucker diabetic fatty (ZDF) rats (n = 40; age 6 wk; prediabetic) and their lean controls (n = 40; age 6 wk) were randomly assigned to a diet containing 20% casein (CAS) or 20%, 10%, 5%, or 2.5% protein from whole egg (20% EGG, 10% EGG, 5% EGG, and 2.5% EGG, respectively). All diets contained 20% total protein (wt:wt). All rats received their respective diets for 8 wk, at a stage of growth and development that translates to adolescence in humans, until 14 wk of age, a point at which ZDF rats exhibit overt T2D. Weight gain was measured 5 d/wk, and circulating 25-hydroxyvitamin D [25(OH)D] was measured by ELISA. Mean values were compared by 2-factor ANOVA. RESULTS The 20% EGG diet maintained serum 25(OH)D at 30 nmol/L in ZDF rats, whereas the 10%, 5%, and 2.5% EGG diets did not prevent insufficiency, resulting in mean serum 25(OH)D concentrations of 24 nmol/L in ZDF rats. Body weight gain was reduced by 29% (P < 0.001) and 31% (P < 0.001) in ZDF rats consuming 20% and 10% EGG diets, respectively, and by 16% (P = 0.004) and 12% (P = 0.030) in ZDF rats consuming 5% and 2.5% EGG diets, respectively, compared with CAS. CONCLUSIONS Whole-egg-based diets exerted a dose-dependent response with respect to attenuating weight gain. These data could support dietary recommendations aimed at body weight management in individuals predisposed to obesity and T2D.
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Affiliation(s)
- Cassondra J Saande
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, USA.,Interdepartmental Graduate Program in Nutritional Sciences, Iowa State University, Ames, IA, USA
| | - Joseph L Webb
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, USA.,Interdepartmental Graduate Program in Nutritional Sciences, Iowa State University, Ames, IA, USA
| | - Paige E Curry
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, USA
| | - Matthew J Rowling
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, USA.,Interdepartmental Graduate Program in Nutritional Sciences, Iowa State University, Ames, IA, USA
| | - Kevin L Schalinske
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, USA.,Interdepartmental Graduate Program in Nutritional Sciences, Iowa State University, Ames, IA, USA
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20
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Abdollahi AM, Virtanen HEK, Voutilainen S, Kurl S, Tuomainen TP, Salonen JT, Virtanen JK. Egg consumption, cholesterol intake, and risk of incident stroke in men: the Kuopio Ischaemic Heart Disease Risk Factor Study. Am J Clin Nutr 2019; 110:169-176. [PMID: 31095282 DOI: 10.1093/ajcn/nqz066] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 03/28/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Epidemiologic studies suggest inverse associations between consumption of egg, a major source of dietary cholesterol, and stroke. However, the evidence of the relation remains limited, especially among carriers of apolipoprotein E4 (apoE4), which influences cholesterol metabolism. OBJECTIVE The aim of this study was to investigate associations of egg and cholesterol intakes with risk of stroke and with the major stroke risk factor, blood pressure, in middle-aged and older men from eastern Finland and whether apoE phenotype could modify these associations. METHODS A total of 1950 men aged 42-60 y in 1984-1989 were included at the baseline examinations of the prospective population-based Kuopio Ischaemic Heart Disease Risk Factor Study. Data on apoE phenotype were available for 1015 men. Dietary intakes were assessed with 4-d food records at baseline and incident stroke events were assessed by record linkage to hospital discharge registries. Cox proportional hazards regression analyses were used to estimate associations with stroke risk. Associations with baseline blood pressure were evaluated with ANCOVA. RESULTS During the mean ± SD follow-up of 21.2 ± 7.2 y, there were 217 incidences of any stroke: 166 of ischemic stroke and 55 of hemorrhagic stroke. Comparing the highest egg intake quartile with the lowest, the multivariable-adjusted HRs were 0.81 for total stroke (95% CI: 0.54, 1.23; P-trend = 0.32), 0.84 for ischemic stroke (95% CI: 0.53, 1.34; P-trend = 0.44), and 0.75 for hemorrhagic stroke (95% CI: 0.32, 1.77; P-trend = 0.40). The respective HRs for the highest cholesterol intake quartile compared with the lowest were 0.86 (95% CI: 0.57, 1.32; P-trend = 0.42), 0.74 (95% CI: 0.46, 1.20; P-trend = 0.32), and 1.10 (95% CI: 0.45, 2.66; P-trend = 0.75). Diastolic blood pressure was 1.6 mm Hg (P-trend = 0.04) lower in the highest egg intake quartile compared with the lowest, but there were no associations with systolic blood pressure or with cholesterol intake. ApoE phenotype (32% had apoE4 phenotype) did not modify the associations. CONCLUSION Neither egg nor cholesterol intakes were associated with stroke risk in this cohort, regardless of apoE phenotype.This trial was registered at www.clinicaltrials.gov as NCT03221127.
