Egg consumption and risk of cardiovascular disease: three large prospective US cohort studies, systematic review, and updated meta-analysis
Drouin-Chartier JP, Chen S, Li Y, Schwab AL, Stampfer MJ, Sacks FM, Rosner B, Willett WC, Hu FB, Bhupathiraju SN
BMJ (Clinical research ed.) · 94 citations
How it was studied
- Design
- Meta-analysis (indexed by PubMed)
- Studied in
- People
- Main outcome
- Clinical events such as disease or death
- Intake measured by
- Not stated
Who paid for it
- Funding
- Independent funding
- Government
- Canadian Institutes of Health Research
- Government
- National Heart, Lung, and Blood Institute
- Government
- National Cancer Institute
- Government
- National Institute of Diabetes and Digestive and Kidney Diseases
- Government
- NCI NIH HHS
- Government
- CIHR
- Government
- NHLBI NIH HHS
- Government
- NIDDK NIH HHS
- Grants
- National Cancer Institute (U01 CA167552); National Cancer Institute (P01 CA087969); National Institute of Diabetes and Digestive and Kidney Diseases (K01 DK107804); National Heart, Lung, and Blood Institute (R01-HL034594); National Cancer Institute (UM1 CA186107); National Heart, Lung, and Blood Institute (R01 HL035464); National Heart, Lung, and Blood Institute (R01-HL-088521); National Cancer Institute (U01 CA176726); National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK112940); National Cancer Institute (UM1 CA176726); National Heart, Lung, and Blood Institute (R01HL118264); National Heart, Lung, and Blood Institute (R01 HL060712)
Based on 8 listed funder(s).
Publication
- Published
- 2020-03-04 · BMJ · vol. 368 · p. m513
- Cited
- 158 citations · more than 97% of similar papers · 5.5× the field average
- Impact
- Top 10% most cited in its field
- References
- 71 works
- Access
- Open access (hybrid journal) · CC-BY
- Research areas
- Nutritional Studies and Diet · Sodium Intake and Health · Obesity, Physical Activity, Diet
- Keywords
- Medicine, Prospective cohort study, Hazard ratio, Cohort study, Cohort, Myocardial infarction, Meta-analysis, Disease, Body mass index, Internal medicine, Nurses' Health Study, Type 2 diabetes, Confidence interval, Diabetes mellitus, Endocrinology
- MeSH
- humans, cardiovascular diseases, cohort studies, prospective studies, eggs, united states
10 authors
From US
- Jean‐Philippe Drouin‐ChartierHarvard University
- Siyu ChenHarvard University
- Yanping LiHarvard University
- Amanda L SchwabHarvard University
- Meir J. StampferBrigham and Women's Hospital; Harvard University
- Frank M. SacksBrigham and Women's Hospital; Harvard University
Abstract
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, I2=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, I2=38.2%), and stroke (22 risk estimates, 1 059 315 participants, 53 617 stroke events; 0.99, 0.91 to 1.07, I2=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, I2=30.8%) or European cohorts (1.05, 0.92 to 1.19, I2=64.7%), but an inverse association was seen in Asian cohorts (0.92, 0.85 to 0.99, I2=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.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
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