ArticleLiterature Review

Meta-analysis of Egg Consumption and Risk of Coronary Heart Disease and Stroke

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Abstract

The possible relationship between dietary cholesterol and cardiac outcomes has been scrutinized for decades. However, recent reviews of the literature have suggested that dietary cholesterol is not a nutrient of concern. Thus, we conducted a meta-analysis of egg intake (a significant contributor to dietary cholesterol) and risk of coronary heart disease (CHD) and stroke. A comprehensive literature search was conducted through August 2015 to identify prospective cohort studies that reported risk estimates for egg consumption in association with CHD or stroke. Random-effects meta-analysis was used to generate summary relative risk estimates (SRREs) for high vs low intake and stratified intake dose–response analyses. Heterogeneity was examined in subgroups where sensitivity and meta regression analyses were conducted based on increasing egg intake. A 12% decreased risk (SRRE = 0.88, 95% confidence interval [CI], 0.81–0.97) of stroke was observed in the meta-analysis of 7 studies of egg intake (high vs low; generally 1/d vs <2/wk), with little heterogeneity (p-H = 0.37, I² = 7.50). A nonstatistically significant SRRE of 0.97 (95% CI, 0.88–1.07, p-H = 0.67, I² = 0.00) was observed in the meta-analysis of 7 studies of egg consumption and CHD. No clear dose–response trends were apparent in the stratified intake meta-analyses or the meta regression analyses. Based on the results of this meta-analysis, consumption of up to one egg daily may contribute to a decreased risk of total stroke, and daily egg intake does not appear to be associated with risk of CHD. Key Teaching Points: • The role of egg consumption in the risk of stroke and coronary heart disease has come under scrutiny over many years. • A comprehensive meta-analysis of prospective cohort studies that reported risk estimates for egg consumption in association with CHD or stroke was performed on the peer-reviewed epidemiologic literature through August 2015. • Overall, summary associations indicate that intake of up to 1 egg daily may be associated with reduced risk of total stroke. • Overall, summary associations show no clear association between egg intake and increased or decreased risk of CHD. • Eggs are a relatively low-cost and nutrient-dense whole food that provides a valuable source of protein, essential fatty acids, antioxidants, choline, vitamins, and minerals.

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... Epidemiological studies have shown that high concentrations of plasma cholesterol levels, especially low-density lipoprotein cholesterol (LDL-C), is directly positively correlated with CVDs, while high-density lipoprotein cholesterol (HDL-C) is negatively associated with CVDs (Chen & Levy, 2016). An increasing number of prospective cohort studies (Kurotani et al., 2014;Nakamura et al., 2006;Zazpe et al., 2011;Zhong et al., 2019), human intervention Lemos et al., 2018;Missimer et al., 2017;Rueda & Khosla, 2013), and meta-analytical evidence (Alexander et al., 2016;Godos et al., 2020;Rong et al., 2013;Shin et al., 2013;Tamez et al., 2016;Xu et al., 2019) ultimately lead to consensus: compared to other lifestyle factors, egg intake does affect cholesterol levels in the blood, but produce relatively small and clinically insignificant effects on the level of plasma LDL-C/HDL-C, the morbidity and mortality risk of stroke, heart disease, and CVDs in healthy people. ...
... However, there seemed to be a positive relationship between egg intake and CVDs risk in patients with diabetic CVDs (Rong et al., 2013;Tamez et al., 2016;Zhong et al., 2019), uncertain relationship (Zazpe et al., 2011), or no relationship (Alexander et al., 2016;Kurotani et al., 2014). The reason for the inconsistency may be that volunteers in above studies came from different regions. ...
... There were no significant or negative correlation between egg consumption and risk of CVDs, stroke, and type 2 diabetes in non-U.S. regions, such as China, Japan, and Finland (Alexander et al., 2016;Kurotani et al., 2014;Tamez et al., 2016;Xu et al., 2019;Zazpe et al., 2011). Most of the above studies were from the western populations, only three were from Japan (Alexander et al., 2016;Nakamura et al., 2006;Shin et al., 2013) and two of the epidemiological survey and cohort study were from China (Qin et al., 2018;Xu et al., 2019), which worked on the effect of egg consumption on lipoprotein metabolism or the risk of CVDs. ...
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Approximately 90% of the cholesterol content of the body is derived from de novo synthesis and the enterohepatic circulation. As numerous studies have shown previously, one egg per day intake has little impact of cholesterol balance in human body. Therefore, this study assumed that intake of up two eggs a day has little effect on biomarkers of cardiovascular diseases (CVDs) risk in Chinese young adults. With the increase in egg intake, total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and choline all increased among all the groups as the study progressed from autumn to winter (p < .05). However, there were no differences in the plasma triglycerides, LDL-C/HDL-C ratio, glucose, liver enzymes, C-reactive protein, and urinary microalbumin during the diet periods. Subjects who ate eggs at breakfast felt less hungry and more satisfied, which were relative with decreased fasting plasma ghrelin level (p < .05). Furthermore, egg-derived cholesterol appeared to upregulate the mRNA levels of low-density lipoprotein receptor and lecithin–cholesterol acyltransferase, and downregulate cholesteryl ester transfer protein and flavin-containing monooxygenase 3 mRNA levels in isolated peripheral blood mononuclear cells. These results demonstrate that intake of up to two eggs a day had little effect on biomarkers of CVDs in young, healthy Chinese college students and provided useful evidence for the dietary guidelines regarding egg consumption.
... To underscore the lack of evidence supporting the link between dietary SFA intake and cardiovascular health, foods containing a high proportion of fat calories as SFA have largely failed to be associated with CVD outcomes ( Table 6). [94][95][96][97][98][99][100][101] Despite the established recommendation to eliminate or reduce red meat, full-fat dairy products, butter, and eggs, 21 recent meta-analyses have found that total dairy, 96 milk, 96 high-fat dairy, 97 cheese, 98 butter, 99 eggs, 100 and unprocessed red meat 94 are not associated with CVD outcomes. [96][97][98][99][100] In 2 meta-analyses of RCTs, total red meat intake 101,102 was not associated with cardiovascular risk factors. ...
... To underscore the lack of evidence supporting the link between dietary SFA intake and cardiovascular health, foods containing a high proportion of fat calories as SFA have largely failed to be associated with CVD outcomes ( Table 6). [94][95][96][97][98][99][100][101] Despite the established recommendation to eliminate or reduce red meat, full-fat dairy products, butter, and eggs, 21 recent meta-analyses have found that total dairy, 96 milk, 96 high-fat dairy, 97 cheese, 98 butter, 99 eggs, 100 and unprocessed red meat 94 are not associated with CVD outcomes. [96][97][98][99][100] In 2 meta-analyses of RCTs, total red meat intake 101,102 was not associated with cardiovascular risk factors. ...
... [94][95][96][97][98][99][100][101] Despite the established recommendation to eliminate or reduce red meat, full-fat dairy products, butter, and eggs, 21 recent meta-analyses have found that total dairy, 96 milk, 96 high-fat dairy, 97 cheese, 98 butter, 99 eggs, 100 and unprocessed red meat 94 are not associated with CVD outcomes. [96][97][98][99][100] In 2 meta-analyses of RCTs, total red meat intake 101,102 was not associated with cardiovascular risk factors. Coconut oil, which is the richest source of SFA at 92% of total fat, decreased LDL-c compared with butter and elicited no change in LDL-c compared with olive oil. ...
Article
The American Heart Association (AHA) recently published a meta-analysis that confirmed their 60-year-old recommendation to limit saturated fat (SFA, saturated fatty acid) and replace it with polyunsaturated fat to reduce the risk of heart disease based on the strength of 4 Core Trials. To assess the evidence for this recommendation, meta-analyses on the effect of SFA consumption on heart disease outcomes were reviewed. Nineteen meta-analyses addressing this topic were identified: 9 observational studies and 10 randomized controlled trials. Meta-analyses of observational studies found no association between SFA intake and heart disease, while meta-analyses of randomized controlled trials were inconsistent but tended to show a lack of an association. The inconsistency seems to have been mediated by the differing clinical trials included. For example, the AHA meta-analysis only included 4 trials (the Core Trials), and those trials contained design and methodological flaws and did not meet all the predefined inclusion criteria. The AHA stance regarding the strength of the evidence for the recommendation to limit SFAs for heart disease prevention may be overstated and in need of reevaluation.
... Thirteen (44.8%) of the 29 included reviews were conducted in China (5,6,8,(17)(18)(19)(20)(21)(22)(23)(24)(25)(26), 6 in the USA (10,(27)(28)(29)(30)(31), three in Iran (32)(33)(34), and 1 each in France (35), the Netherlands (36), Japan (9), Australia (7), Sweden (37), Canada (38) and Singapore (39). Twenty-six reviews were quantitative analyses and the remaining three (10,35,38) were qualitative studies. ...
... Nine reviews (5,6,8,21,24,31,34,35,39) included less than ten original studies. Most (n=21) reviews (6)(7)(8)(9)(10)17,(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)33,37) had a total sample of more than 10,000 participants. ...
... Ten studies (6,(8)(9)(10)20,21,26,30,31,39) examined the close to that of the estimate of the effect; moderate: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different; low: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect; very low: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. OS, observational study; RCT, randomized controlled trial. ...
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Background: Several systematic reviews and meta-analyses have assessed the association between egg consumption and human health, but the evidence is often conflicting. Methods: We conducted a systematic literature search to find all systematic reviews and meta-analyses that assess the association between egg consumption and any type of health outcome. We used AMSTAR to evaluate the methodological quality of the reviews, and GRADE to determine the quality of evidence. We visualized the results using a human anatomy diagram and evidence mapping. Results: Our search revealed 29 systematic reviews and meta-analyses. Eight studies were of high methodological quality, 16 studies of medium quality, and five studies of low quality. We identified 34 primary outcomes from the included 29 reviews, which were combined into a total of 22 different health outcomes. Two of the primary outcomes were based on high-quality evidence, 18 on moderate-quality evidence, and 14 on low-quality evidence. Egg consumption was associated with an increased risk of two diseases and decreased risk of six outcomes. For ten outcomes, no significant association was found, and for four outcomes, different reviews came to conflicting conclusions. Conclusions: The association between egg consumption and the risk of cancer, diabetes, cardiovascular diseases and other related diseases has been studied in several meta-analyses. The evidence from different studies on the same topic was often conflicting, which can complicate the making of dietary recommendations.
... Five studies showed an increased risk of stroke (5,10,12,16,18,22), although the results were not statistically significant, some indicated a significant or non-significant inverse relationship (6-8, 17, 20, 21), and only one study revealed no association (14). To provide a reliable quantitative assessment of this association, several meta-analyses were performed (19,20,(23)(24)(25)(26). Previous studies mainly involved the relationship between total stroke and egg consumption, but few investigations clarified the effect of sex, stroke type, dose-response on stroke risk, and regional difference. ...