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Affiliation(s)
- Anna M Abdollahi
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Heli E K Virtanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Sari Voutilainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Sudhir Kurl
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jukka T Salonen
- The Faculty of Medicine, Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Jyrki K Virtanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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21
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Mazidi M, Katsiki N, Mikhailidis DP, Pencina MJ, Banach M. Egg Consumption and Risk of Total and Cause-Specific Mortality: An Individual-Based Cohort Study and Pooling Prospective Studies on Behalf of the Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group. J Am Coll Nutr 2019; 38:552-563. [PMID: 31173548 DOI: 10.1080/07315724.2018.1534620] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Mohsen Mazidi
- Key State Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Chaoyang, Beijing, China
| | - Niki Katsiki
- Institute of Genetics and Developmental Biology, International College, University of Chinese Academy of Science (IC-UCAS), West Beichen Road, Chaoyang, China
| | - Dimitri P. Mikhailidis
- Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London, London, UK
| | - Michael J. Pencina
- Department of Biostatistics and Bioinformatics, Duke Clinical Research Institute, Durham, North Carolina
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland
- Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
- Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland
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22
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Magriplis E, Mitsopoulou AV, Karageorgou D, Bakogianni I, Dimakopoulos I, Micha R, Michas G, Chourdakis M, Chrousos GP, Roma E, Panagiotakos D, Zampelas A. Frequency and Quantity of Egg Intake Is Not Associated with Dyslipidemia: The Hellenic National Nutrition and Health Survey (HNNHS). Nutrients 2019; 11:nu11051105. [PMID: 31108988 PMCID: PMC6566236 DOI: 10.3390/nu11051105] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 05/08/2019] [Accepted: 05/10/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Gaps remain on the safety of egg intake on cardiovascular health, setting the study's aim to investigate the association between quantity and frequency of egg consumption, with established dyslipidemia. METHODS Study participants (N = 3558, 40.3% males) included individuals from the Hellenic National and Nutrition Health Survey (HNNHS), of national representation. Quantity and frequency of egg consumption was determined. Minimally adjusted, multivariable logistic and linear analysis were used to assess egg consumption and dyslipidemia. RESULTS The more frequent egg consumption compared to no or rare egg consumption significantly decreased the odds of dyslipidemia in the minimally adjusted (Odds Ratio (OR) for frequency: 0.83; 95% Confidence Interval (CI): 0.752, 0.904; OR for quantified frequency: 0.87; 95% CI: 0.796, 0.963) and the fully adjusted models (OR for frequency: 0.80; 95% CI: 0.718, 0.887; OR for quantified frequency: 0.85; 95%CI: 0.759, 0.945). Level of serum cholesterol and LDL-c were significantly lower with higher frequency and quantified frequency of egg consumption in all models. CONCLUSION Eggs do not increase the risk of dyslipidemia and can be consumed as part of a healthy diet that is high in fiber and low in saturated fat, without excessive energy intake, by all individuals.
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Affiliation(s)
- Emmanuella Magriplis
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 11855 Athens, Greece.
| | | | - Dimitra Karageorgou
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 11855 Athens, Greece.
| | - Ioanna Bakogianni
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 11855 Athens, Greece.
| | - Ioannis Dimakopoulos
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 11855 Athens, Greece.
| | - Renata Micha
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 11855 Athens, Greece.
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02215, USA.
| | - George Michas
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 11855 Athens, Greece.
- Department of Cardiology, "Elpis" General Hospital of Athens, 11522 Athens, Greece.
| | - Michail Chourdakis
- Medical School, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece.
| | - George P Chrousos
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, 11527 Athens, Greece.
| | - Eleftheria Roma
- First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, 11527 Athens, Greece.
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education Harokopio University, Athens, Eleftheriou Venizelou 70, 17676 Athens, Greece.
| | - Antonis Zampelas
- Department of Food Science and Human Nutrition, Agricultural University of Athens, Iera odos 75, 11855 Athens, Greece.
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23
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Poursafar Z, Joukar F, Hasavari F, Atrkar Roushan Z. The Associations between Meat Group Consumption and Acute Myocardial Infarction Risks in an Iranian Population: a Case-Control Study. Clin Nutr Res 2019; 8:159-168. [PMID: 31089469 PMCID: PMC6494747 DOI: 10.7762/cnr.2019.8.2.159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 04/19/2019] [Accepted: 04/21/2019] [Indexed: 11/19/2022] Open
Abstract
Acute myocardial infraction (AMI) is a highly frequent cause of mortality and disability around the world. The aim of the present study was to evaluate the associations between meat group intake levels and AMI risks in an adult Iranian population. This case-control study was conducted on 200 first AMI cases and 200 healthy individuals matched by age, sex, and body mass index. A Food Frequency Questionnaire validated for Iranian populations was used to assess usual dietary intake levels over the previous year. Data was extracted regarding the meat group-including meat (red and processed), fish, poultry, eggs, nuts, and legumes. The associations between meat group items and AMI were calculated by multivariable logistic regression. Red meat consumption was significantly positively associated with increased risk of AMI. After adjustment for potential confounders, a positive association was found between higher frequency of processed and red meat intake, and increased risk of AMI (processed meat consumption: odds ratio [OR], 1.71; 95% confidence interval [CI], 1.31-2.23 and red meat consumption: OR, 2.51; 95% CI, 1.84-5.11). In addition, the results indicated an inverse association between the frequency of nuts consumption and AMI (OR, 0.52; 95% CI, 0.31-0.92). There were no associations seen between poultry, fish, eggs and beans intake levels, and the odds of AMI. The current study suggested a direct association between the frequency of processed/red meat consumption and increased AMI risks. In addition, an inverse relation was observed between frequency of nuts consumption and the risks of AMI.
