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Current Atherosclerosis Reports
Published in: Current Atherosclerosis Reports 7/2023

Open Access 23-05-2023 | Stroke

Eggs and Cardiovascular Disease Risk: An Update of Recent Evidence

Authors: Sharayah Carter, Elizabeth S. Connole, Alison M. Hill, Jonathan D. Buckley, Alison M. Coates

Published in: Current Atherosclerosis Reports | Issue 7/2023

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Abstract

Purpose of Review

This review summarizes recent evidence published since a previous review in 2018 on the association between egg consumption and risk of cardiovascular disease (CVD) mortality, CVD incidence, and CVD risk factors.

Recent Findings

No recent randomized controlled trials were identified. Evidence from observational studies is mixed, with studies reporting either an increased risk or no association of highest egg consumption with CVD mortality, and a similar spread of increased risk, decreased risk, or no association between egg intake and total CVD incidence. Most studies reported a reduced risk or no association between egg consumption and CVD risk factors. Included studies reported low and high egg intake as between 0 and 1.9 eggs/week and 2 and ≥14 eggs/week, respectively. Ethnicity may influence the risk of CVD with egg consumption, likely due to differences in how eggs are consumed in the diet rather than eggs themselves.

Summary

Recent findings are inconsistent regarding the possible relationship between egg consumption and CVD mortality and morbidity. Dietary guidance should focus on improving the overall quality of the diet to promote cardiovascular health.
Appendix
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Literature
1.
2.
Dietschy JM, Siperstein MD. Effect of cholesterol feeding and fasting on sterol synthesis in seventeen tissues of the rat. J Lipid Res. 1967;8(2):97–104.PubMedCrossRef
3.
Wilson JD, Lindsey CA, Dietschy JM. Influence of dietary cholesterol on cholesterol metabolism. Ann N Y Acad Sci. 1968;149(2):808–21.PubMedCrossRef
4.
American Heart Association: Diet and heart disease. American Heart Association Dallas, TX, USA. In.; 1968.
5.
Dawber TR, Nickerson RJ, Brand FN, Pool J. Eggs, serum cholesterol, and coronary heart disease. Am J Clin Nutr. 1982;36(4):617–25.PubMedCrossRef
6.
7.
Jones PJ, Pappu AS, Hatcher L, Li ZC, Illingworth DR, Connor WE. Dietary cholesterol feeding suppresses human cholesterol synthesis measured by deuterium incorporation and urinary mevalonic acid levels. Arterioscler Thromb Vasc Biol. 1996;16(10):1222–8.PubMedCrossRef
8.
Eckel RH, Jakicic JM, Ard JD, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63(25 Pt B):2960–84.PubMedCrossRef
9.
Soliman GA. Dietary cholesterol and the lack of evidence in cardiovascular disease. Nutrients. 2018;10(6).
10.
Hu FB, Manson JE, Willett WC. Types of dietary fat and risk of coronary heart disease: a critical review. J Am Coll Nutr. 2001;20(1):5–19.PubMedCrossRef
11.
Food Standards Australia New Zealand. AUSNUT 2011–13 – Australian food composition database. Canberra: FSANZ. 2014;Available at www.foodstandards.gov.au. In
12.
Xu Z, McClure ST, Appel LJ. Dietary cholesterol intake and sources among U.S adults: results from National Health and Nutrition Examination Surveys (NHANES), 2001-2014. Nutrients. 2018;10(6).
13.
Geiker NRW, Larsen ML, Dyerberg J, Stender S, Astrup A. Egg consumption, cardiovascular diseases and type 2 diabetes. Eur J Clin Nutr. 2018;72(1):44–56.PubMedCrossRef