... Thus, this issue requires further verification in future studies. The relationship between egg consumption and stroke risk has been addressed in several meta-analyses and systematic reviews (19,20,(22)(23)(24)(25). Two meta-analyses published before June 2012, which incorporated half a dozen studies, showed a non-statistically significant inverse association between the highest vs. lowest egg intakes and stroke risk (22,23). ...
... This finding was confirmed in a later metaanalysis of nine studies, but the shape of the dose-response curve was unclear (20). Another two meta-analyses published in 2019 showed a non-statistically significant positive association (19) or no association between egg intake and stroke risk and no evidence of a non-linear dose-response association (25). Compared with previous meta-analyses, our current study included 16 articles, involving 24 cohort studies, and thus provided relatively reliable estimates. ...
Article
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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.
... Another similar analysis included 7 prospective cohort studies which looked specifically at egg consumption with risk of ASCVD. Interestingly, the authors demonstrated a statistically significant lower risk of stroke in the high consuming group (approximately 1 egg per day) when compared to the low consumers (less than 2 eggs per week) with a summary relative risk estimate of 0.88 [57]. Furthermore, there was no significant association with risk of CHD. ...
... As mentioned previously, multiple meta-analyses [55][56][57][58]61] have been conducted that explore the association between stroke risk and egg consumption. Largely, there has been no significant evidence that egg consumption increases stroke risk. ...
... Largely, there has been no significant evidence that egg consumption increases stroke risk. In fact, a number of meta-analyses have shown a decrease in stroke risk [56][57][58] with increased egg consumption consistent with prior prospective observational data mentioned above. In otherwise healthy individuals, egg consumption is likely safe in moderate servings of up to one egg per day in regard to stroke risk, and there may even be a reduction in overall stroke risk in healthy individuals. ...
Article
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Purpose of Review Our aims are to explore the evidence for egg consumption effects on cardiovascular disease risk factors and the relationship between egg consumption with risk of coronary heart disease, stroke, heart failure, hypertension, and also to briefly discuss cardiovascular implications of egg consumption in individuals with diabetes and chronic kidney disease. Additionally, we provide a framework for health professionals when counseling patients on egg consumption as it relates to cardiovascular disease risk, and highlight areas where evidence is inconclusive and in need of future investigation. Recent Findings The relationship between egg consumption and cardiovascular diseases remains an area of significant debate among health professionals, as historically, eggs have been seen as potentially harmful if consumed frequently. The majority of existing evidence supports that assertion that moderate egg consumption of up to one egg per day in otherwise healthy individuals is not associated with a higher risk of ASCVD. In fact, eggs are a nutritious staple food that can be consumed in moderation in healthy individuals. Summary Diet is all about balance. Moderate egg consumption, i.e., up to one egg per day, is not associated with a higher risk of cardiovascular diseases. Besides, eggs are an affordable food with a high content of many important nutrients.
... For example, results from previous research indicate that higher intake of phospholipids can inhibit cholesterol absorption in vitro, in animal studies and in limited studies in humans [38]. Egg yolks have one of the highest levels of dietary phospholipids (about 1.75 g total phospholipids per yolk) [38,39], and this may explain, at least in part, the lower than expected circulating cholesterol response to higher dietary cholesterol intake during the Egg condition. It is also possible that changes in dietary intake at eating occasions other than breakfast affected LDL-C levels. ...
... Other large, prospective cohort studies in the USA and elsewhere have shown conflicting results regarding effects of dietary cholesterol and/or egg intake on incident CVD [4,39,[42][43][44][45][46]. Thus, at present, the impact of consuming eggs and dietary cholesterol on CVD risk is uncertain. ...
Article
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To assess effects of egg-based versus non-egg, higher-carbohydrate (CHO) breakfast meals on cardiometabolic health markers in overweight or obese adults with prediabetes and/or metabolic syndrome. This randomized, crossover study included two 4-week dietary interventions, separated by a ≥4-week washout. Subjects incorporated into their habitual diets breakfast meals containing either 2 eggs/day for 6 days/week (Egg condition), or energy-matched, non-egg, higher-CHO-based foods (Non-Egg condition). Dietary intakes, insulin sensitivity, and other CHO metabolism indices, lipid biomarkers, high-sensitivity C-reactive protein, and blood pressures were measured. Thirty men and women with mean age 54.1 ± 1.9 years and body mass index 31.9 ± 0.7 kg/m² provided data. Neither diet condition significantly altered insulin sensitivity indices, but the homeostasis model assessment for insulin resistance was significantly (p = 0.028) higher after the Non-Egg vs. the Egg condition. Low-density lipoprotein cholesterol (LDL-C) was decreased from baseline (119 mg/dL) by 2.9 and 6.0% with Egg and Non-Egg breakfasts, respectively (p = 0.023). Systolic blood pressure was reduced from baseline (127 mm Hg) by 2.7 and 0.0% with Egg and Non-Egg, respectively (p = 0.018). Diet records indicated 149 kcal/day higher (p = 0.008) energy intake from non-study foods during the Egg condition; however, weight change from baseline did not differ between conditions. Compared with the baseline diet, consumption of 12 eggs/week for 4 weeks at breakfast was associated with less reduction in LDL-C, and more lowering of systolic blood pressure, than observed with non-egg-based, energy-matched, control foods higher in CHO.
... A meta-analysis assessing the impact of consuming 1 egg per day versus < 2 eggs per week on the risk of CAD and stroke found no association between egg consumption and coronary risk in 7 studies of low heterogeneity. 453 Conversely, there was a 12% reduction in the risk of stroke with increased egg consumption and no dose-response relationship in the risk trend for stroke with increased egg consumption. 453 In a cohort study of the Chinese population, high egg consumption (7 or more eggs per week) compared to low egg consumption (< 1 egg per week) was not associated with cardiovascular mortality, CAD, or stroke. ...
... 453 Conversely, there was a 12% reduction in the risk of stroke with increased egg consumption and no dose-response relationship in the risk trend for stroke with increased egg consumption. 453 In a cohort study of the Chinese population, high egg consumption (7 or more eggs per week) compared to low egg consumption (< 1 egg per week) was not associated with cardiovascular mortality, CAD, or stroke. 454 A study evaluating American population cohorts, considering an average consumption of 0.5 eggs per day (3 to 4 eggs per week), concluded that each additional 0.5 eggs consumed per day is associated with a 6% increase in risk of CVD (95% CI: 1.03-1.10) ...
... However, recent meta-analyses have found no association between egg intake and risk of CVD. [8][9][10] Results even suggested that intake of 1 egg per day compared with <2 eggs per week was associated with lower risk of total stroke 8 and hemorrhagic stroke. 9 The associations for yogurt and risk of stroke are unclear. ...
... 7,35 Hypercholesterolemia is a strong risk factor in total stroke and ischemic stroke but not in hemorrhagic stroke. 1 The existing evidence on egg consumption and stroke risk suggests that there is little or no association with total stroke, though there might be a protective effect against total hemorrhagic stroke. 8,9,36 Intake of dietary cholesterol from eggs is associated with increased total and LDL cholesterol, but a favorable effect on HDL (high-density lipoprotein) cholesterol level might explain why egg intake overall is not associated ...
Article
Background and Purpose— Studies indicate that consuming breakfast every day, and particularly oatmeal, is associated with lower risk of stroke. However, few studies have considered replacement foods when considering foods usually consumed at breakfast. We, therefore, aimed to model substitutions between the breakfast food products oatmeal, eggs, yogurt, or white bread and subsequent risk of stroke. Methods— Participants from the Danish cohort study (Diet, Cancer and Health; n=55 095) were followed for 13.4 years, during which 2260 subjects experienced a first-ever stroke. Breakfast foods were assessed using a validated 192-item food-frequency questionnaire at baseline. Cox proportional hazards models were used to estimate adjusted hazard ratios and 95% CIs for associations between hypothetical substitutions of standard portion sizes of breakfast foods and stroke. Results— Modeling replacement of white bread or eggs with oatmeal was associated with a lower rate of total stroke (hazard ratio [HR]=0.96 [95% CI, 0.95–0.98]; HR=0.96 [95% CI, 0.93–0.98], respectively), total ischemic stroke (HR=0.96 [95% CI, 0.94–0.98]; HR=0.96 [95% CI, 0.94–0.99], respectively), and ischemic stroke due to small-artery occlusion (HR=0.95 [95% CI, 0.93–0.98]; HR=0.95 [95% CI, 0.91–0.99], respectively). Furthermore, modeling replacement of eggs with oatmeal was associated with a lower rate of total hemorrhagic stroke (HR=0.94 [95% CI, 0.89–0.99]). Modeling replacement of yogurt with oatmeal was not associated with stroke. Conclusions— Our findings suggest that a diet containing oatmeal instead of white bread or eggs may be associated with a lower rate of stroke.
... In the meta-analyses examining the association between egg intake and risk of CHD or stroke in the general population, the analyses (highest vs. lowest intake, dose-response analyses) showed no risk relation [38][39][40][41][42] or respectively risk reduction for stroke [42] ( Table 3). Of the meta-analyses examining the association between egg intake and risk of cardiovascular diseases overall, one meta-analysis showed no relation and another showed risk increase [40,43]. ...
... In the meta-analyses examining the association between egg intake and risk of CHD or stroke in the general population, the analyses (highest vs. lowest intake, dose-response analyses) showed no risk relation [38][39][40][41][42] or respectively risk reduction for stroke [42] ( Table 3). Of the meta-analyses examining the association between egg intake and risk of cardiovascular diseases overall, one meta-analysis showed no relation and another showed risk increase [40,43]. ...
Article
Although eggs are a valuable source of nutrients, the role of egg intake has been controversially discussed due to eggs´ high content of cholesterol. Currently there is no consensus in the recommendations of (inter)national nutrition and cardiological scientific bodies on egg and cholesterol intake. Meta-analyses, systematic reviews and recent cohort studies predominantly show no association between egg intake and the risk of cardiovascular diseases in the general population. As regards people with type 2 diabetes mellitus, study results mainly indicate an increased risk for cardiovascular diseases in relation to egg intake. Controlled intervention studies are required to confirm these associations. The current knowledge on the effects of egg intake on cardiometabolic risk factors and the risk of type 2 diabetes mellitus are presented and reviewed in a second article.
... Eggs are a low-cost, nutrient-dense food comprised of numerous vitamins and bioactive compounds, and have been proposed to play a role in disease prevention (1,2). Dietary whole eggs and their derived compounds (3) have been linked to several mechanisms of modulating gene expression, such as vitamin D-mediated transcriptional regulation and methyl group metabolism, by supplying choline, methionine, folate, B 12 , B 6 , and B 2 (4). Despite the beneficial components of eggs, they remain one of the most controversial foods (5), due to their cholesterol content (6,7). ...
... Dietary whole eggs and their derived compounds (3) have been linked to several mechanisms of modulating gene expression, such as vitamin D-mediated transcriptional regulation and methyl group metabolism, by supplying choline, methionine, folate, B 12 , B 6 , and B 2 (4). Despite the beneficial components of eggs, they remain one of the most controversial foods (5), due to their cholesterol content (6,7). Observational studies examining the role of long-term egg intake on the risk of developing cardiovascular disease (CVD) have reported inconsistent results (8), but most recently, Dehghan and others reported no significant association between whole egg intake and major CVD events in a conglomerate of 50 studies (9). ...