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Affiliation(s)
- Zeinab Poursafar
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht 4144666949, Iran
| | - Farahnaz Joukar
- Department of Epidemiology, Social Determinants of Health Research Center, Caspian Digestive Diseases Research Center, Guilan University of Medical Sciences, Rasht 4144666949, Iran
| | - Farideh Hasavari
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht 4144666949, Iran
| | - Zahra Atrkar Roushan
- Department of Epidemiology, Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht 4144666949, Iran
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24
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Song J, Jiang X, Cao Y, Juan J, Wu T, Hu Y. Interaction between an ATP-Binding Cassette A1 (ABCA1) Variant and Egg Consumption for the Risk of Ischemic Stroke and Carotid Atherosclerosis: a Family-Based Study in the Chinese Population. J Atheroscler Thromb 2019; 26:835-845. [PMID: 30828007 PMCID: PMC6753237 DOI: 10.5551/jat.46615] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Aims: ATP-binding cassette A1 (ABCA1) plays an important role in reducing the risk of stroke. Egg is the major source of dietary cholesterol and is known to be associated with the risk of stroke and atherosclerosis. We aimed to assess the effects of interaction between an ABCA1 variant (rs2066715) and egg consumption on the risk of ischemic stroke (IS), carotid plaque, and carotid-intima media thickness (CIMT) in the Chinese population. Methods: In total, 5869 subjects (including 1213 IS cases) across 1128 families were enrolled and divided into two groups based on the median egg consumption (4 eggs per week). In the analyses for the presence of carotid plaque and CIMT, 3171 out of 4656 IS-free controls without self-reported history of coronary heart disease and lipid-lowering medications were included. Multilevel logistic regression models were used to model the genetic association of rs2066715 with the risk of IS, and mixed-effect linear regression for the genetic association of rs2066715 with carotid plaque, and CIMT. The gene-by-egg cross-product term was included in the regression model for interaction analysis. Results: We found that rs2066715 was associated with the increased risk of carotid plaque among those who consumed < 4 eggs per week after adjustment (odds ratio [95% confidence interval]: 1.61 [1.08, 2.39], P = 0.019). A significant effect of interaction between rs2066715 and egg consumption on the risk of carotid plaque was identified (P = 0.011). Conclusion: rs2066715 was found to interact with egg consumption in modifying the risk of carotid plaque in the Chinese population.
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Affiliation(s)
- Jing Song
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University
| | - Xia Jiang
- Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health.,Unit of Cardiovascular Epidemiology, Institute of Environmental Health, Karolinska Institute
| | - Yaying Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University
| | - Juan Juan
- Department of Obstetrics and Gynecology, Peking University First Hospital
| | - Tao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University
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25
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Qin C, Lv J, Guo Y, Bian Z, Si J, Yang L, Chen Y, Zhou Y, Zhang H, Liu J, Chen J, Chen Z, Yu C, Li L. Associations of egg consumption with cardiovascular disease in a cohort study of 0.5 million Chinese adults. Heart 2018; 104:1756-1763. [PMID: 29785957 PMCID: PMC6241631 DOI: 10.1136/heartjnl-2017-312651] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 03/05/2018] [Accepted: 03/12/2018] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To examine the associations between egg consumption and cardiovascular disease (CVD), ischaemic heart disease (IHD), major coronary events (MCE), haemorrhagic stroke as well as ischaemic stroke. METHODS During 2004-2008, over 0.5 million adults aged 30-79 years were recruited from 10 diverse survey sites in China. Participants were asked about the frequency of egg consumption and were followed up via linkages to multiple registries and active investigation. Among 461 213 participants free of prior cancer, CVD and diabetes, a total of 83 977 CVD incident cases and 9985 CVD deaths were documented, as well as 5103 MCE. Stratified Cox regression was performed to yield adjusted hazard ratios for CVD endpoints associated with egg consumption. RESULTS At baseline, 13.1% of participants reported daily consumption (usual amount 0.76 egg/day) and 9.1% reported never or very rare consumption (usual amount 0.29 egg/day). Compared with non-consumers, daily egg consumption was associated with lower risk of CVD (HR 0.89, 95% CI 0.87 to 0.92). Corresponding multivariate-adjusted HRs (95% CI) for IHD, MCE, haemorrhagic stroke and ischaemic stroke were 0.88 (0.84 to 0.93), 0.86 (0.76 to 0.97), 0.74 (0.67 to 0.82) and 0.90 (0.85 to 0.95), respectively. There were significant dose-response relationships of egg consumption with morbidity of all CVD endpoints (P for linear trend <0.05). Daily consumers also had an 18% lower risk of CVD death and a 28% lower risk of haemorrhagic stroke death compared to non-consumers. CONCLUSION Among Chinese adults, a moderate level of egg consumption (up to <1 egg/day) was significantly associated with lower risk of CVD, largely independent of other risk factors.
