Abstract P421: Eggs as Part of a Healthy Eating Pattern Are Not Adversely Associated With Dyslipidemia in the Framingham Offspring Study

Abstract

Background: For decades, dietary guidelines have recommended restricting egg consumption out of concern about the high content of dietary cholesterol and potential effects on LDL cholesterol levels and, in turn, cardiovascular risk. However, the evidence supporting these recommendations has been increasingly questioned. Objective: To examine the association of egg consumption with plasma lipid levels and risk of dyslipidemia in adults in the Framingham Offspring Study, and to determine whether these effects are modified by other dietary factors. Methods: We included 1,852 adults aged 30-64 years with available 3-day food records, and without prevalent CVD or use of lipid-lowering or glucose-lowering medications. Multivariable Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for risks of elevated fasting LDL-C and triglycerides after adjusting for confounding. Analysis of covariance models were used to estimate sex-specific mean plasma levels of total cholesterol, LDL, the ratio of LDL:HDL, and triglycerides associated with categories of egg intake. Confounding factors retained in the final models included age, BMI, and other dietary factors. Stratified analyses were used to evaluate effect modification by several dietary factors. Findings: Over approximately 6 years of follow-up, 372 adults developed new-onset elevated LDL and 306 adults developed new-onset elevated triglycerides levels. Overall, those with higher egg consumption (vs. lower) had very similar intakes of other healthy foods at baseline (e.g., whole grains, fruits, vegetables, dairy, and fish). Men and women consuming ≥5 eggs per week (vs. <0.5) had no increased risk of elevated LDL (HR=0.85, 95% CI: 0.59-1.22) or triglycerides (HR=1.25, 95% CI: 0.83-1.86). In fact, men with higher egg intakes (≥5 vs. <0.5 per week) had a total cholesterol level that was 8.6 mg/dL lower, an LDL level that was 5.9 mg/dL lower, and a log-transformed triglyceride level that was 0.13 units lower (p<0.05 for all differences) after 4 years of follow-up. Further, participants with higher egg consumption in combination with higher fiber intake had lower levels of all lipids (p<0.05 for total cholesterol, LDL, and LDL:HDL for the category of higher egg & higher fiber vs. lower egg & lower fiber). Moreover, consumption of >5 eggs/week (vs. <0.5) combined with either higher intakes of total fish or fiber was also associated with statistically significant reductions in LDL levels. Conclusions: This study suggests that higher egg intakes had no adverse effects on serum lipids in healthy adults and may be beneficial as part of a healthy eating pattern.