Article
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Eggs are protein-rich, nutrient-dense, and contain bioactive ingredients that have been shown to modify gene expression and impact health. To understand the effects of egg consumption on tissue-specific mRNA and microRNA expression, we examined the role of whole egg consumption (20% protein, w/w) on differentially expressed genes (DEGs) between rat (n = 12) transcriptomes in the prefrontal cortex (PFC), liver, kidney, and visceral adipose tissue (VAT). Principal component analysis with hierarchical clustering was used to examine transcriptome profiles between dietary treatment groups. We performed Gene Ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis as well as genetic network and disease enrichment analysis to examine which metabolic pathways were the most predominantly altered in each tissue. Overall, our data demonstrates that whole egg consumption for 2 weeks modified the expression of 52 genes in the PFC, 22 genes in VAT, and two genes in the liver (adj p < 0.05). Additionally, 16 miRNAs were found to be differentially regulated in the PFC, VAT, and liver, but none survived multiple testing correction. The main pathways influenced by WE consumption were glutathione metabolism in VAT and cholesterol biosynthesis in the PFC. These data highlight key pathways that may be involved in diseases and are impacted by acute consumption of a diet containing whole eggs.
... In addition, it contains high levels of proteins, vitamins, antioxidants and minerals. [3,4] Despite the relatively high unsaturated fatty acid level, its role in the prevention of diabetes mellitus and Diabetes mellitus, Dyslipidaemia, Quail egg, Chicken egg, Insulin ...
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Objective: This study aimed to evaluate effects of quail and chicken eggs on fasting blood glucose level, insulin level and lipid profile in male rats fed high fructose diet. Methods: Forty-eight male Sprague-Dawley rats were divided into six groups i.e. Control + Distilled water, Control + Quail, Control + Chicken, High Fructose Diet + Distilled water, High Fructose Diet + Quail, High Fructose Diet + Chicken groups. Hyperglycaemia was confirmed at the 20th week, after which blood samples were collected and plasma extracted for measurement of insulin and fasting lipid profile. ABSTRACT Conclusion: Both eggs administration seems beneficial in delaying the onset of diabetes mellitus with the quail egg appearing to have a better effect on lipid profile compared to chicken egg. The reason for this disparity is unknown and would be a subject of further research.
... According to the results of these studies, egg consumption alone cannot increase the risk of cholesterol. Daily use of an egg does not increase the level of dangerous cholesterol (Alexander et al., 2016, Park et al., 2018, Rong et al., 2013. ...
Article
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Background: Eggs are of the few naturally occurring foods that meet the needs of human body in a balanced manner. The present study was conducted to determine the rate of egg per capita consumption in Tehran city in 2018. Methods: The present cross-sectional study was conducted on 4.213 heads of families living in 22 regions of Tehran. Selected randomly using multistage cluster sampling method. The research data were collected through a researcher-made questionnaire completed by interviews. Results: Mean egg consumption per person was 2.58 per week and 134 per capita (95%CI; 134-137). Moreover, 39.59% of the participants believed that brown-shelled eggs had a higher nutritional value and 61.99% were unaware about the presence of omega 3-enriched eggs. Concerning the participants' attitudes towards egg consumption effective factors, the 'recommendations of physicians and nutritionists to use eggs' and knowing about harmlessness of cholesterol found in eggs' received the mean highest scores of 3.47 and 3.31, respectively. Conclusion: Per capita consumption of eggs among families in Tehran was much lower than the recommended standards. Physicians and nutritionists are recommended to try to raise the community awareness about the nutritional value and correct the misconceptions about egg cholesterol.
... One study indicated that dietary cholesterol contained in whole eggs is not well-absorbed and is not associated with longer-term plasma cholesterol control [5], while other studies indicated that the concentration of low-density lipoprotein cholesterol (LDL-c) and high-density lipoprotein cholesterol (HDL-c) significantly increased in an egg-consuming group [6,7]. To clarify this controversy, some systematic reviews tried to determine whether egg consumption influences cholesterol levels, but most of them only focused on LDL-c, HDL-c, total cholesterol and triglycerides [8][9][10][11]. However, current evidence indicates that LDLc/HDL-c ratio is a better predictor of cardiovascular diseases than isolated parameters [12]. ...
Article
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The association of egg consumption and serum cholesterol concentrations in healthy people has been discussed for a long time. In this study, we aimed to explore association of egg consumption with on low-density lipoprotein cholesterol (LDL-c) and high-density lipoprotein cholesterol (HDL-c) concentrations and the LDL-c/HDL-c ratio through meta-analysis. This systematic review only included randomized controlled trials (RCTs) investigating egg consumption in healthy populations without combination therapy. We extracted mean and standard deviation for LDL-c/HDL-c ratio, LDL-c/HDL-c. The extracted data were pooled in a random-effects model and were presented as mean difference (MD) with 95% confidence interval (CI). Moreover, subgroup analyses were conducted for understanding effects of more egg consumption (MEC) on different intervention periods, egg-consumption levels, classification of responders. Overall, 17 RCTs met the eligibility criteria and pooled results showed MEC group had a higher LDL-c/HDL-c ratio than the control group (MD = 0.14, p = 0.001, I 2 = 25%). The MEC group also had higher LDL-c than the control group (MD = 8.14, p < 0.0001, I 2 = 18%). Moreover, for the subset of intervention over two months, the MEC group seemed to have a larger effect size than the subset of intervention within two months. This synthesis, the largest meta-analysis on this topic, shows the impact of egg consumption on lipid profiles among healthy subjects. Notably, longer time with MEC may lead to higher LDL-c/HDL-c ratio and LDL-c. However, RCTs with long tern follow-up are needed to guarantee the association between egg consumption and human health.
... [6][7][8] A possible protective association with stroke was even reported. 9 Accordingly, the latest science advisory from the American Heart Association Xia et al Egg, Cholesterol and Mortality supported daily consumption of 1 whole egg in healthy individuals with normal cholesterol level. 10 In contrast, in early 2019, a pooled analysis of 6 US prospective cohorts reported positive associations between dietary intakes of egg and cholesterol and risk of incident CVD and all-cause mortality. ...
Article
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).
... In a series of studies in active, 9 month old db/db mice with diabetes for 30-32 weeks, we demonstrated that a specific loss of cardiac GSH causes extensive myocardial damage, which is largely reversed through exogenous GSH administration [15][16][17]. Egg consumption has recently been shown to be safe for CVD in non-diabetic individuals [18,19]. Moreover, egg does contain sulphur amino acids (AA) that can augment thiol antioxidants like GSH [20]. ...
Article
The number of geriatrics with an advanced age is rising worldwide, with attendant cardiovascular disorders, characterized by elevated oxidative stress. Such oxidative stress is accelerated by an age-related loss of critical antioxidants like glutathione (GSH) and dietary solutions to combat this loss does not exist. While egg white is rich in sulphur amino acids (AAs), precursors for GSH biosynthesis, whether they can increase sulphur AA in vivo and augment GSH in the aged myocardium remain unclear. We hypothesized that egg white consumption increases GSH and reduces oxidative damage and inflammation in the geriatric heart. To this end, 101-102 week-old mice were given a AIN 76A diet supplemented with either 9% w/w egg white powder or casein for 8 weeks. Subsequent analysis revealed that egg white increased serum sulphur AA and cardiac GSH, while reducing the cysteine carrying transporter SNAT-2 and elevating glutamine transporter ASCT2 in the heart. Increased GSH was accompanied by elevated expression of GSH biosynthesis enzyme glutathione synthase as well as mitochondrial antioxidants like superoxide dismutase 2 and glutathione peroxidase 1 in egg white-fed hearts. These hearts also demonstrated lower oxidative damage of lipids (4-hydroxynonenal) and proteins [nitrotyrosine] with elevated anti-inflammatory IL-10 gene expression. These data demonstrate that even at the end of lifespan, egg whites remain effective in promoting serum sulphur AAs and preserve cardiac GSH with potent anti-oxidant and mild anti-inflammatory effects in the geriatric myocardium. We conclude that egg white intake may be an effective dietary strategy to attenuate oxidative damage in the senescent heart.
... Eggs are a main source of dietary cholesterol, and their consumption has been associated with an increased risk of cardiovascular disease [5], all-cause mortality [6], haemorrhagic stroke [7], and diabetes [8,9]; paradoxically, in meta-analysis eggs are associated with a decreased risk of hypertension [10], which is a major risk-factor for cardiovascular disease [11]. Further, results are inconsistent between regions, and results are conflicting when studying specific CVD such as stroke or ischemic heart disease [12,13,14,15,16,17,18,19,20]. Aside from cholesterol, eggs are a source of essential nutrients, vitamins, and high-quality proteins [21], which may be a reason for the inconsistencies, as overall diet quality may be important in the relationship between eggs and CVD. ...
Article
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Purpose: The relationship between egg and cholesterol intakes, and cardiovascular disease is controversial. Meta-analyses indicate that egg consumption is associated with increased cardiovascular disease and mortality, but reduced incidence of hypertension, a major risk factor for cardiovascular disease. This study aims to investigate the associations between consumption of egg and cholesterol, and hypertension risk in a cohort of French women. Methods: We used data from the E3N cohort study, a French prospective population-based study initiated in 1990. From the women in the study, we included those who completed a detailed diet history questionnaire, and who did not have prevalent hypertension or cardiovascular disease at baseline, resulting in 46,424 women. Hypertension cases were self-reported. Egg and cholesterol intake was estimated from dietary history questionnaires. Cox proportional hazard models with time-updated exposures were used to calculate hazard ratios. Spline regression was used to determine any dose-respondent relationship. Results: During 885,321 person years, 13,161 cases of incident hypertension were identified. Higher cholesterol consumption was associated with an increased risk of hypertension : HRQ1-Q5 = 1.22 [1.14:1.30], with associations similar regarding egg consumption up to seven eggs per week: HR4-7 eggs = 1.14 [1.06:1.18]. Evidence for a non-linear relationship between hypertension and cholesterol intake was observed. Conclusion: Egg and cholesterol intakes were associated with a higher risk of hypertension in French women. These results merit further investigation in other populations.
... Eggs are consumed by millions of people worldwide, being considered a complete food for the human diet due to their large amounts of essential nutrients such as proteins, lipoproteins (ovalbumin, ovotransferrin, HDL and LDL), a wide variety of minerals (potassium, phosphorus, calcium, iron, magnesium), vitamins (A, D, E, K, B6, B9, B12, riboflavin), lipids (MUFAs, PUFAs, carotenoids, choline and phospholipids) and other bioactive compounds [1]. It is also proved that a moderate consumption of eggs can improve the lipid profile [2], decreasing the risk of cardiovascular disease [3,4] or reducing the prevalence of metabolic syndrome [5]. ...