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Affiliation(s)
- Chenxi Qin
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Beijing, China
| | - Jiahui Si
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Ling Yang
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yiping Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yonglin Zhou
- Jiangsu Center for Disease Control and Prevention, Nanjing, China
| | - Hao Zhang
- Liuyang Center for Disease Control and Prevention, Liuyang, China
| | - Jianjun Liu
- Jili Community Health Service, Liuyang, China
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
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26
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Dietary patterns and components to prevent and treat heart failure: a comprehensive review of human studies. Nutr Res Rev 2018; 32:1-27. [DOI: 10.1017/s0954422418000148] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
AbstractGrowing evidence has emerged about the role of dietary patterns and components in heart failure (HF) incidence and severity. The objective here is to provide a comprehensive summary of the current evidence regarding dietary patterns/components and HF. A comprehensive search of online databases was conducted using multiple relevant keywords to identify relevant human studies. The Dietary Approaches to Stop Hypertension (DASH) and Mediterranean diets have consistently been associated with decreased HF incidence and severity. Regarding specific dietary components, fruit, vegetables, legumes and whole grains appear beneficial. Current evidence suggests that red/processed meats, eggs and refined carbohydrates are harmful, while fish, dairy products and poultry remain controversial. However, there is a notable lack of human intervention trials. The existing but limited observational and interventional evidence from human studies suggests that a plant-based dietary pattern high in antioxidants, micronutrients, nitrate and fibre but low in saturated/trans-fat and Na may decrease HF incidence/severity. Potential mechanisms include decreased oxidative stress, homocysteine and inflammation but higher antioxidant defence and NO bioavailability and gut microbiome modulation. Randomised, controlled trials are urgently required.
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27
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Park SJ, Jung JH, Choi SW, Lee HJ. Association between Egg Consumption and Metabolic Disease. Korean J Food Sci Anim Resour 2018; 38:209-223. [PMID: 29805272 PMCID: PMC5960820 DOI: 10.5851/kosfa.2018.38.2.209] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 02/22/2018] [Accepted: 02/28/2018] [Indexed: 11/06/2022] Open
Abstract
The effect of high egg intake on metabolic syndrome (MetS), a major risk factor
for cardiovascular disease (CVD), has not been clearly elucidated. This study
was conducted to review the literature related to egg consumption and the risk
of metabolic disease as well as to examine the association between high egg
intake and MetS in Korean adults. A literature review was conducted using
published papers in PubMed and EMBASE through December 2017. We have reviewed 26
articles, which were associated with egg consumption and metabolic diseases, and
found that the results were controversial. Therefore, we analyzed data from
23,993 Korean adults aged 19 yrs and older. MetS was defined based on criteria
from the Adult Treatment Panel III. Egg consumption of 4-6 times/wk and 1
time/day were significantly associated with reduced prevalence of MetS (Odds
ratio (OR)=0.82; 95% Confidence interval (CI)=0.71-0.95 for 4-6 times/wk,
OR=0.83; 95% CI=0.69-0.99 for 1 time/day) compared to those who consumed eggs
less than once monthly. However, consuming two or more eggs per day was not
associated with MetS. As for the components of MetS, an egg intake of once daily
decreased the prevalence of abdominal obesity and an intake of 2-7 eggs weekly
was shown to prevent a reduction in the high-density lipoprotein cholesterol
levels. This study suggests that while consuming eggs 4-7 times weekly is
associated with a lower prevalence of MetS, consuming two or more eggs daily is
not associated with a reduced risk for MetS.
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Affiliation(s)
- Seon-Joo Park
- Department of Food and Nutrition, College of BioNano Technology, Gachon University, Seongnam 13120, Korea
| | - Ji-Hye Jung
- Institute for Clinical Nutrition, Inje University, Seoul 04551, Korea
| | - Sang-Woon Choi
- Chaum Life Center, CHA University School of Medicine, Seoul 06062, Korea.,Friedman School of Nutrition Science and Policy, Tufts University, Medford 02155, USA
| | - Hae-Jeung Lee
- Department of Food and Nutrition, College of BioNano Technology, Gachon University, Seongnam 13120, Korea
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28
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Egg consumption and the risk of cardiovascular disease and all-cause mortality: Guangzhou Biobank Cohort Study and meta-analyses. Eur J Nutr 2018; 58:785-796. [PMID: 29680985 DOI: 10.1007/s00394-018-1692-3] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 04/13/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE Eggs are highly nutritious but concerns over their cholesterol content have led to dietary avoidance among many. There are also important international differences in relevant dietary guidance. We conducted the first prospective study in China investigating the association of egg consumption, cardiovascular disease (CVD) mortality, and a meta-analysis. METHODS We included 28,024 participants without CVD at baseline (2003-8) in Guangzhou Biobank Cohort Study. All-cause and CVD mortality were identified through record linkage. We used Cox proportional hazards regression. We followed the Meta-analysis Of Observational Studies in Epidemiology reporting guidelines. RESULTS During 275,343 person-years follow-up (average 9.8 years), we found 2685 all-cause and 873 CVD deaths. We found no significant difference in all-cause mortality between higher (7+ eggs/week) and low consumption (< 1 egg/week) [adjusted hazard ratio (HR) 1.08, 95% confidence interval (CI) 0.93-1.24], and mortality from CVD (0.99, 95% CI 0.76-1.27), ischemic heart disease (IHD) (0.92, 95% CI 0.63-1.36), or stroke (0.88, 95% CI 0.57-1.35). The updated meta-analyses including our results showed that 7+ eggs/week was not associated with all-cause mortality (HR 1.09, 95% CI 0.997-1.200) or IHD (HR 0.97, 95% CI 0.90-1.05), but associated with a small reduction in stroke (HR 0.91. 95% CI 0.85-0.98). CONCLUSIONS Eating one egg daily is not associated with increase in CVD or all-cause mortality. The small observed reduction in stroke risk needs to be confirmed. Our findings support current guidelines recommending eggs as part of a healthy diet, and should be considered in other dietary recommendations.