14.
Vincent MJ, Allen B, Palacios OM, Haber LT, Maki KC. Meta-regression analysis of the effects of dietary cholesterol intake on LDL and HDL cholesterol. Am J Clin Nutr. 2019;109(1):7–16.PubMedCrossRef
15.
Xu L, Lam TH, Jiang CQ, et al. Egg consumption and the risk of cardiovascular disease and all-cause mortality: Guangzhou Biobank cohort study and meta-analyses. Eur J Nutr. 2019;58(2):785–96.PubMedCrossRef
16.
Bechthold A, Boeing H, Schwedhelm C, et al. Food groups and risk of coronary heart disease, stroke and heart failure: a systematic review and dose-response meta-analysis of prospective studies. Crit Rev Food Sci Nutr. 2019;59(7):1071–90.PubMedCrossRef
17.
Shin JY, Xun P, Nakamura Y, He K. Egg consumption in relation to risk of cardiovascular disease and diabetes: a systematic review and meta-analysis. Am J Clin Nutr. 2013;98(1):146–59.PubMedPubMedCentralCrossRef
18.
Rong Y, Chen L, Zhu T, et al. Egg consumption and risk of coronary heart disease and stroke: dose-response meta-analysis of prospective cohort studies. BMJ. 2013;346:e8539.PubMedPubMedCentralCrossRef
19.
Alexander DD, Miller PE, Vargas AJ, Weed DL, Cohen SS. Meta-analysis of egg consumption and risk of coronary heart disease and stroke. J Am Coll Nutr. 2016;35(8):704–16.PubMedCrossRef
20.
Qin C, Lv J, Guo Y, et al. Associations of egg consumption with cardiovascular disease in a cohort study of 0.5 million Chinese adults. Heart. 2018;104(21):1756–63.PubMedCrossRef
21.
Khawaja O, Singh H, Luni F, et al. Egg consumption and incidence of heart failure: a meta-analysis of prospective cohort studies. Front Nutr. 2017;4:10.PubMedPubMedCentralCrossRef
22.
Missimer A, DiMarco DM, Andersen CJ, Murillo AG, Vergara-Jimenez M, Fernandez ML. Consuming two eggs per day, as compared to an oatmeal breakfast, decreases plasma ghrelin while maintaining the LDL/HDL ratio. Nutrients. 2017;9(2).
23.
Li Y, Zhou C, Zhou X, Li L. Egg consumption and risk of cardiovascular diseases and diabetes: a meta-analysis. Atherosclerosis. 2013;229(2):524–30.PubMedCrossRef
24.
Zhuang P, Wu F, Mao L, et al. Egg and cholesterol consumption and mortality from cardiovascular and different causes in the United States: a populationbased cohort study. PLoS Med. 2021;18(2) (no pagination)(e1003508).
25.
•• Zhong VW, Van Horn L, Cornelis MC, et al. Associations of dietary cholesterol or egg consumption with incident cardiovascular disease and mortality. JAMA. 2019;321(11):1081–95. Data associations changed when adjusting for fat quality.PubMedPubMedCentralCrossRef
26.
Zhong VW, Allen NB, Greenland P, et al. Protein foods from animal sources, incident cardiovascular disease and all-cause mortality: a substitution analysis. Int J Epidemiol. 2021;50(1):223–33.PubMedPubMedCentralCrossRef
27.
Xia PF, Pan XF, Chen C, Wang Y, Ye Y, Pan A. Dietary intakes of eggs and cholesterol in relation to all-cause and heart disease mortality: a prospective cohort study. J Am Heart Assoc. 2020;9(10) (no pagination)(e015743).
28.
Wang M, Wang Z, Lee Y, et al. Dietary meat, trimethylamine N-oxide-related metabolites, and incident cardiovascular disease among older adults: the cardiovascular health study. Arterioscler Thromb Vasc Biol. 2022;42(9):E273–88.PubMedCrossRef
29.
Sun Y, Liu B, Snetselaar LG, et al. Association of major dietary protein sources with all-cause and cause-specific mortality: prospective cohort study. J Am Heart Assoc. 2021;10(5):1–24.CrossRef
30.