Article
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Eggs are a nutritious food, offering a balanced source of essential amino and fatty acids, minerals, and vitamins. Genetic and diet factors can modify hen egg traits. Thus, the effects of breed and feed on egg quality using two laying hens, Mos (autochthonous breed) and Isa Brown (commercial hybrid), and three feeds, commercial fodder (CF), corn/pea/triticale (CPT) and corn/wheat (CW), were investigated. Freshness parameters (egg weight, eggshell weight and thickness, albumen height, Haugh units and yolk color), chemical composition, color and textural parameters, as well as fatty acid profile, were assessed on a total of 288 eggs, from the two breeds. The samples were divided in 96 eggs, corresponding to each of the three dietary treatments. There were significant differences (p < 0.001) in albumen height and Haugh units, obtaining the highest values for Isa Brown genotype; meanwhile, laying hens fed with CF had the highest weight, as well as the greatest eggshell thickness. Cooked yolks of Isa Brown eggs presented the highest values of luminosity, while the yellowness was higher for Mos eggs. Regarding the texture of eggs, genotype was again the parameter having the greatest impact, obtaining higher values in hardness, gumminess and chewiness in those eggs from the Mos breed. Concerning egg chemical composition, it was affected by breed and diet type, but Mos eggs were characterized by a significantly (p < 0.001) higher contents of fat (9.53% vs. 7.58%), protein (12.31% vs. 11.66%) and ash (1.10% vs. 1.04%) than Isa Brown ones. Finally, diet type influenced the fatty acid profile, mainly affecting oleic and linoleic acids, which showed significantly (p < 0.05) highest values (42.90 and 14.66 g/100 g of total fatty acids) in CW and CF diets, respectively. Overall, breed and bird diet factors had a strong effect on egg quality and nutritional profile. Moreover, eggs from Mos hens had more attractive nutritional indices, and they could even be improved more by changing the diet.
... 12 Even metaanalyses of prospective studies on egg consumption and cardiovascular disease risk did not provide consistent results and created further confusion. [13][14][15][16][17] To evaluate the association between egg intake and cardiovascular disease risk, it is desirable to have repeated measures of diet and lifestyle. Such measures account for random variation in intake, provide a measure of long term or usual diet, and sufficiently account for confounding owing to lifestyle factors because atherosclerosis develops over many decades. ...
Article
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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, I ² =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, I ² =38.2%), and stroke (22 risk estimates, 1 059 315 participants, 53 617 stroke events; 0.99, 0.91 to 1.07, I ² =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, I ² =30.8%) or European cohorts (1.05, 0.92 to 1.19, I ² =64.7%), but an inverse association was seen in Asian cohorts (0.92, 0.85 to 0.99, I ² =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.
... The lack of good quality evidence to support the restriction of eggs has resulted in a recent changes to guidelines with many removing any reference to limiting egg and cholesterol intake, 1 3 although this is still highlighted in the most recent American guidelines from primary prevention of CVD. 2 In a very recent analysis of prospective cohort data, Zhong et al 31 indicated higher consumption of eggs and dietary cholesterol was positively associated with incident CVD and allcause mortality. These findings are inconsistent with those from previous prospective cohort studies [32][33][34][35] and a large review of meta-analyses 11 or other prospective studies 26 showing no association or a benefit to egg consumption However, in Zhong et al, 31 the effects of egg consumption were modest, and based on selfreported dietary intake at baseline (with an average follow-up of 17 years) in a US population that may not be representative of a UK diet. ...
Article
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Nutrition has a central role in both primary and secondary prevention of cardiovascular disease yet only relatively recently has food been regarded as a treatment, rather than as an adjunct to established medical and pharmacotherapy. As a field of research, nutrition science is constantly evolving making it difficult for patients and practitioners to ascertain best practice. This is compounded further by the inherent difficulties in performing double-blind randomised controlled trials. This paper covers dietary patterns that are associated with improved cardiovascular outcomes, including the Mediterranean Diet but also low-carbohydrate diets and the potential issues encountered with their implementation. We suggest there must be a refocus away from macronutrients and consideration of whole foods when advising individuals. This approach is fundamental to practice, as clinical guidelines have focused on macronutrients without necessarily considering their source, and ultimately people consume foods containing multiple nutrients. The inclusion of food-based recommendations aids the practitioner to help the patient make genuine and meaningful changes in their diet. We advocate that the cardioprotective diet constructed around the traditional Mediterranean eating pattern (based around vegetables and fruits, nuts, legumes, and unrefined cereals, with modest amounts of fish and shellfish, and fermented dairy products) is still important. However, there are other approaches that can be tried, including low-carbohydrate diets. We encourage practitioners to adopt a flexible dietary approach, being mindful of patient preferences and other comorbidities that may necessitate deviations away from established advice, and advocate for more dietitians in this field to guide the multi-professional team.
... Previous evidence on egg consumption and stroke has been inconsistent. 6,52,53 Egg consumption in EPIC-Europe was low overall (<20 g per day, compared with an average large egg of 60 g), but higher egg consumption in the current study was associated with slightly higher SBP, an established risk factor for both ischaemic and haemorrhagic strokes, 54 and slightly lower non-HDL-C concentrations, which may be driven by residual confounding of factors not measured in this study. ...
Article
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Aim To investigate the associations between major foods and dietary fibre with subtypes of stroke in a large prospective cohort. Methods and results We analysed data on 418 329 men and women from nine European countries, with an average of 12.7 years of follow-up. Diet was assessed using validated country-specific questionnaires which asked about habitual intake over the past year, calibrated using 24-h recalls. Multivariable-adjusted Cox regressions were used to estimate hazard ratios (HRs) for ischaemic and haemorrhagic stroke associated with consumption of red and processed meat, poultry, fish, dairy foods, eggs, cereals, fruit and vegetables, legumes, nuts and seeds, and dietary fibre. For ischaemic stroke (4281 cases), lower risks were observed with higher consumption of fruit and vegetables combined (HR; 95% CI per 200 g/day higher intake, 0.87; 0.82–0.93, P-trend < 0.001), dietary fibre (per 10 g/day, 0.77; 0.69–0.86, P-trend < 0.001), milk (per 200 g/day, 0.95; 0.91–0.99, P-trend = 0.02), yogurt (per 100 g/day, 0.91; 0.85–0.97, P-trend = 0.004), and cheese (per 30 g/day, 0.88; 0.81–0.97, P-trend = 0.008), while higher risk was observed with higher red meat consumption which attenuated when adjusted for the other statistically significant foods (per 50 g/day, 1.07; 0.96–1.20, P-trend = 0.20). For haemorrhagic stroke (1430 cases), higher risk was associated with higher egg consumption (per 20 g/day, 1.25; 1.09–1.43, P-trend = 0.002). Conclusion Risk of ischaemic stroke was inversely associated with consumption of fruit and vegetables, dietary fibre, and dairy foods, while risk of haemorrhagic stroke was positively associated with egg consumption. The apparent differences in the associations highlight the importance of examining ischaemic and haemorrhagic stroke subtypes separately.
... 112 In fact, even daily egg consumption is not clearly associated with incident CVD in general populations and might reduce stroke risk. [113][114][115] However, US dietary guidelines raised controversy because of apparently contradictory statements, saying that 'cholesterol is not a nutrient of concern for overconsumption', but that 'individuals should eat as little dietary cholesterol as possible'. 7 A recent study involving pooled individual data from six prospective US cohorts found that egg consumption was associated with an increased incidence of CVD and death. ...
Article
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Cardiovascular disease is the leading global cause of death in Western countries, and its development is largely associated with unhealthy dietary patterns. A large body of scientific evidence has reported that nutrition might be the most preventive factor of cardiovascular disease death and could even reverse heart disease. Processes of chronic inflammation and oxidative distress share triggers that are modifiable by nutrition. This review aimed to identify potential targets (food patterns, single foods or individual nutrients) for cardiovascular disease prevention, and analyse the mechanisms implicated in their cardioprotective effects.
... The present meta-analysis provided an updated overview on the association between egg consumption and CVD risk and mortality: compared to previous meta-analyses, we included the highest number of cohorts reviewed to date, several dose-response analyses for the investigated outcomes, a detailed investigation for potential confounding factors by studying subgroups and stratifying the analyses, and we attempted an evaluation of the overall evidence. Previous meta-analyses reported rather mixed results, with no association with stroke risk [55], decreased risk of stroke and no association with CHD [56,57], decreased risk of CHD [58], no association with CVD risk [59], increased risk of heart failure [60,61],compared to these studies, our analysis is more complete and provides a general more in depth analysis of level of evidence. We generally found no strong association with either increased or decreased risk of cardiovascular outcomes following the habitual consumption of eggs (i.e., one egg per day compared to no intake), with exception of risk of heart failure, which resulted higher especially in men from US cohorts. ...
Article
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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.
... According to the results of these studies, egg consumption alone cannot increase the risk of cholesterol. Daily use of an egg does not increase the level of dangerous cholesterol (Alexander et al., 2016, Park et al., 2018, Rong et al., 2013. ...
Article
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ARTICLE INFO ABSTRACT ORIGINAL ARTICLE Background: Eggs are of the few naturally occurring foods that meet the needs of human body in a balanced manner. The present study was conducted to determine the rate of egg per capita consumption in Tehran city in 2018. Methods: The present cross-sectional study was conducted on 4.213 heads of families living in 22 regions of Tehran. Selected randomly using multistage cluster sampling method. The research data were collected through a researcher-made questionnaire completed by interviews. Results: Mean egg consumption per person was 2.58 per week and 134 per capita (95%CI; 134-137). Moreover, 39.59% of the participants believed that brown-shelled eggs had a higher nutritional value and 61.99% were unaware about the presence of omega 3-enriched eggs. Concerning the participants' attitudes towards egg consumption effective factors, the 'recommendations of physicians and nutritionists to use eggs' and knowing about harmlessness of cholesterol found in eggs' received the mean highest scores of 3.47 and 3.31, respectively. Conclusion: Per capita consumption of eggs among families in Tehran was much lower than the recommended standards. Physicians and nutritionists are recommended to try to raise the community awareness about the nutritional value and correct the misconceptions about egg cholesterol.
... Therefore, there are recommendations to pay attention to the cholesterol level in the diet. Nevertheless, the latest research shows that eating even two eggs a day has no adverse health effects [49,50]. ...
Preprint
All over the world birds’ eggs are an important and valuable component of the human diet. The study aimed to compare the content of lipid components and their nutritional value as well as iron and zinc levels in chicken and quail eggs commonly available on the market. In egg lipids, unsaturated acids were dominated, especially oleic acid, the content of which was about 40% of total fatty acids (TFA). Linoleic acid was the major polyunsaturated fatty acid. Compared to other products of animal origin, eggs were characterized by favourable values of lipid quality indices, especially index of atherogenicity, thrombogenicity and hypocholesterolemic to hypercholesterolemic ratio. In the present study, no differences in the content of tested nutrients between eggs from different production methods (organic, free-range, barn, cages), as well as inter-breed differences were noticed. Cluster analysis showed that eggs enriched in n3 PUFA (according to producers’ declaration) differ from other groups of chicken eggs. However, only in eggs from one producer, the amount of EPA and DHA exceed 80 mg per 100 g, entitling to use the nutrition claim on the package. Quail eggs differed from chicken eggs in FA profile; they also had much higher iron and cholesterol levels.