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29
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Dietary Cholesterol, Serum Lipids, and Heart Disease: Are Eggs Working for or Against You? Nutrients 2018; 10:nu10040426. [PMID: 29596318 PMCID: PMC5946211 DOI: 10.3390/nu10040426] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 03/24/2018] [Accepted: 03/27/2018] [Indexed: 12/25/2022] Open
Abstract
The relationship between blood cholesterol and heart disease is well-established, with the lowering of serum low-density lipoprotein (LDL)-cholesterol being the primary target of preventive therapy. Furthermore, epidemiological studies report lower risk for heart disease with higher concentrations of high-density lipoprotein (HDL)-cholesterol. There has also been considerable interest in studying the relationship between dietary cholesterol intake and heart disease risk. Eggs are one of the richest sources of cholesterol in the diet. However, large-scale epidemiological studies have found only tenuous associations between the intake of eggs and cardiovascular disease risk. Well-controlled, clinical studies show the impact of dietary cholesterol challenges via egg intake on serum lipids is highly variable, with the majority of individuals (~2/3 of the population) having only minimal responses, while those with a significant response increase both LDL and HDL-cholesterol, typically with a maintenance of the LDL/HDL cholesterol ratio. Recent drug trials targeting HDL-cholesterol have been unsuccessful in reducing cardiovascular events, and thus it is unclear if raising HDL-cholesterol with chronic egg intake is beneficial. Other important changes with egg intake include potentially favorable effects on lipoprotein particle profiles and enhancing HDL function. Overall, the increased HDL-cholesterol commonly observed with dietary cholesterol feeding in humans appears to also coincide with improvements in other markers of HDL function. However, more investigation into the effects of dietary cholesterol on HDL functionality in humans is warranted. There are other factors found in eggs that may influence risk for heart disease by reducing serum lipids, such as phospholipids, and these may also modify the response to dietary cholesterol found in eggs. In this review, we discuss how eggs and dietary cholesterol affect serum cholesterol concentrations, as well as more advanced lipoprotein measures, such as lipoprotein particle profiles and HDL metabolism.
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30
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Bowen KJ, Sullivan VK, Kris-Etherton PM, Petersen KS. Nutrition and Cardiovascular Disease-an Update. Curr Atheroscler Rep 2018; 20:8. [PMID: 29383458 DOI: 10.1007/s11883-018-0704-3] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW This review summarizes recent developments in nutrition and cardiovascular disease (CVD) prevention. RECENT FINDINGS Contemporary dietary guidance recommends healthy dietary patterns with emphasis on food-based recommendations because the totality of the diet (i.e., the combinations and quantities of foods and nutrients consumed) is an important determinant of health. In many guidelines, recommendations are still made for saturated fat, added sugar, sodium, and dietary cholesterol because these are over-consumed by many people and are related to chronic disease development. Epidemiological research illustrates the importance of considering the total diet and the interrelatedness of nutrients in a dietary pattern. Traditionally, epidemiological research focused on individual nutrients in isolation, which can result in erroneous conclusions. An example of this, which has led to substantial controversy, is the evidence from studies evaluating the association between saturated fat and CVD without considering the replacement nutrient. Another controversial topic is the relationship between dietary cholesterol and CVD, which is confounded by saturated fat intake. Finally, the totality of evidence shows that high sodium intake is associated with greater CVD risk; however, some epidemiological research has suggested that a low-sodium intake is detrimental, which has caused some controversy. Overall, this reductionist approach has led to a debate about recommendations for saturated fat, cholesterol, and sodium. However, if approaches that accounted for the interrelatedness of nutrients had been taken, it is likely that there would be less controversy about these nutrients. To encourage dietary pattern-based approaches and consideration of total intake, dietary guidelines should emphasize food-based recommendations that meet nutrient targets. Thus, nutrient targets should underpin food-based dietary guidelines, and recommended dietary patterns should comply with nutrient-based targets. The evidence reviewed shows that it is imperative to consider total dietary patterns for CVD prevention. Dietary guidance should be aligned with nutrient targets and recommendations should be food and dietary pattern based.
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Affiliation(s)
- Kate J Bowen
- Department of Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA, 16802, USA
| | - Valerie K Sullivan
- Department of Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA, 16802, USA
| | - Penny M Kris-Etherton
- Department of Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA, 16802, USA
| | - Kristina S Petersen
- Department of Nutritional Sciences, The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA, 16802, USA.
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31
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Abstract
Evidence supporting the role of nutrition in heart failure (HF) incidence and severity is growing. A comprehensive search of online databases was conducted using relevant keywords to identify human studies including diet and HF. Several plant-based diets have consistently been associated with decreased HF incidence and severity, notably the Dietary Approaches to Stop Hypertension (DASH) and Mediterranean diets. Several other plant-based dietary patterns, including low-fat diets and the rice diet, also show promise. Higher dietary quality, as assessed using different scores, seems to provide protective qualities. Fruit, vegetables, legumes and wholegrains appear to be beneficial, whereas red/processed meats, eggs and refined carbohydrates appear harmful. Some evidence suggests detrimental effects of dairy products and poultry, but more research is needed. There is observational and interventional evidence that a plant-based diet high in antioxidants, micronutrients, nitrate and fibre but low in saturated/trans fats may decrease the incidence and severity of HF. Potential mechanisms for this include decreased oxidative stress, homocysteine and inflammation levels, as well as higher antioxidant defence and nitric oxide bioavailability with gut microbiome modulation. Well-designed randomised, controlled nutrition intervention trials specific to HF are urgently required.
