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Mohseni GK, Mohammadi S, Aghakhaninejad Z, Tajadod S, Abbasi K, Askarpour SA, Salimi Z, Shafaei Kachaei H, Rajabi Harsini A, Alami F, Bagheri SE, Mosavi Jarrahi SA, Gohari A, Khoshdooz S, Doaei S, Kooshki A, Gholamalizadeh M. Egg consumption and risk of cardiovascular disease: a PERSIAN cohort-based study. BMC Cardiovasc Disord 2023; 23:588. [PMID: 38036988 PMCID: PMC10688106 DOI: 10.1186/s12872-023-03621-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 11/17/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Cardiovascular diseases (CVDs) are one of the main causes of death worldwide. Data on the effect of eggs consumption on the risk of CVDs are still unreliable. Therefore, this study aimed to investigate the association between CVDs and the consumption of eggs. METHODS In this case-control study, the required data were extracted from the Prospective Epidemiologic Research Studies in Iran (PERSIAN) cohort in Sabzevar, Iran. A total of 4241 adults participated including 1535 patients with CVDs as the case group and 2706 healthy people as controls. Egg consumption was assessed using a valid food frequency questionnaire (FFQ). RESULTS A significant association was observed between eggs consumption and stroke after adjustment for physical activity, body mass index (BMI), smoking, systolic blood pressure (SBP), diastolic blood pressure (DBP), using alcohol, lipid profile, diabetes, and the intake of energy, lipid, protein, carbohydrate, and cholestrol (OR:1.007, 95% CI:1.001-1.013, P = 0.03). No association was found between egg consumption with hypertension, cardiac ischemia, and myocardial infarction. CONCLUSIONS There was a significant association between the consumption of eggs and stroke. However, more studies are needed to examine the effect of eggs on CVDs.
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Affiliation(s)
- Golsa Khalatbari Mohseni
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Saeideh Mohammadi
- Department of Nutrition, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Zohreh Aghakhaninejad
- Department of Nutrition and Biochemistry, School of Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Shirin Tajadod
- Department of Nutrition, School of Public Health, International Campus, Iran University of Medical Sciences, Tehran, Iran
| | - Khadijeh Abbasi
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan, Iran
| | - Seyed Ali Askarpour
- Division of Food Safety and Hygiene, Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Salimi
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hanieh Shafaei Kachaei
- Student Research Committee, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Asma Rajabi Harsini
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran university of medical sciences, Tehran, Iran
| | - Farkhondeh Alami
- Student Research Committee, Department of Nutrition, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | | | | | - Ali Gohari
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Sara Khoshdooz
- Faculty of Medicine, Guilan University of Medical Science, Rasht, Iran
| | - Saeid Doaei
- Department of Community Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Akram Kooshki
- Non-Communicable Diseases Research Center, Department of Nutrition & Biochemistry, Faculty of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran.
| | - Maryam Gholamalizadeh
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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2
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Xia X, Liu F, Huang K, Chen S, Li J, Cao J, Yang X, Liu X, Shen C, Yu L, Zhao Y, Zhao L, Li Y, Hu D, Huang J, Lu X, Gu D. Egg consumption and risk of coronary artery disease, potential amplification by high genetic susceptibility: a prospective cohort study. Am J Clin Nutr 2023; 118:773-781. [PMID: 37793743 DOI: 10.1016/j.ajcnut.2023.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/03/2023] [Accepted: 06/08/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Remarkable heterogeneity has been observed among population-based studies on egg consumption and risk of coronary artery disease (CAD). Whether genetic susceptibility serves as a potential explanation for this inconsistency remains unknown. OBJECTIVES We performed a prospective cohort study to investigate the association of egg consumption with incident CAD at different genetic susceptibilities. METHODS We included 34,111 participants without CAD at baseline from the project of Prediction for Atherosclerotic Cardiovascular Disease Risk in China. Egg consumption was assessed with food frequency questionnaires. Genetic susceptibility was quantified by a predefined polygenic risk score (PRS) with 540 genetic variants. The hazard ratio (HR) and 95% confidence interval (95% CI) of incident CAD associated with egg consumption and PRS were estimated using the Cox proportional hazards models. RESULTS Over a median 11.7 y of follow-up, 1,128 incident cases of CAD were recorded. Both higher egg consumption and increased PRS were related to higher risk of CAD. When stratified by genetic risk, each increment of 3 eggs/wk was associated with a 5% higher risk of CAD for participants at low to intermediate genetic risk (HR: 1.05; 95% CI: 1.01, 1.09), whereas risk increased to HR 1.10 (95% CI: 1.05, 1.16) for those at high genetic risk; a significant synergistic interaction was also indicated at both multiplicative (Pinteraction = 0.007) and additive (relative excess risk: 0.73; 95% CI: 0.24, 1.22) scales. When the joint effect was examined, in comparison with those at low to intermediate genetic risk and consuming <1 egg/wk, the HR (95% CI) was 2.95 (2.41, 3.62) for participants with high genetic risk and consumption of ≥10 eggs/wk, and the corresponding standardized 10-y CAD rates increased from 1.37% to 4.24%. CONCLUSIONS Genetic predisposition may synergistically interact with egg consumption in relation to increased CAD risk. PRS-stratified recommendations on egg consumption may help formulate personalized nutrition policies.
