Dietary Intakes of Eggs and Cholesterol in Relation to All‐Cause and Heart Disease Mortality: A Prospective Cohort Study

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).

Dietary habits of patients with coronary artery disease in a tertiary-care hospital of Bangladesh: a case-controlled study

“…Although most information on the nutritional risk factors CVD is derived (not clear) from the western reports, the prevalence of CVD is rapidly evolving towards epidemic proportions in the LEDCs with rapid changes in people’s lifestyle and food consumption behavior over the past few years [ 8 , 9 ] . However, a study in the USA did not find a significant association between dietary intake of eggs and all-cause and heart disease mortality among the US adults, whereas the total dietary cholesterol intake at high levels seemed to be associated with the higher risk of all-cause mortality [ 10 ].…”

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

“…The epidemiologic evidence regarding dietary cholesterol/eggs with health outcomes among non-White populations has been limited. To our knowledge, only two studies have examined the associations of cholesterol intake with cardiometabolic disease or all-cause mortality among Black Americans, including a subgroup analysis of 9204 Black Americans from a pooling project of six cohorts in the US and an analysis of 7683 Black Americans using the NHANES 1999–2014 data [ 12 , 30 ]. Consistent with our findings, both studies reported positive associations of cholesterol intake with all-cause mortality among Black Americans.…”

“…Consistent with our findings, both studies reported positive associations of cholesterol intake with all-cause mortality among Black Americans. However, neither study, with small sample sizes, reported varied cholesterol–mortality associations across ethnicities [ 12 , 30 ]. Among White Americans, the null association between cholesterol and cardiometabolic mortality we observed was in line with the findings from two systematic reviews of 17 cohort studies [ 6 , 10 ], which included primarily white populations.…”

“…Across populations, a 2020 meta-analysis of 28 prospective studies including 1.72 million participants showed that 1 egg/day was not associated with a risk of CVD and its subtypes, whereas with stratification by geographic regions, a significant inverse association (8% decrease in CVD risk for 1 egg/day increase) was observed in Asian cohorts but not in US or European cohorts, which supports our ethnicity-specific findings [ 11 ]. Besides the different intake levels of eggs (higher in Chinese and Black Americans than in White Americans) in our study, the possible heterogeneity across ethnicities may reflect different egg consumption patterns: eggs were typically consumed with meats and refined grains in western populations but with vegetables in Chinese populations [ 30 ]. Thus, caution should be taken in interpreting the harms or benefits of eggs across ethnicities due to the observational nature of the current analyses, as there remains possible residual confounding from sociodemographics and lifestyle factors.…”

RNA Sequencing Reveals Key Metabolic Pathways Are Modified by Short-Term Whole Egg Consumption

“…It is important that we examined these differences in gene expression, as we identified upregulation not only in VAT, but also observed an increase of glutathione S-transferase mu 2 (Gstm2) expression in the PFC of rats fed WE-based diet. These are important considerations, as the data from clinical trials regarding WE consumption on inflammation-mediated cardiovascular disease are nuanced and remain contradictory ( 7 , 48 – 50 ). When specifically examining genes associated with disease we identified SPP1 which was down regulated 8.8-fold in VAT after consumption of the WE diet.…”