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Affiliation(s)
- Conor P Kerley
- Chronic Cardiovascular Disease Management Unit and Heart Failure Unit, St Vincent's Healthcare Group/St Michael's Hospital Dublin, Ireland
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32
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Bechthold A, Boeing H, Schwedhelm C, Hoffmann G, Knüppel S, Iqbal K, De Henauw S, Michels N, Devleesschauwer B, Schlesinger S, Schwingshackl L. Food groups and risk of coronary heart disease, stroke and heart failure: A systematic review and dose-response meta-analysis of prospective studies. Crit Rev Food Sci Nutr 2017; 59:1071-1090. [PMID: 29039970 DOI: 10.1080/10408398.2017.1392288] [Citation(s) in RCA: 359] [Impact Index Per Article: 51.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Despite growing evidence for food-based dietary patterns' potential to reduce cardiovascular disease risk, knowledge about the amounts of food associated with the greatest change in risk of specific cardiovascular outcomes and about the quality of meta-evidence is limited. Therefore, the aim of this meta-analysis was to synthesize the knowledge about the relation between intake of 12 major food groups (whole grains, refined grains, vegetables, fruits, nuts, legumes, eggs, dairy, fish, red meat, processed meat, and sugar-sweetened beverages [SSB]) and the risk of coronary heart disease (CHD), stroke and heart failure (HF). METHODS We conducted a systematic search in PubMed and Embase up to March 2017 for prospective studies. Summary risk ratios (RRs) and 95% confidence intervals (95% CI) were estimated using a random effects model for highest versus lowest intake categories, as well as for linear and non-linear relationships. RESULTS Overall, 123 reports were included in the meta-analyses. An inverse association was present for whole grains (RRCHD: 0.95 (95% CI: 0.92-0.98), RRHF: 0.96 (0.95-0.97)), vegetables and fruits (RRCHD: 0.97 (0.96-0.99), and 0.94 (0.90-0.97); RRstroke: 0.92 (0.86-0.98), and 0.90 (0.84-0.97)), nuts (RRCHD: 0.67 (0.43-1.05)), and fish consumption (RRCHD: 0.88 (0.79-0.99), RRstroke: 0.86 (0.75-0.99), and RRHF: 0.80 (0.67-0.95)), while a positive association was present for egg (RRHF: 1.16 (1.03-1.31)), red meat (RRCHD: 1.15 (1.08-1.23), RRstroke: 1.12 (1.06-1.17), RRHF: 1.08 (1.02-1.14)), processed meat (RRCHD: 1.27 (1.09-1.49), RRstroke: 1.17 (1.02-1.34), RRHF: 1.12 (1.05-1.19)), and SSB consumption (RRCHD: 1.17 (1.11-1.23), RRstroke: 1.07 (1.02-1.12), RRHF: 1.08 (1.05-1.12)) in the linear dose-response meta-analysis. There were clear indications for non-linear dose-response relationships between whole grains, fruits, nuts, dairy, and red meat and CHD. CONCLUSION An optimal intake of whole grains, vegetables, fruits, nuts, legumes, dairy, fish, red and processed meat, eggs and SSB showed an important lower risk of CHD, stroke, and HF.
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Affiliation(s)
| | - Heiner Boeing
- b Department of Epidemiology , German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE) , Nuthetal , Germany
| | - Carolina Schwedhelm
- b Department of Epidemiology , German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE) , Nuthetal , Germany
| | - Georg Hoffmann
- c Department of Nutritional Sciences , University of Vienna , Vienna , Austria
| | - Sven Knüppel
- b Department of Epidemiology , German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE) , Nuthetal , Germany
| | - Khalid Iqbal
- b Department of Epidemiology , German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE) , Nuthetal , Germany
| | | | - Nathalie Michels
- d Department of Public Health , Ghent University , Gent , Belgium
| | - Brecht Devleesschauwer
- e Department of Public Health and Surveillance , Scientific Institute of Public Health (WIV-ISP) , Brussels , Belgium
| | - Sabrina Schlesinger
- f Institute for Biometry and Epidemiology, Deutsches Diabetes-Zentrum (DDZ) at Heinrich Heine University Düsseldorf , Düsseldorf , Germany
| | - Lukas Schwingshackl
- b Department of Epidemiology , German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE) , Nuthetal , Germany
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Guo J, Hobbs DA, Cockcroft JR, Elwood PC, Pickering JE, Lovegrove JA, Givens DI. Association between egg consumption and cardiovascular disease events, diabetes and all-cause mortality. Eur J Nutr 2017; 57:2943-2952. [PMID: 29098427 PMCID: PMC6267402 DOI: 10.1007/s00394-017-1566-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 10/13/2017] [Indexed: 01/26/2023]
Abstract
Purpose The association between egg consumption and cardiovascular disease (CVD) or type 2 diabetes (T2D) remains controversial. We investigated the association between egg consumption and risk of CVD (primary outcome), T2D and mortality in the Caerphilly prospective cohort study (CAPS) and National Diet and Nutritional Survey (NDNS). Methods CAPS included 2512 men aged 45–59 years (1979–1983). Dietary intake, disease incidence and mortality were updated at 5-year intervals. NDNS included 754 adults aged 19–64 years from 2008 to 2012. Results Men free of CVD (n = 1781) were followed up for a mean of 22.8 years, egg consumption was not associated with new incidence of CVD (n = 715), mortality (n = 1028) or T2D (n = 120). When stroke (n = 248), MI (n = 477), heart failure (n = 201) were investigated separately, no associations between egg consumption and stroke and MI were identified, however, increased risk of stroke in subjects with T2D and/or impaired glucose tolerance (IGT, fasting plasma glucose ≥ 6.1 mmol/L), adjusted hazard ratios (95% CI) were 1.0 (reference), 1.09 (0.41, 2.88), 0.96 (0.37, 2.50), 1.39 (0.54, 3.56) and 2.87 (1.13, 7.27) for egg intake (n) of 0 ≤ n ≤ 1, 1 < n ≤ 2, 2 < n ≤ 3, 3 < n < 5, and n ≥ 5 eggs/wk, respectively (P = 0.01). In addition, cross-sectional analyses revealed that higher egg consumption was significantly associated with elevated fasting glucose in those with T2D and/or IGT (CAPS: baseline P = 0.02 and 5-year P = 0.04; NDNS: P = 0.05). Conclusions Higher egg consumption was associated with higher blood glucose in subjects with T2D and/or IGT. The increased incidence of stroke with higher egg consumption among T2D and/or IGT sub-group warrants further investigation. Electronic supplementary material The online version of this article (doi:10.1007/s00394-017-1566-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jing Guo