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Affiliation(s)
- Xue Xia
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, China; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Fangchao Liu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, China
| | - Keyong Huang
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shufeng Chen
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianxin Li
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie Cao
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xueli Yang
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xiaoqing Liu
- Division of Epidemiology, Guangdong Provincial People's Hospital and Cardiovascular Institute, Guangzhou, China
| | - Chong Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Ling Yu
- Department of Cardiology, Fujian Provincial Hospital, Fuzhou, China
| | - Yingxin Zhao
- Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan, China
| | - Liancheng Zhao
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ying Li
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China; Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, China
| | - Jiangfeng Huang
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiangfeng Lu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, China.
| | - Dongfeng Gu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, China; School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, China.
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3
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Nguyen XMT, Whitbourne SB, Li Y, Quaden RM, Song RJ, Nguyen HNA, Harrington K, Djousse L, Brewer JVV, Deen J, Muralidhar S, Ramoni RB, Cho K, Casas JP, Tsao PS, Gaziano JM. Data Resource Profile: Self-reported data in the Million Veteran Program: survey development and insights from the first 850 736 participants. Int J Epidemiol 2023; 52:e1-e17. [PMID: 35748351 DOI: 10.1093/ije/dyac133] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2022] [Indexed: 12/12/2022] Open
Affiliation(s)
- Xuan-Mai T Nguyen
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, USA.,Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Champaign, IL, USA
| | - Stacey B Whitbourne
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA.,Department of Medicine, Division of Aging, Brigham and Women's Hospital, Boston, MA, USA
| | - Yanping Li
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, USA
| | - Rachel M Quaden
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, USA
| | - Rebecca J Song
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, USA
| | - Hai-Nam A Nguyen
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, USA
| | - Kelly Harrington
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, USA
| | - Luc Djousse
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, USA.,New England Geriatric Research, Education, and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA, USA
| | - Jessica V V Brewer
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, USA
| | - Jennifer Deen
- Office of Research and Development, Veterans Health Administration, Washington, DC, USA
| | - Sumitra Muralidhar
- Office of Research and Development, Veterans Health Administration, Washington, DC, USA
| | - Rachel B Ramoni
- Office of Research and Development, Veterans Health Administration, Washington, DC, USA
| | - Kelly Cho
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA.,Department of Medicine, Division of Aging, Brigham and Women's Hospital, Boston, MA, USA
| | - Juan P Casas
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA.,Department of Medicine, Division of Aging, Brigham and Women's Hospital, Boston, MA, USA
| | - Philip S Tsao
- VA Palo Alto Epidemiology Research and Information Center for Genomics, VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - John M Gaziano
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA.,Department of Medicine, Division of Aging, Brigham and Women's Hospital, Boston, MA, USA
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4
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Ueng KC, Chiang CE, Chao TH, Wu YW, Lee WL, Li YH, Ting KH, Su CH, Lin HJ, Su TC, Liu TJ, Lin TH, Hsu PC, Wang YC, Chen ZC, Jen HL, Lin PL, Ko FY, Yen HW, Chen WJ, Hou CJY. 2023 Guidelines of the Taiwan Society of Cardiology on the Diagnosis and Management of Chronic Coronary Syndrome. ACTA CARDIOLOGICA SINICA 2023; 39:4-96. [PMID: 36685161 PMCID: PMC9829849 DOI: 10.6515/acs.202301_39(1).20221103a] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 11/03/2022] [Indexed: 01/24/2023]
Abstract