• Huang J, Liao LM, Weinstein SJ, Sinha R, Graubard BI, Albanes D. Association between plant and animal protein intake and overall and cause-specific mortality. JAMA Intern Med. 2020;180(9):1173–84. Only paper to consider protein equivalents and controlled for saturated fat.PubMedCrossRef
31.
Al-Ramady O, Latifi AN, Treu T, et al. Egg consumption and risk of acute stroke in the million veteran program. Clin Nutr ESPEN. 2022;50:178–82.PubMedCrossRef
32.
Djousse L, Ho YL, Nguyen XMT, et al. Egg consumption and risk of coronary artery disease in the million veteran program. Clin Nutr. 2020;39(9):2842–7.PubMedCrossRef
33.
Djousse L, Zhou G, McClelland RL, et al. Egg consumption, overall diet quality, and risk of type 2 diabetes and coronary heart disease: a pooling project of US prospective cohorts. Clin Nutr. 2021;40(5):2475–82.PubMedPubMedCentralCrossRef
34.
Chen GC, Chen LH, Mossavar-Rahmani Y, et al. Dietary cholesterol and egg intake in relation to incident cardiovascular disease and all-cause and cause-specific mortality in postmenopausal women. Am J Clin Nutr. 2021;113(4):948–59.PubMedCrossRef
35.
• Pan XF, Yang JJ, Lipworth LP, et al. Cholesterol and egg intakes with cardiometabolic and all-cause mortality among Chinese and low-income Black and White Americans. Nutrients. 2021;13(6):15. Associations differed by population.CrossRef
36.
Riseberg E, Lopez-Cepero A, Mangano KM, Tucker KL, Mattei J. Specific dietary protein sources are associated with cardiometabolic risk factors in the Boston Puerto Rican health study. J Acad Nutr Diet. 2022;122(2):298-+.
37.
Zhang X, Liu F, Li J, et al. Longitudinal association of egg consumption habits with blood lipids among Chinese adults: results from the prediction for atherosclerotic cardiovascular disease risk in China project. Chin Med J. 2022;135(6):747–9.PubMedCrossRef
38.
•• Xia X, Liu FC, Yang XL, et al. Associations of egg consumption with incident cardiovascular disease and all-cause mortality. Sci China Life Sci. 2020;63(9):1317–27. Study in a Chinese population goes against the trends of other studies.PubMedCrossRef
39.
Wang K, Wang L, Liu LJ, et al. Longitudinal association of egg intake frequency with cardiovascular disease in Chinese adults. Nutr Metab Carbiovasc Dis. 2022;32(4):908–17.CrossRef
40.
Pan L, Chen L, Lv J et al. Association of egg consumption, metabolic markers, and risk of cardiovascular diseases. medRxiv. 2021;07.
41.
Liu RR, Zhao YL, Li Q, Dang SN, Yan H. Body fat mass, fat distribution and egg consumption: a population-based study in Chinese adults egg consumption and body fat in rural Chinese. J Am Coll Nutr. 2020;39(6):528–36.PubMedCrossRef
42.
Liang J, Zhao JK, Wang JP, Wang T. Association between animal source foods consumption and risk of hypertension: a cohort study. Eur J Nutr. 2021;60(5):2469–83.PubMedCrossRef
43.
Zupo R, Sardone R, Donghia R, et al. Traditional Dietary patterns and risk of mortality in a longitudinal cohort of the Salus in Apulia study. Nutrients. 2020;12(4):15.CrossRef
44.
Zamora-Ros R, Cayssials V, Cleries R, et al. Moderate egg consumption and all-cause and specific-cause mortality in the Spanish European prospective into cancer and nutrition (EPIC-Spain) study. Eur J Nutr. 2019;58(5):2003–10.PubMedCrossRef
45.
Tong TYN, Appleby PN, Key TJ, et al. The associations of major foods and fibre with risks of ischaemic and haemorrhagic stroke: a prospective study of 418 329 participants in the EPIC cohort across nine European countries. Eur Heart J. 2020;41(28):2632–40.PubMedPubMedCentralCrossRef
46.