- Institute for Food, Nutrition and Health, University of Reading, Reading, RG6 6AR, UK.,Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, RG6 6AR, UK
| | - Ditte A Hobbs
- Hugh Sinclair Unit of Human Nutrition, University of Reading, Reading, RG6 6AR, UK.,Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, RG6 6AR, UK
| | | | - Peter C Elwood
- Department of Primary Care and Public Health, Cardiff University, Cardiff, UK
| | - Janet E Pickering
- Institute for Food, Nutrition and Health, University of Reading, Reading, RG6 6AR, UK
| | - Julie A Lovegrove
- Institute for Food, Nutrition and Health, University of Reading, Reading, RG6 6AR, UK. .,Hugh Sinclair Unit of Human Nutrition, University of Reading, Reading, RG6 6AR, UK. .,Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, RG6 6AR, UK.
| | - David I Givens
- Institute for Food, Nutrition and Health, University of Reading, Reading, RG6 6AR, UK.,Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, RG6 6AR, UK
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34
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Egg consumption, cardiovascular diseases and type 2 diabetes. Eur J Clin Nutr 2017; 72:44-56. [PMID: 28952608 DOI: 10.1038/ejcn.2017.153] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 08/07/2017] [Accepted: 08/15/2017] [Indexed: 01/05/2023]
Abstract
Eggs are rich in nutrients and a source of essential fatty- and amino acids, and the food item with highest cholesterol content. Since the 1970s dietary recommendations have advised limiting egg intake to 2-4 a week for the healthy population, and in those diagnosed with cardiovascular disease (CVD) and type 2 diabetes (T2D) an even more restricted consumption. The aim of the present paper was to assess the recommendation to lower the dietary intake of cholesterol and especially the intake of egg to reduce the risk of CVD and T2D. We performed three web-based literature searches on human studies (observational and interventional) published within the past 10 years during spring 2015. High-quality intervention studies have found nonsignificant effects of increasing the consumption of eggs on risk markers for CVD and T2D in healthy subjects and subjects with T2D. The risk associations found in the observational studies are more likely to be attributed to a dietary pattern often accompanying high egg intake and/or the cluster of other risk factors in people with high egg consumption. Dietary patterns, physical activity and genetics affect the predisposition of CVD and T2D more than a single food item as eggs. In conclusion, up to seven eggs per week can safely be consumed, but in patients with established CVD or T2D only with special emphasis on a healthy lifestyle.
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Larsson SC. Dietary Approaches for Stroke Prevention. Stroke 2017; 48:2905-2911. [PMID: 28818862 DOI: 10.1161/strokeaha.117.017383] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 07/02/2017] [Accepted: 07/28/2017] [Indexed: 11/16/2022]
Affiliation(s)
- Susanna C Larsson
- From the Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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Khawaja O, Singh H, Luni F, Kabour A, Ali SS, Taleb M, Ahmed H, Gaziano JM, Djoussé L. Egg Consumption and Incidence of Heart Failure: A Meta-Analysis of Prospective Cohort Studies. Front Nutr 2017; 4:10. [PMID: 28396858 PMCID: PMC5367008 DOI: 10.3389/fnut.2017.00010] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 03/13/2017] [Indexed: 01/27/2023] Open
Abstract
Introduction Heart failure (HF) remains a major health problem affecting 5.7 million adults in USA. Data on the association of egg consumption with incident HF have been inconsistent. We, therefore, conducted this meta-analysis of prospective cohort studies to assess the relation of egg consumption with incident HF in the general population. Methods Using extensive online search, we conducted a meta-analysis of new onset HF following exposure to egg consumption. A random effects model was used and between studies heterogeneity was estimated with I2. Publication bias was assessed graphically using a funnel plot. All analyses were performed with Comprehensive Meta-Analysis (version 2.2.064). Results We identified four prospective cohorts for a total of 105,999 subjects and 5,059 cases of new onset HF. When comparing the highest (≥1/day) to the lowest category of egg consumption, pooled relative risk of HF was 1.25 (95% confidence interval = 1.12–1.39; p = 0.00). There was no evidence for heterogeneity (I2 = 0%) nor publication bias. On sensitivity analysis, stratification by gender differences, follow-up duration, and region where study was conducted did not alter the main conclusion. Conclusion Our meta-analysis suggests an elevated risk of incident HF with frequent egg consumption.