Coronary artery disease (CAD) covers a wide spectrum from persons who are asymptomatic to those presenting with acute coronary syndromes (ACS) and sudden cardiac death. Coronary atherosclerotic disease is a chronic, progressive process that leads to atherosclerotic plaque development and progression within the epicardial coronary arteries. Being a dynamic process, CAD generally presents with a prolonged stable phase, which may then suddenly become unstable and lead to an acute coronary event. Thus, the concept of "stable CAD" may be misleading, as the risk for acute events continues to exist, despite the use of pharmacological therapies and revascularization. Many advances in coronary care have been made, and guidelines from other international societies have been updated. The 2023 guidelines of the Taiwan Society of Cardiology for CAD introduce a new concept that categorizes the disease entity according to its clinical presentation into acute or chronic coronary syndromes (ACS and CCS, respectively). Previously defined as stable CAD, CCS include a heterogeneous population with or without chest pain, with or without prior ACS, and with or without previous coronary revascularization procedures. As cardiologists, we now face the complexity of CAD, which involves not only the epicardial but also the microcirculatory domains of the coronary circulation and the myocardium. New findings about the development and progression of coronary atherosclerosis have changed the clinical landscape. After a nearly 50-year ischemia-centric paradigm of coronary stenosis, growing evidence indicates that coronary atherosclerosis and its features are both diagnostic and therapeutic targets beyond obstructive CAD. Taken together, these factors have shifted the clinicians' focus from the functional evaluation of coronary ischemia to the anatomic burden of disease. Research over the past decades has strengthened the case for prevention and optimal medical therapy as central interventions in patients with CCS. Even though functional capacity has clear prognostic implications, it does not include the evaluation of non-obstructive lesions, plaque burden or additional risk-modifying factors beyond epicardial coronary stenosis-driven ischemia. The recommended first-line diagnostic tests for CCS now include coronary computed tomographic angiography, an increasingly used anatomic imaging modality capable of detecting not only obstructive but also non-obstructive coronary plaques that may be missed with stress testing. This non-invasive anatomical modality improves risk assessment and potentially allows for the appropriate allocation of preventive therapies. Initial invasive strategies cannot improve mortality or the risk of myocardial infarction. Emphasis should be placed on optimizing the control of risk factors through preventive measures, and invasive strategies should be reserved for highly selected patients with refractory symptoms, high ischemic burden, high-risk anatomies, and hemodynamically significant lesions. These guidelines provide current evidence-based diagnosis and treatment recommendations. However, the guidelines are not mandatory, and members of the Task Force fully realize that the treatment of CCS should be individualized to address each patient's circumstances. Ultimately, the decision of healthcare professionals is most important in clinical practice.
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Affiliation(s)
- Kwo-Chang Ueng
- Division of Cardiology, Department of Internal Medicine, Chung Shan Medical University Hospital; School of Medicine, Chung Shan Medical University, Taichung
| | - Chern-En Chiang
- General Clinical Research Center and Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei
- School of Medicine, National Yang Ming Chiao Tung University, Taipei
| | - Ting-Hsing Chao
- Department of Internal Medicine, National Cheng Kung University Hospital; College of Medicine, National Cheng Kung University, Tainan
| | - Yen-Wen Wu
- School of Medicine, National Yang Ming Chiao Tung University, Taipei
- Division of Cardiology, Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City
| | - Wen-Lieng Lee
- School of Medicine, National Yang Ming Chiao Tung University, Taipei
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung
| | - Yi-Heng Li
- Department of Internal Medicine, National Cheng Kung University Hospital; College of Medicine, National Cheng Kung University, Tainan
| | - Ke-Hsin Ting
- Division of Cardiology, Department of Internal Medicine, Yunlin Christian Hospital, Yunlin
| | - Chun-Hung Su
- Division of Cardiology, Department of Internal Medicine, Chung Shan Medical University Hospital; School of Medicine, Chung Shan Medical University, Taichung
| | - Hung-Ju Lin
- Cardiovascular Center, Department of Internal Medicine, National Taiwan University Hospital
| | - Ta-Chen Su
- Cardiovascular Center, Department of Internal Medicine, National Taiwan University Hospital
- Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine, Taipei
| | - Tsun-Jui Liu
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung
| | - Tsung-Hsien Lin
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung
| | - Po-Chao Hsu
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung
| | - Yu-Chen Wang
- Division of Cardiology, Asia University Hospital, Department of Medical Laboratory Science and Biotechnology, Asia University, Taichung
| | - Zhih-Cherng Chen
- Division of Cardiology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan
| | - Hsu-Lung Jen
- Division of Cardiology, Cheng Hsin Rehabilitation Medical Center, Taipei
| | - Po-Lin Lin
- Division of Cardiology, Hsinchu MacKay Memorial Hospital, Hsinchu
| | - Feng-You Ko
- Cardiovascular Center, Kaohsiung Veterans General Hospital, Kaohsiung
| | - Hsueh-Wei Yen
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung
| | - Wen-Jone Chen
- Division of Cardiology, Department of Internal Medicine, Min Sheng General Hospital, Taoyuan
| | - Charles Jia-Yin Hou
- Cardiovascular Center, Department of Internal Medicine, MacKay Memorial Hospital; Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
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5