Ruggiero E, Di Castelnuovo A, Costanzo S, et al. Egg consumption and risk of all-cause and cause-specific mortality in an Italian adult population. Eur J Nutr. 2021;60(7):3691–702.PubMedPubMedCentralCrossRef
47.
Macdonald CJ, Madika AL, Bonnet F, Fagherazzi G, Lajous M, Boutron-Ruault MC. Cholesterol and egg intakes, and risk of hypertension in a large prospective cohort of french women. Nutrients. 2020;12(5) (no pagination)(1350).
48.
Key TJ, Appleby PN, Bradbury KE, et al. Consumption of meat, fish, dairy products, and eggs and risk of ischemic heart disease: a prospective study of 7198 incident cases among 409 885 participants in the pan-European EPIC cohort. Circulation. 2019;139(25):2835–45.PubMedPubMedCentralCrossRef
49.
Abdollahi AM, Virtanen HEK, Voutilainen S, et al. Egg consumption, cholesterol intake, and risk of incident stroke in men: the Kuopio Ischaemic Heart Disease Risk Factor Study. Am J Clin Nutr. 2019;110(1):169–76.PubMedCrossRef
50.
Kunutsor SK, Laukkanen JA, Virtanen JK. Egg and cholesterol intake, apolipoprotein E4 phenotype and risk of venous thromboembolism: findings from a prospective cohort study. Br J Nutr. 2022.
51.
Mohammadifard N, Taheri M, Haghighatdoost F et al. Egg consumption and risk of cardiovascular events among Iranians: results from Isfahan Cohort Study (ICS). Eur J Clin Nutr. 2022.
52.
• Dehghan M, Mente A, Rangarajan S, et al. Association of egg intake with blood lipids, cardiovascular disease, and mortality in 177,000 people in 50 countries. Am J Clin Nutr. 2020;111(4):795–803. Associations differed by population.PubMedPubMedCentralCrossRef
53.
Liu C, Xue Y, Wang Y, et al. Association between dietary patterns and dyslipidemia in adults from the Henan rural cohort study. Asia Pac J Clin Nutr. 2020;29(2):299–308.PubMed
54.
Song WO, Kerver JM. Nutritional contribution of eggs to American diets. J Am Coll Nutr. 2000;19(5 Suppl):556s–62s.PubMedCrossRef
55.
Godos J, Micek A, Brzostek T, et al. Egg consumption and cardiovascular risk: a dose-response meta-analysis of prospective cohort studies. Eur J Nutr. 2021;60(4):1833–62.PubMedCrossRef
56.
Ma W, Zhang Y, Pan L et al. Association of egg consumption with risk of all-cause and cardiovascular disease mortality: a systematic review and dose-response meta-analysis of observational studies. J Nutr. 2022;07.
57.
Yang PF, Wang CR, Hao FB, et al. Egg consumption and risks of all-cause and cause-specific mortality: a dose-response meta-analysis of prospective cohort studies. Nutr Rev. 2022;80(7):1739–54.PubMedCrossRef
58.
Su C, Jia X, Wang Z, Wang H, Zhang B. Trends in dietary cholesterol intake among Chinese adults: a longitudinal study from the China Health and Nutrition Survey, 1991–2011. BMJ Open. 2015;5(6):e007532.PubMedPubMedCentralCrossRef
59.
Carson JAS, Lichtenstein AH, Anderson CAM, et al. Dietary cholesterol and cardiovascular risk: a science advisory from the American Heart Association. Circulation. 2020;141(3):e39–53.PubMedCrossRef
60.
Tang D, Wang R, He X, et al. Comparison of the edible quality of liquid egg with different cooking methods and their antioxidant activity after in vitro digestion. Food Res Int. 2021;140:110013.PubMedCrossRef
61.
Sarlak S, Tabeidian SA, Toghyani M, Shahraki ADF, Goli M, Habibian M. Effects of replacing inorganic with organic iron on performance, egg quality, serum and egg yolk lipids, antioxidant status, and iron accumulation in eggs of laying hens. Biol Trace Elem Res. 2021;199(5):1986–99.PubMedCrossRef
62.