... In a meta-analysis study, it has been determined that the consumption of one egg per day will contribute to the reduction of the total stroke risk, and daily egg consumption is not associated with the risk of coronary heart disease (Alexander et al., 2016). Americans accentuate taking cholesterol more than 300 mg per day. ...
Article
This study was planned and conducted to investigate the effects of egg consumption on metabolic syndrome components and potential mechanisms of action on humans. Egg, an important source of animal protein, is defined as a functional food containing various bioactive compounds that can affect the proinflammatory and anti-inflammatory pathways. As a matter of fact, the egg can show immunomodulatory, anti-inflammatory, antioxidant, anticancer, or antihypertensive effects with its bioactive components. It is claimed that egg consumption may protect individuals against metabolic syndrome by increasing HDL-C levels and reducing inflammation. The increase in egg consumption creates the perception that it may lead to cardiovascular diseases due to its cholesterol content. However, there is insufficient evidence as to whether dietary cholesterol-lowers LDL-C. The possible potential mechanisms of egg impact on human health, MEDLINE, Embase, the Cochrane Central, www.ClinicalTrials.gov, PubMed, Science Direct, Google Scholar, and selected websites including) and databases were examined in this regard. With a view to delving into the rather mysterious relationship between egg cholesterol and blood cholesterol, it is necessary to understand the absorption of cholesterol from the egg and to know the functioning of the intestinal microbiota. Studies conducted to date have generally yielded inconsistent results regarding egg consumption and risks of CVD, diabetes, and metabolic syndrome.
... Recent reviews and meta-analyses mostly indicate consumption of eggs does not increase risk of coronary heart disease and does not affect risk of cardiovascular disease [81,91]. The PURE Study that spanned 177,000 participants in 50 countries reported no significant association between egg consumption and major CVD events [92]. ...
Article
This dietary guidance, informed by best contemporary evidence, aims to assist medical practitioners and allied health professionals in advising patients for the primary and secondary prevention of cardiovascular disease (CVD). While differing in some details from other current guidelines, the core messages accord with those published in 2019 by the American College of Cardiology/American Heart Association and the European Society of Cardiology/European Atherosclerosis Society; the National Lipid Association in 2014 and the NH&MRC Australian Dietary Guidelines in 2013. These were assessed through the Appraisal of Guidelines for Research and Evaluation (AGREE II) and the levels of evidence and classes of a recommendation developed using the GRADE system. Recommendations with high levels of evidence include increased consumption of plant based foods comprising mainly complex, fibre enriched carbohydrates (wholegrains, fruits and vegetables) while limiting intake of refined starches; partial replacement of saturated fats with monounsaturated or polyunsaturated fats and oils; reduced salt intake; achievement and maintenance of healthy weight; and low-to-moderate consumption of alcohol. Additional guidance but with moderate levels of evidence includes increased consumption of fish (and fish oils where indicated); reduction in sugar-sweetened beverages and added sugars; avoidance of butter and cream especially in those at increased CVD risk but encouragement of yoghurt; allow moderate consumption of lean meat but limit intake of processed meats; and limit cholesterol-rich foods such as eggs and crustaceans for those at increased CVD risk. Guidance has been formulated qualitatively on food categories of commonly eaten foods while avoiding prescriptive quantitative measures that are less readily translatable. This approach accords with current guidelines such as the American College of Cardiology/American Heart Association 2019 guidelines and is understandable and readily implemented.
... 13 High dietary cholesterol is frequently associated with chronic lifestyle diseases, including CVD, coronary heart disease, diabetes, as well as MS, although there is not enough evidence to indicate causation. 14 15 Similarly, the association between the other components of eggs besides cholesterol (eg, egg white protein, lutein or zeaxanthin) and MS has not been Strengths and limitations of this study ► This is the first study exploring the association between egg consumption and the prevalence of MS in Chinese population. ► The sample size of this cross-sectional study was relatively large, which may strengthen the accuracy of the results. ...
Article
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Objectives Metabolic syndrome (MS) comprises a constellation of symptoms that include abdominal obesity, hypertension, hyperglycaemia and dyslipidaemia. Dietary intake is a crucial environmental risk factor for MS, but the exact association between MS and egg consumption, which accounts for more than half of the daily total cholesterol intake in Chinese population, has not been previously studied. The aim of this study was to examine the correlation between dietary egg consumption and the prevalence of MS in the context of a large population. Design A cross-sectional study. Settings Our study was conducted in a health examination centre in China. Participants Participants who aged ≥40 years and received routine physical examinations were included for analyses. Main outcome measures MS was diagnosed in accordance with the clinical diagnosis criteria specified in the American Heart Association Guidelines. Egg consumption was assessed by a validated semi-quantitative food frequency questionnaire. Results A total of 11 529 participants (46.2% women) were included in the present study. On the basis of multivariable logistic regression analysis, egg consumption was negatively associated with the prevalence of MS after adjusting for dietary energy intake (OR=0.84, 95% CI 0.76 to 0.93, p value for trend=0.001). The above findings did not change with further adjustment for other potential confounders: model 2 was further adjusted for age, body mass index and sex (based on model 1) and model 3 was further adjusted for education level, physical activity level, smoking status, alcohol use status, dietary fat intake, dietary fibre intake and nutritional supplementation (based on model 2). Consistent results were obtained from the analysis in the female subgroup but not in male subjects. Conclusions A higher level of egg consumption was associated with a lower prevalence of MS in our study participants, and particularly in female subjects.
... Mismos que algunos estudios demuestran posibles relaciones de consumo de huevo con enfermedades coronaria o cerebro vascular y diabetes (Shi et al., 2011), sin embargo, estudios más recientes y más conclusivos demuestran que el consumo de huevo presenta nula asociación al riesgo de dichas enfermedades (Abdollahi et al., 2019;Alexander et al., 2016). No obstante, la inclusión en las dietas de niños, adolescentes (Papanikolaou & Fulgoni, 2019) y personas de mediana edad y adultos son recomendadas (Wang et al., 2019). ...
Article
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El objetivo de la presente investigación fue verificar el perfil y preferencia sobre el consumo de huevo en la ciudad de Pedro Juan Caballero. Fue aplicada una encuesta tipo survey, siendo la muestra compuesta por 140 personas. Los resultados demostraron que 62,2% de los encuestados fueron del sexo femenino, con 49,3% de franja etaria de entre 15 a 35 años, con 80,0% universitario con 74,3% perciben un salario mínimo. En total 97,9% confirman consumir el huevo. En la elección, la coloración de la cáscara de huevos no influye entre edad, sexo, escolaridad y nivel de renda de los encuestados. No obstante, según sexo, la escolaridad, la coloración de la cáscara tiene influencia en la calidad. El consumo de huevo, según la escolaridad de los encuestados se relaciona con algunas enfermedades. De acuerdo a la investigación, se demuestra que el huevo hace parte de la dieta cotidiana de la población, no obstante, persiste la creencia sobre su relación con algunas enfermedades a pesar de que fue refutada por la ciencia, situación que deben ser encarada mediante estrategias marketing que permita evitar esa percepción.
... Eggs, because of their high content of cholesterol, are always controversially associated with CVD risk. In fact, a 2016 meta-analysis demonstrated no association between egg intake and CVD risk and a reduced risk of heart stroke of 12% with a higher consumption of eggs [63]. Therefore, egg consumption could be allowed in the context of a varied and balanced diet. ...
Article
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The quality of life of people living with HIV (PLWH) has remarkably increased thanks to the introduction of combined antiretroviral therapy. Still, PLWH are exposed to an increased risk of cardiovascular diseases, diabetes, chronic kidney disease, and liver disease. Hence, the purpose of this review is to summarize the current knowledge about diagnosis and nutritional management with specific indication of macro and micronutrients intake for the main comorbidities of PLWH. In fact, a prompt diagnosis and management of lifestyle behaviors are fundamental steps to reach the "fourth 90". To achieve an early diagnosis of these comorbidities, clinicians have at their disposal algorithms such as the Framingham Score to assess cardiovascular risk; transient elastography and liver biopsy to detect NAFLD and NASH; and markers such as the oral glucose tolerance test and GFR to identify glucose impairment and renal failure, respectively. Furthermore, maintenance of ideal body weight is the goal for reducing cardiovascular risk and to improve diabetes, steatosis and fibrosis; while Mediterranean and low-carbohydrate diets are the dietetic approaches proposed for cardioprotective effects and for glycemic control, respectively. Conversely, diet management of chronic kidney disease requires different nutritional assessment, especially regarding protein intake , according to disease stage and eventually concomitant diabetes.
... Similarly, another meta-analysis did not support a conclusive association between cholesterol intake and CVD outcomes [6]. However, the available studies in these meta-analyses had small sample sizes or few death cases and did not strengthen the methodological rigor to obtain precise effect estimates [6,13,14,29,30]. In addition, residual confounding could also be a reason for these inconsistent findings, given that egg consumption was commonly correlated with unhealthy lifestyle factors, including smoking, low physical activity, and unhealthy dietary patterns in Western countries [31], and that dietary cholesterol usually coexists with saturated fat and animal protein [2]. ...
Article
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Background Whether consumption of egg and cholesterol is detrimental to cardiovascular health and longevity is highly debated. Data from large-scale cohort studies are scarce. This study aimed to examine the associations of egg and cholesterol intakes with mortality from all causes, cardiovascular disease (CVD), and other causes in a US population. Methods and findings Overall, 521,120 participants (aged 50–71 years, mean age = 62.2 years, 41.2% women, and 91.8% non-Hispanic white) were recruited from 6 states and 2 additional cities in the US between 1995 and 1996 and prospectively followed up until the end of 2011. Intakes of whole eggs, egg whites/substitutes, and cholesterol were assessed by a validated food frequency questionnaire. Cause-specific hazard models considering competing risks were used, with the lowest quintile of energy-adjusted intake (per 2,000 kcal per day) as the reference. There were 129,328 deaths including 38,747 deaths from CVD during a median follow-up of 16 years. Whole egg and cholesterol intakes were both positively associated with all-cause, CVD, and cancer mortality. In multivariable-adjusted models, the hazard ratios (95% confidence intervals) associated with each intake of an additional half of a whole egg per day were 1.07 (1.06–1.08) for all-cause mortality, 1.07 (1.06–1.09) for CVD mortality, and 1.07 (1.06–1.09) for cancer mortality. Each intake of an additional 300 mg of dietary cholesterol per day was associated with 19%, 16%, and 24% higher all-cause, CVD, and cancer mortality, respectively. Mediation models estimated that cholesterol intake contributed to 63.2% (95% CI 49.6%–75.0%), 62.3% (95% CI 39.5%–80.7%), and 49.6% (95% CI 31.9%–67.4%) of all-cause, CVD, and cancer mortality associated with whole egg consumption, respectively. Egg white/substitute consumers had lower all-cause mortality and mortality from stroke, cancer, respiratory disease, and Alzheimer disease compared with non-consumers. Hypothetically, replacing half a whole egg with equivalent amounts of egg whites/substitutes, poultry, fish, dairy products, or nuts/legumes was related to lower all-cause, CVD, cancer, and respiratory disease mortality. Study limitations include its observational nature, reliance on participant self-report, and residual confounding despite extensive adjustment for acknowledged dietary and lifestyle risk factors. Conclusions In this study, intakes of eggs and cholesterol were associated with higher all-cause, CVD, and cancer mortality. The increased mortality associated with egg consumption was largely influenced by cholesterol intake. Our findings suggest limiting cholesterol intake and replacing whole eggs with egg whites/substitutes or other alternative protein sources for facilitating cardiovascular health and long-term survival. Trial registration ClinicalTrials.gov NCT00340015 .