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Egg consumption and risk of acute stroke in the Million Veteran Program. Clin Nutr ESPEN 2022; 50:178-182. [DOI: 10.1016/j.clnesp.2022.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/23/2022] [Accepted: 05/27/2022] [Indexed: 11/19/2022]
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6
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Egg consumption and risk of cardiovascular events among Iranians: results from Isfahan Cohort Study (ICS). Eur J Clin Nutr 2022; 76:1409-1414. [DOI: 10.1038/s41430-022-01118-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/26/2022] [Accepted: 03/10/2022] [Indexed: 11/09/2022]
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7
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Sanlier N, Üstün D. Egg consumption and health effects: A narrative review. J Food Sci 2021; 86:4250-4261. [PMID: 34472102 DOI: 10.1111/1750-3841.15892] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 07/13/2021] [Accepted: 08/02/2021] [Indexed: 11/26/2022]
Abstract
This study was planned and conducted to investigate the effects of egg consumption on metabolic syndrome components and potential mechanisms of action on humans. Egg, an important source of animal protein, is defined as a functional food containing various bioactive compounds that can affect the proinflammatory and anti-inflammatory pathways. As a matter of fact, the egg can show immunomodulatory, anti-inflammatory, antioxidant, anticancer, or antihypertensive effects with its bioactive components. It is claimed that egg consumption may protect individuals against metabolic syndrome by increasing HDL-C levels and reducing inflammation. The increase in egg consumption creates the perception that it may lead to cardiovascular diseases due to its cholesterol content. However, there is insufficient evidence as to whether dietary cholesterol-lowers LDL-C. The possible potential mechanisms of egg impact on human health, MEDLINE, Embase, the Cochrane Central, www.ClinicalTrials.gov, PubMed, Science Direct, Google Scholar, and selected websites including) and databases were examined in this regard. With a view to delving into the rather mysterious relationship between egg cholesterol and blood cholesterol, it is necessary to understand the absorption of cholesterol from the egg and to know the functioning of the intestinal microbiota. Studies conducted to date have generally yielded inconsistent results regarding egg consumption and risks of CVD, diabetes, and metabolic syndrome.
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Affiliation(s)
- Nevin Sanlier
- Department of Nutrition and Dietetics, School of Health Sciences, Ankara Medipol University, Ankara, Turkey
| | - Dilara Üstün
- Department of Nutrition and Dietetics, Institute of Health Sciences, Ankara Medipol University, Ankara, Turkey
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8
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Djoussé L, Zhou G, McClelland RL, Ma N, Zhou X, Kabagambe EK, Talegawkar SA, Judd SE, Biggs ML, Fitzpatrick AL, Clark CR, Gagnon DR, Steffen LM, Gaziano JM, Lee IM, Buring JE, Manson JE. 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; 40:2475-2482. [PMID: 33932789 PMCID: PMC8564713 DOI: 10.1016/j.clnu.2021.03.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 01/25/2021] [Accepted: 03/02/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND AIMS Data on the relation of egg consumption with risk of type 2 diabetes (T2D) and coronary heart disease (CHD) are limited and inconsistent. Few studies have controlled for overall dietary patterns in egg-T2D or egg-CHD analyses, and it is unclear whether any observed elevated risks of T2D and CHD with frequent egg consumption is real or due to confounding by dietary habits. We tested the hypothesis that frequent egg consumption is associated with a higher risk of T2D and CHD risk after adjustment for overall dietary patterns among adults. DESIGN We used prospective cohort design to complete time-to-event analyses. METHODS We pooled de novo, harmonized, individual-level analyses from nine US cohorts (n = 103,811). Cox regression was used to estimate hazard ratios separately in each cohort adjusting for age, ethnicity, body mass index (BMI), exercise, smoking, alcohol intake, and dietary patterns. We pooled cohort-specific results using an inverse-variance weighted method to estimate summary relative risks. RESULTS Median age ranged from 25 to 72 years. Median egg consumption was 1 egg per week in most of the cohorts. While egg consumption up to one per week was not associated with T2D risk, consumption of ≥2 eggs per week was associated with elevated risk [27% elevated risk of T2D comparing 7+ eggs/week with none (95% CI: 16%-37%)]. There was little evidence for heterogeneity across cohorts and we observed similar conclusions when stratified by BMI. Overall, egg consumption was not associated with the risk of CHD. However, in a sensitivity analysis, there was a 30% higher risk of CHD (95% CI: 3%-56%) restricted to older adults consuming 5-6 eggs/week. CONCLUSIONS Our data showed an elevated risk of T2D with egg consumption of ≥2 eggs per week but not with <2 eggs/week. While there was no overall association of egg consumption with CHD risk, the elevated CHD observed with consumption of 5-6 eggs/week in older cohorts merits further investigation.
