Systematic review2022Open access

Egg and Dietary Cholesterol Intake and Risk of All-Cause, Cardiovascular, and Cancer Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies

Darooghegi Mofrad M, Naghshi S, Lotfi K, Beyene J, Hypponen E, Pirouzi A, Sadeghi O

Frontiers in nutrition · 18 citations

How it was studied

Design
Systematic review (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

Based on full-text disclosure statement.

Publication

Published
2022-05-27 · Front Nutr · vol. 9 · p. 878979
Publisher
Frontiers Media
Cited
21 citations · more than 73% of similar papers · 1.2× the field average
References
94 works
Access
Open access (journal) · CC-BY
Research areas
Nutritional Studies and Diet · Antioxidant Activity and Oxidative Stress · Phytoestrogen effects and research
Keywords
Medicine, Meta-analysis, Relative risk, Prospective cohort study, Cancer, Cohort study, Confidence interval, Internal medicine

7 authors

From IR, CA, AU

  • Manije Darooghegi MofradTehran University of Medical Sciences
  • Sina NaghshiTehran University of Medical Sciences
  • Keyhan LotfiTehran University of Medical Sciences
  • Joseph BeyeneMcMaster University Medical Centre; Impact; McMaster University
  • Elina HyppönenUniversity of South Australia; South Australian Health and Medical Research Institute
  • Aliyar Pirouzi · correspondingGerash University of Medical Sciences

Abstract

Objective

This systematic review and meta-analysis of prospective cohort studies examined the associations between egg and dietary cholesterol intake and the risk of mortality from all causes, including cardiovascular disease (CVD) and cancer.

Methods

We searched PubMed, Scopus, ISI Web of Knowledge, and Google Scholar until April 2021, as well as references to the relevant articles retrieved. Random-effects models were used to calculate summary relative risk (RR) and 95% confidence intervals (CIs) for the highest vs. lowest categories of egg and dietary cholesterol intake. Also, linear and non-linear dose-response analyses were conducted to examine the dose-response relationships.

Results

We included 55 studies, comprising data from 2,772,486 individuals with 228,425, 71,745, and 67,211 cases of all-cause, CVD, and cancer mortality, respectively. Intake of each additional egg per day was associated with a 7% higher risk of all-cause (1.07, 95% CI: 1.02-1.12, I2 = 84.8%) and a 13% higher risk of cancer mortality (1.13, 95% CI: 1.06-1.20, I2 = 54.2%), but was not associated with CVD mortality (1.00, 95% CI: 0.92-1.09, I2 = 81.5%). Non-linear analyses showed increased risks for egg consumption of more than 1.5 and 0.5 eggs/day, respectively. Each 100 mg/day increment in dietary cholesterol intake was associated with a 6% higher risk of all-cause mortality (1.06, 95% CI: 1.03-1.08, I2 = 34.5%) and a 6% higher risk of cancer mortality (1.06, 95% CI: 1.05-1.07, I2 = 0%), but was not associated with CVD mortality (1.04, 95% CI: 0.99-1.10, I2 = 85.9%). Non-linear analyses demonstrated elevated risks of CVD and cancer mortality for intakes more than 450 and 250 mg/day, respectively.

Conclusions and relevance

High-dietary intake of eggs and cholesterol was associated with all-cause and cancer mortality. Little evidence for elevated risks was seen for intakes below 0.5 egg/day or 250 mg/day of dietary cholesterol. Our findings should be considered with caution because of small risk estimates and moderate between-study heterogeneity.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=252564, PROSPERO, identifier: CRD42021252564.

Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).

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