Zheng M, Mao P, Tian X, Guo Q, Meng L. Effects of dietary supplementation of alfalfa meal on growth performance, carcass characteristics, meat and egg quality, and intestinal microbiota in Beijing-you chicken. Poult Sci. 2019;98(5):2250–9.PubMedCrossRef
63.
Pliego AB, Tavakoli M, Khusro A, et al. Beneficial and adverse effects of medicinal plants as feed supplements in poultry nutrition: a review. Anim Biotechnol. 2022;33(2):369–91.PubMedCrossRef
64.
Islam Z, Sultan A, Khan S, Alhidary IA, Abdelrahman MM, Khan RU. Impact of varying housing systems on egg quality characteristics, fatty acid profile, and cholesterol content of Rhode Island Red × Fyoumi laying hens. Trop Anim Health Prod. 2021;53(5):456.PubMedCrossRef
65.
Anderson KE. Comparison of fatty acid, cholesterol, and vitamin A and E composition in eggs from hens housed in conventional cage and range production facilities. Poult Sci. 2011;90(7):1600–8.PubMedCrossRef
66.
Marventano S, Godos J, Tieri M, et al. Egg consumption and human health: an umbrella review of observational studies. Int J Food Sci Nutr. 2020;71(3):325–31.PubMedCrossRef
67.
Mah E, Chen CO, Liska DJ. The effect of egg consumption on cardiometabolic health outcomes: an umbrella review. Public Health Nutr. 2020;23(5):935–55.PubMedCrossRef
68.
Rouhani MH, Rashidi-Pourfard N, Salehi-Abargouei A, Karimi M, Haghighatdoost F. Effects of egg consumption on blood lipids: a systematic review and meta-analysis of randomized clinical trials. J Am Coll Nutr. 2018;37(2):99–110.PubMedCrossRef
69.
Wang MX, Wong CH, Kim JE. Impact of whole egg intake on blood pressure, lipids and lipoproteins in middle-aged and older population: a systematic review and meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis. 2019;29(7):653–64.PubMedCrossRef
70.
Zhang Y, Zhang DZ. Red meat, poultry, and egg consumption with the risk of hypertension: a meta-analysis of prospective cohort studies. J Hum Hypertens. 2018;32(7):507–17.PubMedCrossRef
71.
Schwingshackl L, Schwedhelm C, Hoffmann G, et al. Food groups and risk of hypertension: a systematic review and dose-response meta-analysis of prospective studies. Adv Nutr. 2017;8(6):793–803.PubMedPubMedCentralCrossRef
72.
Vu T-HT, Van Horn L, Daviglus ML, et al. Association between egg intake and blood pressure in the USA: the International Study on Macro/Micronutrients and Blood Pressure (INTERMAP). Public Health Nutr. 2021;24(18):6272–80.PubMedCrossRef
73.
Li MY, Chen JH, Chen C, Kang YN. Association between egg consumption and cholesterol concentration: a systematic review and meta-analysis of randomized controlled trials. Nutrients. 2020;12(7):1–15.CrossRef
74.
Richard C, Cristall L, Fleming E, et al. Impact of egg consumption on cardiovascular risk factors in individuals with type 2 diabetes and at risk for developing diabetes: a systematic review of randomized nutritional intervention studies. Can J Diabetes. 2017;41(4):453–63.PubMedCrossRef
75.
Pallazola VA, Davis DM, Whelton SP, et al. A clinician’s guide to healthy eating for cardiovascular disease prevention. Mayo Clin Proc Innov Qual Outcomes. 2019;3(3):251–67.PubMedPubMedCentralCrossRef
Metadata
Title
Eggs and Cardiovascular Disease Risk: An Update of Recent Evidence
Authors
Sharayah Carter
Elizabeth S. Connole
Alison M. Hill
Jonathan D. Buckley
Alison M. Coates
Publication date
23-05-2023
Publisher
Springer US
Published in
Current Atherosclerosis Reports / Issue 7/2023
Print ISSN: 1523-3804
Electronic ISSN: 1534-6242
DOI
https://doi.org/10.1007/s11883-023-01109-y

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