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Affiliation(s)
- Luc Djoussé
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Boston VA Healthcare System, Boston, MA, USA.
| | - Guohai Zhou
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Nanxun Ma
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Xia Zhou
- University of Minnesota School of Public Health Division of Epidemiology and Community, Health, Minneapolis, MN, USA
| | | | - Sameera A Talegawkar
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health at the George Washington University, Washington, DC, USA
| | | | - Mary L Biggs
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | | | - Cheryl R Clark
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - David R Gagnon
- Boston VA Healthcare System, Boston, MA, USA; Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Lyn M Steffen
- University of Minnesota School of Public Health Division of Epidemiology and Community, Health, Minneapolis, MN, USA
| | - J Michael Gaziano
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Boston VA Healthcare System, Boston, MA, USA
| | - I-Min Lee
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Julie E Buring
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
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9
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Sugano M, Matsuoka R. Nutritional Viewpoints on Eggs and Cholesterol. Foods 2021; 10:494. [PMID: 33669005 PMCID: PMC7996514 DOI: 10.3390/foods10030494] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/20/2021] [Accepted: 02/22/2021] [Indexed: 12/17/2022] Open
Abstract
Although most current epidemiologic studies indicate no significant association between consuming one egg daily and blood cholesterol levels and cardiovascular risk, arguments still persist with a positive association. Since the diet is one of the most influential factors for this association, we illustrate characteristic features in Japanese people whose dietary pattern is distinct from that, for example, the US (United States) population. Available epidemiologic studies in healthy Japanese people show no association between consumption of one egg daily and blood cholesterol level, consistent with those observed in the US population. However, when consumption of major nutrients and food sources of cholesterol are compared to the US population, Japanese people may have an extra-reserve against the influence of eggs on cardiovascular risk markers, despite consuming relatively more eggs. Further discussion on the influence of nutrients contained in the egg and dietary pattern, including interaction with gut microbes, is necessary. In addition, special consideration at the personalized level is needed for judgment regarding dietary cholesterol not only for hypercholesterolemic patients but for hyper-responsive healthy persons. Although randomized controlled trials with long-term follow-up are required to evaluate the association between consumption of eggs and human health, available information, at least from the nutritional viewpoint, suggests that egg is a healthy and cost-efficient food worldwide.
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Affiliation(s)
- Michihiro Sugano
- Kyushu University, Fukuoka 819-0395, Japan;
- Prefectural University of Kumamoto, Kumamoto 862-8502, Japan
- Japan Egg Science Society, Tokyo 182-0002, Japan
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10
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Godos J, Micek A, Brzostek T, Toledo E, Iacoviello L, Astrup A, Franco OH, Galvano F, Martinez-Gonzalez MA, Grosso G. Egg consumption and cardiovascular risk: a dose-response meta-analysis of prospective cohort studies. Eur J Nutr 2020; 60:1833-1862. [PMID: 32865658 PMCID: PMC8137614 DOI: 10.1007/s00394-020-02345-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 07/21/2020] [Indexed: 12/11/2022]
Abstract
Purpose Cardiovascular disease (CVD) is a leading cause of mortality globally and is strongly influenced by dietary risk factors. The aim was to assess the association between egg consumption and risk of CVD risk/mortality, including coronary heart disease (CHD), stroke, and heart failure. Methods MEDLINE, Embase, and Web of Science databases were searched through April 2020 for prospective studies. Two independent reviewers screened and extracted the data through standardized methods. Size effects were calculated as summary relative risks (SRRs) in a dose–response fashion through random-effects meta-analyses. Results Thirty-nine studies including nearly 2 million individuals and 85,053 CHD, 25,103 stroke, 7536 heart failure, and 147,124 CVD cases were included. The summary analysis including 17 datasets from 14 studies conducted on CVD (incidence and/or mortality) showed that intake of up to six eggs per week is inversely associated with CVD events, when compared to no consumption [for four eggs per week, SRR = 0.95 (95% CI: 0.90; 1.00)]; a decreased risk of CVD incidence was observed for consumption of up to one egg per day [SRR = 0.94 (95% CI: 0.89; 0.99)]. The summary analysis for CHD incidence/mortality including 24 datasets from 16 studies showed a decreased risk up to two eggs per week [(SRR = 0.96 (95% CI: 0.91; 1.00)]. No associations were retrieved with risk of stroke. The summary