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Affiliation(s)
- Owais Khawaja
- Department of Cardiology, Mercy St. Vincent Medical Center , Toledo, OH , USA
| | - Hemindermeet Singh
- Department of Cardiology, Mercy St. Vincent Medical Center , Toledo, OH , USA
| | - Faraz Luni
- Department of Cardiology, Mercy St. Vincent Medical Center , Toledo, OH , USA
| | - Ameer Kabour
- Department of Cardiology, Mercy St. Vincent Medical Center , Toledo, OH , USA
| | - Syed S Ali
- Department of Cardiology, Mercy St. Vincent Medical Center , Toledo, OH , USA
| | - Mohammed Taleb
- Department of Cardiology, Mercy St. Vincent Medical Center , Toledo, OH , USA
| | - Hafeezuddin Ahmed
- Department of Cardiology, Mercy St. Vincent Medical Center , Toledo, OH , USA
| | - John Michael Gaziano
- Division of Aging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Massachusetts Veterans Epidemiology and Research Information Center (MAVERIC), Boston Veterans Affairs Healthcare System, Boston, MA, USA; Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Geriatric Research, Education, and Clinical Center (GRECC), Boston Veterans Affairs Healthcare System, Boston, MA, USA
| | - Luc Djoussé
- Division of Aging, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Geriatric Research, Education, and Clinical Center (GRECC), Boston Veterans Affairs Healthcare System, Boston, MA, USA
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Contrasting association between alcohol consumption and risk of myocardial infarction and heart failure: Two prospective cohorts. Int J Cardiol 2016; 231:207-210. [PMID: 28043668 DOI: 10.1016/j.ijcard.2016.12.149] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Revised: 11/19/2016] [Accepted: 12/21/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND The potential cardioprotective effect of light-to-moderate alcohol consumption is disputed, and the association between heavy drinking and heart failure (HF) risk is unclear. We examined the association between alcohol consumption and risk of myocardial infarction (MI) and HF in two prospective cohorts. METHODS We analyzed data from the Cohort of Swedish Men (40,590 men) and the Swedish Mammography Cohort (34,022 women). Participants were free of ischemic heart disease and HF at baseline. MI and HF cases were ascertained by linkage with the Swedish National Patient Register. Cox proportional hazards regression model was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). RESULTS During follow-up (1998-2010), we ascertained 3678 and 1905 cases of MI and HF, respectively, in men and 1500 and 1328 cases of MI and HF, respectively, in women. Alcohol consumption was inversely associated with MI in both men and women (P trend <0.001); compared with light drinkers, the multivariable HRs were 0.70 (95% CI, 0.56-0.87) in men who consumed >28 drinks/week and 0.32 (95% CI, 0.15-0.67) in women who consumed 15-21 drinks/week. Alcohol consumption was not inversely associated with HF risk. However, in men, the risk of HF was higher in never, former, and heavy drinkers (>28 drinks/week; HR=1.45; 95% CI, 1.09-1.93) compared with light drinkers. CONCLUSIONS Alcohol consumption has divergent associations with MI and HF, with an inverse association observed for MI but not HF. Heavy drinking was associated with an increased HF risk in men.
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Larsson SC, Wolk A. Potato consumption and risk of cardiovascular disease: 2 prospective cohort studies. Am J Clin Nutr 2016; 104:1245-1252. [PMID: 27680993 DOI: 10.3945/ajcn.116.142422] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 09/01/2016] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Whether consumption of potatoes, which are rich in potassium and have a high glycemic index and glycemic load, is associated with the risk of cardiovascular disease (CVD) is unknown. OBJECTIVE The aim was to examine the association between potato consumption and risk of total and specific CVD events as well as mortality from CVD in 2 prospective cohorts of Swedish adults, a population with a high consumption of potatoes. DESIGN Information on potato consumption was available from 69,313 men and women, free of CVD and diabetes, in the Cohort of Swedish Men and the Swedish Mammography Cohort. Nonfatal and fatal cases of CVD diagnosed over 13 y of follow-up were identified by linkage with the Swedish National Patient and Cause of Death Registers. Analyses were conducted by using a Cox proportional hazards regression model, controlled for potential confounders. RESULTS We ascertained 10,147 major CVD events [myocardial infarction (MI), heart failure (HF), and stroke] and 4003 deaths due to CVD. Total potato consumption was not associated with the risk of major CVD events, specific CVD endpoints, or CVD mortality in either men or women. Multivariable HRs (95% CIs) per an increment of 3 servings/wk of total potato consumption (boiled potatoes, fried potatoes, and French fries) were 1.00 (0.97, 1.02) for major CVD events, 1.01 (0.97, 1.04) for MI, 0.97 (0.93, 1.02) for HF, 1.01 (0.97, 1.05) for stroke, and 0.99 (0.95, 1.03) for CVD mortality. There were no significant trends between the consumption of boiled potatoes, fried potatoes, or French fries and risk of any CVD outcome. CONCLUSION Potato consumption was not associated with the risk of CVD in this population. The Swedish Mammography Cohort and the Cohort of Swedish Men are registered at clinicaltrials.gov as NCT01127698 and NCT01127711, respectively.
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Affiliation(s)
- Susanna C Larsson
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Alicja Wolk
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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