... Attention was first drawn to the cholesterol content of eggs through studies suggesting that cholesterol-rich food consumption may elevate blood cholesterol and increase the risk of coronary heart disease [60]. However, recent trials have revealed that the regular consumption of eggs is not associated with an increased risk of coronary heart disease [55,[61][62][63][64], although heavy egg consumption over a longer period of time requires studies to point out possible adverse effects. Considering our study results, daily egg consumption may be something to consider. ...
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... In a commentary about an exposé of the sugar industry by Kearns et al 3 , Nestlé extended the issue to the food industry in general. Barnard et al 4 recently reviewed the influence of industry on cholesterol research. ...
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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 ages 16–110 years without CVD at baseline were derived from 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 to 0.94) for 1–2 times per week, 0.78 (0.69 to 0.88) for 3–6/week, and 0.83 (0.72 to 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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The association between dairy product consumption and cardiovascular health remains highly debated. We quantitatively synthesized prospective cohort evidence on the associations between dairy consumption and risk of hypertension (HTN), coronary heart disease (CHD) and stroke. We systematically searched PubMed, Embase, and Web of Science through August 1st, 2020 to retrieve prospective cohort studies that reported on dairy consumption and risk of HTN, CHD or stroke. We used random-effects models to calculate the pooled relative risk (RR) and 95% confidence interval (CI) for the highest vs the lowest category of intake and for 1 serving/day increase in consumption. We rated the quality of evidence using NutriGrade. Fifty-five studies were included. Total dairy consumption was associated with a lower risk of HTN (RR for highest vs lowest level of intake: 0.91, 95% CI: 0.86–0.95, I2 = 73.5%; RR for 1 serving/day increase: 0.96, 95% CI: 0.94–0.97, I2 = 66.5%), CHD (highest vs lowest level of intake: 0.96, 95% CI: 0.92–1.00, I2 = 46.6%; 1 serving/day increase: 0.98, 95% CI: 0.95–1.00, I2 = 56.7%), and stroke (highest vs lowest level of intake: 0.90, 95% CI: 0.85–0.96, I2 = 60.8%; 1 serving/day increase: 0.96, 95% CI: 0.93–0.99, I2 = 74.7%). Despite moderate to considerable heterogeneity, these associations remained consistent across multiple subgroups. Evidence on the relationship between total dairy and risk of HTN and CHD were of moderate quality and of low quality for stroke. Low-fat dairy consumption was associated with lower risk of HTN and stroke, and high-fat dairy with a lower risk of stroke. Milk, cheese, or yogurt consumption showed inconsistent associations with the cardiovascular outcomes in high vs. low intake and dose-response meta-analyses. Total dairy consumption was associated with a modestly lower risk of hypertension, CHD and stroke. Moderate to considerable heterogeneity was observed in the estimates and the overall quality of the evidence was low to moderate.
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Purpose of review: We identified and quantified the results of randomized controlled trials (RCTs) that have assessed the impact of egg consumption on blood pressure in adults. Recent findings: We conducted a comprehensive search of medical bibliographic databases up to February 2019 for RCTs investigating the effect of egg consumption on blood pressure in adults. Fifteen RCTs were included with a total of 748 participants. Overall, egg consumption had no significant effect on systolic blood pressure (weighted mean difference (WMD) = 0.046 mmHg; 95% CI - 0.792, 0.884) and diastolic blood pressure (WMD = - 0.603 mmHg; 95% CI - 1.521, 0.315). Subgroup analyses had no effect on pooled results and no heterogeneity was found among included studies. Egg consumption has no significant effects on systolic and diastolic blood pressure in adults. Due to several limitations among existing studies, general conclusions cannot be drawn regarding the beneficial or neutral impact of egg consumption on blood pressure in adults.
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Hypercholesterolemia, which is considered as the presence of high levels of cholesterol in the blood, is one of the main risk factors for cardiovascular disease progression that may be prevented by lifestyle changes, including diet. Although clinical studies are more in favor of a relevant role of plant proteins in the prevention of hypercholesterolemia, bioactive peptides with hypocholesterolemic activity have been isolated also from some animal sources. Therefore this chapter will discuss peptides either from plant (soybean, lupin, cowpea, hempseed, and rice bran) or animal (milk, meat, and egg) sources. The very diversified structures of the hypocholesterolemic peptides so far identified explain why they exert their activity through different mechanisms of action that will be extensively described in this review. Doubtlessly, their potential use in nutritional application is desirable, however, only few of them are assessed in vivo. Therefore more efforts need to be pursued for singling out good candidates for the development of functional foods or dietary supplements.
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Purpose of review: We have focused on recent research relevant to effects of dietary patterns and major food groups on cardiovascular outcomes, taking into account guidelines and position statements from expert authorities, with an emphasis on important changes in recommendations, some of which remain controversial. Recent findings: Major findings include: refocusing on qualitative patterns of food consumption replacing quantitative prescriptive advice on nutrients; increasing intake of plant foods; substituting saturated fats with polyunsaturated and monounsaturated oils; reducing salt intake; regular consumption of fish with a focus on omega-3 enrichment; not restricting dairy foods, other than butter and cream, with encouragement of some fermented products; reducing cholesterol intake for those at increased cardiovascular risk and diabetes, allowing 7-eggs weekly; restricting processed meats and allowing moderate lean meat consumption; preference for fiber-rich complex carbohydrates and reduced sugar intake; maintaining healthy bodyweight; and although water is the preferred beverage, allowing moderate alcohol consumption to national guidelines and avoiding alcohol in specific cardiovascular disorders. Summary: The new approach that focuses on healthier patterns of food intake is more readily understood by health practitioners and translatable to consumers and patients.
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Background & Aims Evidence linking egg and dietary cholesterol consumption with human health and longevity is highly debated. Data from non-Western populations are sparse. We aim to prospectively assess the egg and cholesterol consumption in relation to mortality in a nationwide Chinese cohort. Methods We followed 18,914 adults aged ≥20 y from China Health and Nutrition Survey (CHNS) between 1991 and 2015. In each survey year, 3-day 24-hr dietary records were used to collect dietary data. Cumulative averages of egg and cholesterol intakes were calculated. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using the Cox proportional hazards model. Results Overall 1,429 deaths were reported after a mean follow-up of 15 years. Egg consumption was significantly associated with lower total mortality (P-trend<0.001). Multivariable-adjusted HRs (95% CIs) were 0.69 (0.59-0.81) for 1-3 eggs/wk, 0.68 (0.59-0.79) for 3-7 eggs/wk, 0.78 (0.66-0.93) for 1-2 eggs/d, and 0.64 (0.52-0.78) for ≥2 eggs/d compared with ≤1 egg/wk. Although total dietary cholesterol was not related to mortality, intake of cholesterol from eggs was inversely associated with total mortality (P-trend=0.001) while intake of cholesterol from non-egg sources was positively related to total mortality (P-trend=0.01). Substituting 50 g/d egg for equivalent amounts of dairy products, nuts/legumes, or red meat was associated with 9%, 7%, or 8% lower total mortality, respectively. Conclusions Egg consumption is associated with lower total mortality among the Chinese population. Consuming cholesterol from non-egg sources may be detrimental to longevity. Habitual consumption of eggs should continue to be recommended in the Chinese dietary guidelines while excess intake of cholesterol from non-egg sources may be discouraged. Clinical Trial Registry This trial was registered at clinicaltrials.gov (NCT04104308).
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Background Limited data are available examining nutritional implications for removing/adding eggs in childhood dietary patterns. Additionally, usual intake data are lacking for choline and lutein + zeaxanthin in childhood. Objectives To determine usual intakes of choline and lutein + zeaxanthin in egg consumers and model the removal and addition of eggs within dietary patterns on choline and lutein + zeaxanthin intakes. Methods Data from the NHANES, 2011–2014, were analyzed in egg consumers (infants, n = 130; children/adolescents, n = 980) of various age groups during childhood. Additionally, a modeling analysis was conducted to examine choline and lutein + zeaxanthin intake following the removal and addition of eggs to the current American diet of children. Results Overall, modeling removal of eggs from the diet in all age groups examined showed decreases in choline intakes, resulting in significantly fewer subjects above the recommended Adequate Intake (AI) for choline. In contrast, the addition of 1 egg per week to the current American eating pattern resulted in nearly 10% more infants 6–23 months of age being above the AI for choline intake. The addition of 7 eggs per week to the current dietary pattern of infants would nearly achieve 100% of infants meeting the AI for choline. In children 2–8 years old, modeling an additional 7 eggs per week to the current dietary pattern resulted in approximately 94% of children being above the AI for choline, while the addition of 7 eggs per week increases the percentages above the AI to 23.0% and 52.4% in children aged 9–18 and 2–18 years, respectively. In children aged 2–8 and 2–18 years old, the addition of 7 eggs per week also showed meaningful increases in lutein + zeaxanthin usual intakes relative to the current dietary pattern (i.e., lutein + zeaxanthin increased from nearly 775 mcg/day to approximately 916 mcg/day and 780 mcg/day to approximately 931 mcg/day, respectively). Conclusions The current data support egg consumption as part of healthy dietary patterns to help meet established choline recommendations, while concurrently increasing lutein and zeaxanthin intakes in childhood.
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Cardiovascular disease (CVD) remains the first cause of mortality in Western countries. Among cardiometabolic risk factors, dyslipidemia, and especially high low-density lipoprotein cholesterol (LDL-C) concentrations, have been extensively linked to the development and progression of atherosclerosis and to CVD events. Recent evidence has shown that the prevention of unhealthy dietary habits and sedentarism is crucial in the management of dyslipidemia. In this sense, a number of scientific societies recommend the adherence to certain healthy dietary patterns (DPs), such as the Mediterranean diet (MedDiet), the Dietary Approaches to Stop Hypertension (DASH), the Portfolio diet, the Vegetarian diet, the Nordic diet and low-carbohydrate diets, as well as increased physical activity between others. This nutritional and lifestyle advice could be adopted by government bodies and implemented in different health programs as a reliable way of providing health-care professionals with efficient tools to manage cardiometabolic risk factors and thus, prevent CVD. In this narrative review, we will discuss recent data about the effects of nutrition on dyslipidemia, mainly focusing on high LDL-C concentrations and other lipid particles related to atherogenic dyslipidemia such as triglycerides (TG) and non-high density lipoprotein cholesterol (non-HDL-C), that are related to CVD. On the other hand, we also comment on other cardiometabolic risk factors such as type 2 diabetes mellitus (T2DM), high blood pressure (HBP), inflammation and endothelial dysfunction. This review includes food groups as well as different healthy DPs.