analysis for heart failure risk including six datasets from four studies showed that intake of one egg per day was associated with increased risk raising for higher intakes compared to no consumption [for 1 egg per day, SRR = 1.15 (95% CI:1.02; 1.30)]. After considering GRADE criteria for strength of the evidence, it was rated low for all outcomes but stroke, for which it was moderate (yet referring to no risk). Conclusion There is no conclusive evidence on the role of egg in CVD risk, despite the fact that higher quality studies are warranted to obtain stronger evidence for a possible protection of CVD associated with moderate weekly egg consumption compared to no intake; equally, future studies may strengthen the evidence for increased heart failure risk associated with high regular egg consumption. Electronic supplementary material The online version of this article (10.1007/s00394-020-02345-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Agnieszka Micek
- Department of Nursing Management and Epidemiology Nursing, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland
| | - Tomasz Brzostek
- Department of Internal Medicine and Community Nursing, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland
| | - Estefania Toledo
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Navarre, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Navarra Institute for Health Research, IdiSNA, Pamplona, Navarre, Spain
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, IS, Italy.,Department of Medicine and Surgery, Research Centre in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy
| | - Arne Astrup
- Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Nørre Campus, Copenhagen, Denmark
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.,Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Fabio Galvano
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia 97, 95123, Catania, Italy
| | - Miguel A Martinez-Gonzalez
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, Pamplona, Navarre, Spain.,CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Carlos III Institute of Health, Madrid, Spain.,Navarra Institute for Health Research, IdiSNA, Pamplona, Navarre, Spain.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Giuseppe Grosso
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia 97, 95123, Catania, Italy.
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Xia P, Pan X, 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:e015743. [PMID: 32400247 PMCID: PMC7660855 DOI: 10.1161/jaha.119.015743] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background The aim of this study was to identify associations between dietary intakes of eggs and cholesterol and all-cause and heart disease mortality in a US population. Methods and Results Data from the National Health and Nutrition Examination Survey 1999-2014 were used in this study, which included 37 121 participants ≥20 years of age. Dietary information was assessed via 24-hour dietary recalls at baseline. Mortality status was documented until December 31, 2015. Cox proportional hazards models were used to examine the associations between dietary intakes of eggs and cholesterol and all-cause and heart disease mortality. During a median follow-up of 7.8 years, 4991 deaths were documented, including 870 deaths from heart disease. No significant association was observed between additional daily consumption of half an egg and all-cause mortality (multivariable-adjusted hazard ratio, 1.04; 95% CI, 0.96-1.13), or heart disease mortality (0.96; 0.80-1.14). Each 50-mg/day increase of cholesterol intake was inversely associated with all-cause mortality among participants with daily intake <250 mg (0.87; 0.77-0.98), but positively associated with all-cause mortality among participants with daily intake ≥250 mg (1.07; 1.01-1.12). No significant association was found between dietary cholesterol intake and heart disease mortality. Conclusions No significant association was found between egg consumption and mortality in US adults. The association between dietary cholesterol intake and all-cause mortality depended on the baseline intake levels, with an inverse association in those with lower intake levels (<250 mg/day) but a positive association in those with higher intake levels (≥250 mg/day).
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Affiliation(s)
- Peng‐Fei Xia
- Department of Epidemiology and BiostatisticsMinistry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - Xiong‐Fei Pan
- Department of Epidemiology and BiostatisticsMinistry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
- Division of EpidemiologyDepartment of MedicineVanderbilt University Medical CenterNashvilleTN
| | - Chen Chen
- Department of Epidemiology and BiostatisticsMinistry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - Yi Wang
- Department of Epidemiology and BiostatisticsMinistry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - Yi Ye
- Department of Epidemiology and BiostatisticsMinistry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
| | - An Pan
- Department of Epidemiology and BiostatisticsMinistry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubation)School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubeiChina
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