Cholesterol and Egg Intakes with Cardiometabolic and All-Cause Mortality among Chinese and Low-Income Black and White Americans

Abstract

We examined the associations of dietary cholesterol and egg intakes with cardiometabolic and all-cause mortality among Chinese and low-income Black and White Americans. Included were 47,789 Blacks, 20,360 Whites, and 134,280 Chinese aged 40–79 years at enrollment. Multivariable Cox models with restricted cubic splines were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality outcomes using intakes of 150 mg cholesterol/day and 1 egg/week as the references. Cholesterol intake showed a nonlinear association with increased all-cause mortality and a linear association with increased cardiometabolic mortality among Black Americans: HRs (95% CIs) associated with 300 and 600 mg/day vs. 150 mg/day were 1.07 (1.03–1.11) and 1.13 (1.05–1.21) for all-cause mortality (P-linearity = 0.04, P-nonlinearity = 0.002, and P-overall < 0.001) and 1.10 (1.03–1.16) and 1.21 (1.08–1.36) for cardiometabolic mortality (P-linearity = 0.007, P-nonlinearity = 0.07, and P-overall = 0.005). Null associations with all-cause or cardiometabolic mortality were noted for White Americans (P-linearity ≥ 0.13, P-nonlinearity ≥ 0.06, and P-overall ≥ 0.05 for both). Nonlinear inverse associations were observed among Chinese: HR (95% CI) for 300 vs. 150 mg/day was 0.94 (0.92–0.97) for all-cause mortality and 0.91 (0.87–0.95) for cardiometabolic mortality, but the inverse associations disappeared with cholesterol intake > 500 mg/day (P-linearity ≥ 0.12; P-nonlinearity ≤ 0.001; P-overall < 0.001 for both). Similarly, we observed a positive association of egg intake with all-cause mortality in Black Americans, but a null association in White Americans and a nonlinear inverse association in Chinese. In conclusion, the associations of cholesterol and egg intakes with cardiometabolic and all-cause mortality may differ across ethnicities who have different dietary patterns and cardiometabolic risk profiles. However, residual confounding remains possible.

Eggs and Cardiovascular Disease Risk: An Update of Recent Evidence

“…1 ). From the 30 studies, 13 were conducted with data from populations living in the USA [ 24 , 25 ••, 26 – 29 , 30 •, 31 – 34 , 35 •, 36 ], eight from China [ 15 , 35 •, 37 , 38 ••, 39 – 42 ], eight from Europe [ 43 – 50 ], one from Iran [ 51 ], and one was a multinational cohort study [ 52 •].

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“…The majority (> 50%) of studies controlled for age, gender, education, smoking status, alcohol consumption, physical activity, energy intake, BMI, hypertension, and diabetes. Two studies (7%) controlled for saturated fat intake [ 25 ••, 30 •], eleven studies (37%) controlled for vegetable intake [ 28 , 29 , 36 , 38 ••, 39 , 41 , 42 , 48 – 50 , 52 •], six studies (20%) controlled for meat intake [ 26 , 38 ••, 39 , 41 , 50 , 52 •] (two (6%) for processed meat [ 26 , 50 ]), three (10%) for Mediterranean diet score [ 28 , 44 , 46 ], three (10%) for dietary approaches to stop hypertension (DASH) score [ 31 – 33 ], and six (20%) for diet quality [ 24 , 26 , 34 , 35 •, 37 , 51 ]. Three (10%) studies which were across multiple countries controlled for center or region but not ethnicity [ 45 , 48 , 52 •].…”

Whole transcriptome sequencing reveals key genes and ceRNA regulatory networks associated with pimpled eggs in hens

“…Eggs are widely consumed worldwide for their rich nutrient content as well as their high digestibility, and are considered an important source of animal protein for humans ( Ahmed et al, 2021 ; Pan et al, 2021 ). Eggshells not only provide mechanical protection for egg contents but also influence consumer choice, and eggshell quality is an important economic indicator for the egg industry ( Hahn et al, 2017 ; Rondoni et al, 2020 ).…”

TMT-based quantitative proteomic analysis unveils uterine fluid difference in hens producing normal and pimpled eggs

“…Chicken eggs, mainly composed of shell (including membrane), albumen, and yolk, are considered a significant source of animal protein for humans ( Ahmed et al, 2021 ; Pan et al, 2021 ; Zhang et al, 2022 ). Eggshell provides mechanical protection to egg contents while ensuring gas exchange and calcium for the developing embryo ( Hahn et al, 2017 ).…”