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Diverse notions exist regarding egg intake, which is one of the main sources of dietary cholesterol, and its effect on blood lipids. We conducted this study to update the previous meta‐analysis for their flaw in calculated effect size. PubMed, Scopus, ISI, and Cochrane were searched up to April 2019, for relevant randomized controlled clinical trials. Mean changes in total cholesterol (TC), LDL‐cholesterol (LDL‐C), HDL‐cholesterol (HDL‐C), triglyceride (TG), very low‐density lipoprotein cholesterol (VLDL‐C), LDL‐C/HDL‐C, TC/HDL‐C, apolipoprotein (apo)A1, and apoB100 were assessed. Meta‐analysis of 66 RCTs with 3,185 participants revealed that egg consumption can significantly increase TC, LDL‐C, HDL‐C, TC/HDL‐C, apoA1/and B100, but there was no significant effect on other serum lipids. Dose‐response analysis showed a linear effect for TC, HDL‐C, ApoA1, ApoB100, and nonlinear for LDL‐C, and TC/HDL‐C. In conclusion, intake of more than one egg daily in less than 12 weeks may increase some blood lipids without any changes in the ratio of LDL‐C/HDL‐C. Practical applications There are controversies reports for egg intake, which is one of the main sources of dietary cholesterol. This study provides comprehensive information about the effect of the number of eggs consumed per day (dietary cholesterol) on blood lipids for nutritionists, physicians, researchers, and the general population. In this regard, our results indicated that there is a linear correlation between consumption of greater than one egg per day in a short time (no long time) and increasing lipid profiles which may increase the risk of cardiovascular diseases. However, consumption of one egg daily can be safe and this can be a useful recommendation for prevention of cardiovascular disease and promotion of healthy life which indeed are the potential or actual uses of this research.
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Introduction Considerable controversy remains on the relationship between egg consumption and cardiovascular disease risk. The objective of this systematic review and meta-analysis was to explore the association between egg consumption and overall cardiovascular disease events. Methods We systematically searched Ovid MEDLINE, Ovid Embase, Ovid Cochrane Database of Systematic Reviews, Scopus, and Web of Science from database inception from 1966 through January 2020 for observational studies that reported the association between egg consumption and cardiovascular disease events. Two investigators independently reviewed data. Conflicts were resolved through consensus. Random-effects meta-analyses were used. Sources of heterogeneity were analyzed. Results We identified 23 prospective studies with a median follow-up of 12.28 years. A total of 1,415,839 individuals with a total of 123,660 cases and 157,324 cardiovascular disease events were included. Compared to the consumption of no or 1 egg/day, higher egg consumption (more than 1 egg/day) was not associated with significantly increased risk of overall cardiovascular disease events (pooled hazard ratios, 0.99; 95% CI, 0.93-1.06; p<0.001; I²= 72.1%). Higher egg consumption (more than 1 egg/day) was associated with a significantly decreased risk of coronary artery disease (pooled hazard ratios, 0.89; 95% CI, 0.86-0.93; p<0.001; I²= 0%), compared to consumption of no or 1 egg/day. Conclusions Our analysis suggests that higher consumption of eggs (more than 1 egg/day) was not associated with increased risk of cardiovascular disease, but associated with a significant reduction in risk of coronary artery disease.
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Background & Aims Cardiovascular diseases (CVDs) are considered as a major cause of health loss for all regions of the world. Atherosclerosis is one of the most important underlying causes of CVDs. Vascular dysfunction is the primary marker of atherosclerosis. Various studies have investigated the effect of egg intake on CVDs. This study aimed to determine the effect of egg and its derivatives consumption on vascular function. Methods Using a comprehensive search strategy, the searching was conducted on PubMed, Scopus and Google Scholar search engines resources (from inception up to Feb 2020). Intended exposure and outcome were egg or its derivatives intake, and vascular function measuring methods, respectively. Results A total of 35 papers were found through search databases. Finally, seven trials were included, which were published between 2005 and 2018. Results showed that acute and chronic consumption of whole eggs did not have a significant adverse effect on flow-mediated dilatation (FMD). Also, lutein-enriched egg yolk and egg ovalbumin-derived protein hydrolysate did not have significant positive effects on FMD and pulse wave velocity (PWV), respectively. However, one month egg-yolk-derived phospholipid (PL) preparation intervention increased FMD by 3.4% (p< 0.05), and replacing a portion of a glucose challenge with whole eggs or egg whites improved postprandial FMD (p< 0.05). Conclusions We concluded that consumption of whole egg, despite being rich in cholesterol, has no adverse effect on vascular function, and even some of egg derivatives may improve vascular function. Further research is needed to justify the potential effects of egg or its derivatives on vascular function.
Article
Objective This study aimed to examine the impact of different dietary patterns on stroke outcomes among type 2 diabetes mellitus (T2DM) patients in China. Design Participants were enrolled by a stratified random cluster sampling method in the study. After collecting dietary data using a quantified food frequency questionnaire, latent class analysis was used to identify dietary patterns, and propensity score matching was used to reduce confounding effects between different dietary patterns. Binary logistic regression and conditional logistic regression were used to analyze the relationship between dietary patterns and stroke in patients with T2DM. Setting A cross-sectional survey available from December 2013 to January 2014. Participants A total of 13731 Chinese residents aged 18 years or over. Results Two dietary patterns were identified: 61.2% of T2DM patients were categorized in the High-fat dietary pattern while 38.8% of patients were characterized by the Balanced dietary pattern. Compared to the High-fat dietary pattern, the Balanced dietary pattern was associated with reduced stroke risk (OR=0.63, 95%CI: 0.52-0.76, P <0.001) after adjusting for confounding factors. The protective effect of the balanced model did not differ significantly (interaction P >0.05). Conclusion This study provides sufficient evidence to support the dietary intervention strategies to prevent stroke effectively. Maintaining a Balanced dietary pattern, especially with moderate consumption of foods rich in quality protein and fresh vegetables in T2DM patients, might decrease the risk of stroke in China.
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The aim of this study is to show that Raman spectroscopy is a sensitive tool, which can be used to analyse eggs obtained in various hens' housing breeding systems. This study provided a new and simple method for testing hens’ eggs breeding systems. Raman methods have the potential to be applied by commercial inspections in the food industry for verification labels placed on eggs. The development of functional technological methods to study the quality of eggs could be an interesting way to gain profitability for the food industry resulting in improvement of public health conditions. A label-free Raman method for detecting spectral changes in eggs from cage systems, barn systems, free range systems and ecological systems is presented. The most important advantage of Raman spectroscopy is the ability to identify biomarkers that help to estimate the quality of eggs from various housing breeding systems based on typical spectra of lipids, proteins and carotenoids. It has been proved that ratios 1656/1004, 1656/1444, 1444/1520 and 1656/1156 can be used to distinguish eggs from various hens' breeding conditions.
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Intake of antioxidants through diet is known to be important in reducing oxidative damage in cells and improving human health. Although eggs are known for their exceptional, nutritional quality, they are not generally considered as antioxidant foods. This review aims to establish the importance of eggs as an antioxidant food by summarizing the current knowledge on egg-derived antioxidants. Eggs have various natural occurring compounds including the proteins ovalbumin, ovotransferrin and lysozyme in egg white, as well as phosvitin, carotenoids and free aromatic amino acids in egg yolk.Some lipophilic antioxidants such as vitamin E, carotenoids, selenium, iodine and others can be transferred from feed into egg yolk to produce antioxidant-enriched eggs.The bioactivity of egg antioxidants can be affected by food processing, storage and gastrointestinal digestion. Generally thermal processing methods can promote loss of antioxidant properties in eggs due to oxidation and degradation, whereas gastrointestinal digestion enhances the antioxidant properties, due to the formation of new antioxidants (free amino acids and peptides). In summary, in addition to its well-known nutritional contribution to our diet, this review emphasizes the role of eggs as an important antioxidant food.
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Background: Prospective data examining the relationship between dietary protein intake and incident coronary heart disease (CHD) are inconclusive. Most evidence is derived from homogenous populations such as health professionals. Large community-based analyses in more diverse samples are lacking. Methods: We studied the association of protein type and major dietary protein sources and risk for incident CHD in 12,066 middle-aged adults (aged 45-64 at baseline, 1987-1989) from four U.S. communities enrolled in the Atherosclerosis Risk in Communities (ARIC) Study who were free of diabetes mellitus and cardiovascular disease at baseline. Dietary protein intake was assessed at baseline and after 6 years of follow-up by food frequency questionnaire. Our primary outcome was adjudicated coronary heart disease events or deaths with following up through December 31, 2010. Cox proportional hazard models with multivariable adjustment were used for statistical analyses. Results: During a median follow-up of 22 years, there were 1,147 CHD events. In multivariable analyses total, animal and vegetable protein were not associated with an increased risk for CHD before or after adjustment. In food group analyses of major dietary protein sources, protein intake from red and processed meat, dairy products, fish, nuts, eggs, and legumes were not significantly associated with CHD risk. The hazard ratios [with 95% confidence intervals] for risk of CHD across quintiles of protein from poultry were 1.00 [ref], 0.83 [0.70-0.99], 0.93 [0.75-1.15], 0.88 [0.73-1.06], 0.79 [0.64-0.98], P for trend = 0.16). Replacement analyses evaluating the association of substituting one source of dietary protein for another or of decreasing protein intake at the expense of carbohydrates or total fats did not show any statistically significant association with CHD risk. Conclusion: Based on a large community cohort we found no overall relationship between protein type and major dietary protein sources and risk for CHD.
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Background: The evidence supporting recommendations to limit intake of cholesterol rich foods is inconclusive. We aimed to examine the association between egg consumption and carotid atherosclerosis phenotypes, and the association with clinical vascular events in a prospective, urban, multi-ethnic population. Methods and results: The Northern Manhattan Study is a population based cohort to determine stroke incidence, risk factors and prognosis. A sub-cohort of 1429 NOMAS participants with both carotid ultrasounds and comprehensive dietary information was evaluated (mean ± SD age of participants 65.80 ± 8.80, 40% male, 18% white, 20% black, 60% Hispanic). The association between egg consumption and carotid intima media thickness (cIMT) was assessed with linear regression. Logistic and quantile regression was used to examine the association between egg consumption and carotid plaque presence, thickness, and area. The relation between egg consumption and clinical vascular events (N = 2669) was examined with Cox models. The mean total cIMT was 0.91 ± 0.08 mm and 58% had carotid plaque present. Increasing egg consumption was inversely associated with cIMT, plaque presence, thickness, and area, in models adjusted for demographics, vascular risk factors and diet. For every additional egg consumed per week, the risk of plaque decreased by 11% (95% CI 3%-18%). No association was detected between egg consumption and risk of clinical vascular outcomes, over a mean follow up of 11 years and after adjustment for covariates. Conclusions: Frequency of egg consumption in the low to moderate range was inversely related to several markers of carotid atherosclerosis. No association with clinical vascular events, including stroke, was detected. Our findings do not support current vascular health guidelines suggesting the extreme limitation or avoidance of egg consumption due to its cholesterol content.
