Abstract
Background/objectivesIt remains unclear if high egg consumption has beneficial or adverse effects on cardiometabolic health. The present study prospectively evaluated the longitudinal association between egg-consumption levels and incident cardiovascular disease (CVD) among Korean adults.Subjects/methodsWe conducted a prospective cohort study of 9248 Korean adults aged 40–69 years without CVD or cancer at the baseline from the Korean Genome and Epidemiology Study, Ansung–Ansan cohort, South Korea. The egg intake of the participants was estimated using a validated semiquantitative food frequency questionnaire at the baseline and the second follow-up examination and categorized into quartiles. CVD cases were identified using biennial questionnaires and confirmed through repeated in-depth personal interviews. Hazard ratios (HR) and 95% confidence interval (CI) were analyzed using Cox proportional hazard regression.ResultsDuring the average follow-up of 7.3 years, 570 cases of CVD were newly diagnosed. After adjusting for multiple confounding variables, egg-intake levels were not associated with CVD incidence (HR: 1.14, 95% CI: 0.87–1.49, P for trend: 0.7). However, the association was modified by type 2 diabetes mellitus (T2DM) status. Egg consumption was significantly associated with an increased risk for incident CVD among participants with T2DM; individuals with the highest egg intake (4.2 ± 0.04 eggs/week) had a 2.8 times higher incidence of CVD (HR: 2.81, 95% CI: 1.25–6.30, P for trend: 0.02) than those with the lowest egg intake (0.1 ± 0.02 eggs/week). However, no association was observed among individuals without T2DM (HR: 1.03, 95% CI: 0.77–1.38, P for trend: 0.8).ConclusionsHigher egg consumption may increase the risk for CVD in Korean patients with T2DM. Our findings provide a basis for the development of an optimal dietary cholesterol intake guideline for the Korean population.
Highlights
Eggs are an affordable and healthy source of high-quality protein and micronutrients (e.g., essentialObservational studies and randomized controlled trials (RCT) have reported conflicting data on the effect of egg consumption on lipid profiles and cardiometabolic health, Nutrition and DiabetesJang et al Nutrition and Diabetes (2018)8:20 with some showing beneficial and others adverse effects[6,7,8]
After adjusting for multiple confounding variables, egg-intake levels were not associated with cardiovascular disease (CVD) incidence (HR: 1.14, 95% confidence interval (CI): 0.87–1.49, P for trend: 0.7)
The association was modified by type 2 diabetes mellitus (T2DM) status
Summary
Eggs are an affordable and healthy source of high-quality protein and micronutrients (e.g., essentialObservational studies and randomized controlled trials (RCT) have reported conflicting data on the effect of egg consumption on lipid profiles and cardiometabolic health, Nutrition and DiabetesJang et al Nutrition and Diabetes (2018)8:20 with some showing beneficial and others adverse effects[6,7,8]. In a recent systematic review, Richard et al.[8] reported that consuming 1–2 eggs per day for 12 weeks did not adversely affect some CVD risk factors, including plasma concentrations of high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), glucose, and inflammation markers (TNF-α and IL-6) among patients with type 2 diabetes mellitus (T2DM). Data on the association between dietary cholesterol intake and CVD risk were mainly reported in the United States (US) and the countries of the European Union (EU). The results of these studies might not be suitable evidence for developing dietary guidelines for populations other than those of the US and the EU. There is limited information on the association between the level of egg consumption and the risk for cardiometabolic disease in the Korean population, whose average cholesterol intake is lower than that of Western populations[9,10]
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