Abstract

Background: Limiting dietary cholesterol intake is widely recommended for prevention of cardiovascular disease (CVD). Eggs are a major source of dietary cholesterol, but they also contain a variety of other nutrients. Several recent studies have examined egg intake and CVD with conflicting findings. Objective: To prospectively evaluate the association between egg intake and CVD risk in three large cohorts. Methods: Women and men from the Nurses’ Health Study (1980-2010; N=84,537), Nurses’ Health Study II (1991-2010; N=92,588), and Health Professionals Follow-up Study (1986-2010; N=42,815) were included if they were free of CVD and cancer at baseline. Egg intake was assessed every 4 years via validated food frequency questionnaire and evaluated in the following categories for frequency of consuming 1 egg: <1/month (reference), 1-3/month, 1/week, 2-4/week, 5-6/week, 1+/day. Incident coronary heart disease (CHD) (nonfatal myocardial infarction (MI) and fatal coronary disease) and stroke cases were ascertained via self-report and confirmed with review of medical records. Relative risks (HR) and 95% confidence intervals (CI) for CVD risk across categories of egg intake were estimated using multivariate Cox proportional hazards models, adjusted for age, race, smoking, physical activity, BMI, family history of CVD, alcohol, red and processed meat, whole milk, and other dietary covariates. Individual cohort estimates were combined using fixed effects meta-analysis. Results: We identified 5,838 incident cases of CHD (nonfatal MI and fatal CHD) and 6,030 stroke cases. Consumption of up to 1+eggs/day was not significantly associated with risk of incident total CVD (CHD and stroke) after adjustment for several diet and lifestyle factors (HR (CI) by category: <1/month: 1(reference); 1-3/month: 0.95(0.88, 1.02); 1/week: 0.85(0.79, 0.91); 2-4/week: 0.88(0.81, 0.96); 5-6/week: 0.96(0.84, 1.09); 1+/day: 0.99 (0.87, 1.13) (p-trend=0.77). When incident stroke and CHD were evaluated individually, egg intake was not associated with either endpoint (p-trend=0.09 for CHD and 0.52 for stroke). Conclusions: After controlling for lifestyle and dietary factors, egg intake (up to 1+/day) was not associated with increased risk of CVD in three prospective cohorts of men and women.

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