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This study reviewed epidemiological and experimental evidence on the relationship between egg consumption and cardiovascular disease (CVD) risks among type II diabetes mellitus (T2DM) individuals, and T2DM risk in nondiabetic subjects. Four of the six studies that examined CVD and mortality and egg consumption among diabetics found a statistically significant association. Of the eight studies evaluating incident T2DM and egg consumption, four prospective studies found a statistically significant association. Lack of adjustment for dietary confounders was a common study limitation. A small number of experimental studies examined the relationship between egg intake and CVD risk biomarkers among diabetics or individuals with T2DM risk factors. Studies among healthy subjects found suggestive evidence that dietary interventions that include eggs may reduce the risk of T2DM and metabolic syndrome. Differences in study design, T2DM status, exposure measurement, subject age, control for confounders and follow-up time present significant challenges for conducting a meta-analysis. Conflicting results, coupled with small sample sizes, prevent broad interpretation. Given the study limitations, these findings need to be further investigated.
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BACKGROUND: The associations of egg consumption with cardiovascular disease (CVD) and diabetes are still unclear. OBJECTIVE: We aimed to quantitatively summarize the literature on egg consumption and risk of CVD, cardiac mortality, and type 2 diabetes by conducting a meta-analysis of prospective cohort studies. DESIGN: A systematic literature review was conducted for published studies in PubMed and EMBASE through March 2012. Additional information was retrieved through Google or a hand review of the reference from relevant articles. Studies were included if they had a prospective study design, were published in English-language journals, and provided HRs and 95% CIs for the associations of interest. Data were independently extracted by 2 investigators, and the weighted HRs and 95% CIs for the associations of interest were estimated by using a random-effects model. RESULTS: A total of 22 independent cohorts from 16 studies were identified, including participants ranging in number from 1600 to 90,735 and in follow-up time from 5.8 to 20.0 y. Comparison of the highest category (≥1 egg/d) of egg consumption with the lowest (<1 egg/wk or never) resulted in a pooled HR (95% CI) of 0.96 (0.88, 1.05) for overall CVD, 0.97 (0.86, 1.09) for ischemic heart disease, 0.93 (0.81, 1.07) for stroke, 0.98 (0.77, 1.24) for ischemic heart disease mortality, 0.92 (0.56, 1.50) for stroke mortality, and 1.42 (1.09, 1.86) for type 2 diabetes. Of the studies conducted in diabetic patients, the pooled HR (95% CI) was 1.69 (1.09, 2.62) for overall CVD. CONCLUSION: This meta-analysis suggests that egg consumption is not associated with the risk of CVD and cardiac mortality in the general population. However, egg consumption may be associated with an increased incidence of type 2 diabetes among the general population and CVD comorbidity among diabetic patients.
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Limited egg consumption is often recommended to reduce serum cholesterol concentration for the prevention of CHD. We examined the association of egg consumption and total cholesterol concentration with the risk of CHD. A total of 90 735 subjects (19 856 men and 21 408 women, aged 40-59 years in cohort I; 23 463 men and 26 008 women, aged 40-69 years in cohort II) were followed from 1990-4 to the end of 2001 under the Japan Public Health Center-based prospective study. Total cholesterol was obtained in 36 % of the subjects. Men and women were combined for the analyses. The subjects were categorised into four groups according to egg consumption. Subjects with total cholesterol >or=2200 mg/l were less frequent in frequent egg consumption groups in both cohorts (trend P<0.0001). Subjects with <1 d/week of egg consumption were more likely to avoid a cholesterol-rich diet. Egg consumption was not associated with the risk of CHD, although total cholesterol was significantly related to the risk of CHD. The multivariate hazard ratio of CHD in subjects with total cholesterol >or=2400 v. <1800 mg/l was 2.17 (95 % CI 1.22, 3.85; trend P=0.0018). In conclusion, eating eggs more frequently, up to almost daily, was not associated with an increase in CHD incidence for middle-aged Japanese men and women. Subjects with hypercholesterolaemia were less frequently in frequent egg consumption groups, probably because they avoided eating eggs.
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A reduction in dietary cholesterol is recommended to prevent cardiovascular disease (CVD). Although eggs are important sources of cholesterol and other nutrients, limited and inconsistent data are available on the effects of egg consumption on the risk of CVD and mortality. We aimed to examine the association between egg consumption and the risk of CVD and mortality. In a prospective cohort study of 21,327 participants from Physicians' Health Study I, egg consumption was assessed with an abbreviated food questionnaire. Cox regression was used to estimate relative risks. In an average follow-up of 20 y, 1550 new myocardial infarctions (MIs), 1342 incident strokes, and 5169 deaths occurred. Egg consumption was not associated with incident MI or stroke in a multivariate Cox regression. In contrast, adjusted hazard ratios (95% CI) for mortality were 1.0 (reference), 0.94 (0.87, 1.02), 1.03 (0.95, 1.11), 1.05 (0.93, 1.19), and 1.23 (1.11, 1.36) for the consumption of <1, 1, 2-4, 5-6, and > or = 7 eggs/wk, respectively (P for trend < 0.0001). This association was stronger among diabetic subjects, in whom the risk of death in a comparison of the highest with the lowest category of egg consumption was twofold (hazard ratio: 2.01; 95% CI: 1.26, 3.20; P for interaction = 0.09). Infrequent egg consumption does not seem to influence the risk of CVD in male physicians. In addition, egg consumption was positively related to mortality, more strongly so in diabetic subjects, in the study population.
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To determine the relationship between continuous egg consumption with Thai life-style dietary and serum lipids of healthy young people. Fifty-six participants with an average age of 35 were enrolled. In an experimental method of cholesterol intake, all participants were fed an additional egg per day to their basic diet. This project ran for 12 weeks. The 12-week egg consumption significantly increased serum total cholesterol by 0.27 +/- 0.15 mmol/L (10.43 +/- 5.80 mg/dL) (p < 0.05). The HDL-cholesterol (HDL-c) increased significant by 0.55 +/- 0.06 mmol/L (21.80 +/- 2.25 mg/dL) (p < 0.001) while the total cholesterol (TC) decreased as the HDL-c ratio was 0.94 +/- 1.1 (p < 0.001). No significant changes were found in LDL-cholesterol (LDL-c) and triglyceride levels. The present study showed that small serum LDL-c changed in response to change of egg consumption. Additionally, 12-week egg consumption also resulted in an increasing HDL-c level. In the majority of healthy adults, an addition of one egg per day to a normal fat diet could raise HDL-c levels and decreased the ratio of TC toHDL-c. Therefore, egg consumption might benefit blood cholesterol.
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Background: Observational data on the association between egg consumption and risk of type 2 diabetes mellitus (DM) have been inconsistent. Because eggs are a good source of protein and micronutrients and are inexpensive, it is important to clarify their role in the risk of developing DM. Objective: We conducted a meta-analysis of published prospective cohort studies to evaluate the relation of egg consumption with the risk of DM. Design: We searched PubMed, Ovid, Cochrane, and Google Scholar (up to October 2015) to retrieve published studies. We used RRs from extreme categories of egg consumption for the main analysis but also evaluated dose response by using cubic splines and generalized least squares regression. Results: We identified 12 cohorts for a total of 219,979 subjects and 8911 cases of DM. When comparing the highest with the lowest category of egg intake, pooled multivariate RRs of DM were 1.09 (95% CI: 0.99, 1.20) using the fixed-effect model and 1.06 (95% CI: 0.86, 1.30) using the random-effect model. There was evidence for heterogeneity (I(2) = 73.6%, P < 0.001). When stratified by geographic area, there was a 39% higher risk of DM (95% CI: 21%, 60%) comparing highest with lowest egg consumption in US studies (I(2) = 45.4%, P = 0.089) and no elevated risk of DM with egg intake in non-US studies (RR = 0.89; 95% CI: 0.79, 1.02 using the fixed-effect model, P < 0.001 comparing US with non-US studies). In a dose-response assessment using cubic splines, elevated risk of DM was observed in US studies among people consuming ≥3 eggs/wk but not in non-US studies. Conclusions: Our meta-analysis shows no relation between infrequent egg consumption and DM risk but suggests a modest elevated risk of DM with ≥3 eggs/wk that is restricted to US studies.
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Context Reduction in egg consumption has been widely recommended to lower blood cholesterol levels and prevent coronary heart disease (CHD). Epidemiologic studies on egg consumption and risk of CHD are sparse. Objective To examine the association between egg consumption and risk of CHD and stroke in men and women. Design and Setting Two prospective cohort studies, the Health Professionals Follow-up Study (1986-1994) and the Nurses' Health Study (1980-1994). Participants A total of 37,851 men aged 40 to 75 years at study outset and 80,082 women aged 34 to 59 years at study outset, free of cardiovascular disease, diabetes, hypercholesterolemia, or cancer. Main Outcome Measures Incident nonfatal myocardial infarction, fatal CHD, and stroke corresponding to daily egg consumption as determined by a food-frequency questionnaire. Results We documented 866 incident cases of CHD and 258 incident cases of stroke in men during 8 years of follow-up and 939 incident cases of CHD and 563 incident cases of stroke in women during 14 years of follow-up. After adjustment for age, smoking, and other potential CHD risk factors, we found no evidence of an overall significant association between egg consumption and risk of CHD or stroke in either men or women. The relative risks (RRs) of CHD across categories of intake were less than 1 per week (1.0), 1 per week (1.06), 2 to 4 per week (1.12), 5 to 6 per week (0.90), and ≥1 per day (1.08) (P for trend=.75) for men; and less than 1 per week (1.0), 1 per week (0.82), 2 to 4 per week (0.99), 5 to 6 per week (0.95), and ≥1 per day (0.82) (P for trend=.95) for women. In subgroup analyses, higher egg consumption appeared to be associated with increased risk of CHD only among diabetic subjects (RR of CHD comparing more than 1 egg per day with less than 1 egg per week among diabetic men, 2.02 [95% confidence interval, 1.05-3.87; P for trend=.04], and among diabetic women, 1.49 [0.88-2.52; P for trend=.008]). Conclusions These findings suggest that consumption of up to 1 egg per day is unlikely to have substantial overall impact on the risk of CHD or stroke among healthy men and women. The apparent increased risk of CHD associated with higher egg consumption among diabetic participants warrants further research.