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Egg consumption and cardiovascular disease according to diabetic status: The PREDIMED study.
Clin Nutr. 2017 08; 36(4):1015-1021.CN

Abstract

BACKGROUND

Eggs are a major source of dietary cholesterol and their consumption has been sometimes discouraged. A relationship between egg consumption and the incidence of cardiovascular disease (CVD) has been suggested to be present exclusively among patients with type2 diabetes.

AIMS

To assess the association between egg consumption and CVD in a large Mediterranean cohort where approximately 50% of participants had type 2 diabetes.

METHODS

We prospectively followed 7216 participants (55-80 years old) at high cardiovascular risk from the PREDIMED (PREvención con DIeta MEDiterránea) study for a mean of 5.8 years. All participants were initially free of CVD. Yearly repeated measurements of dietary information with a validated 137-item food-frequency questionnaire were used to assess egg consumption and other dietary exposures. The endpoint was the rate of major cardiovascular events (myocardial infarction, stroke or death from cardiovascular causes).

RESULTS

A major cardiovascular event occurred in 342 participants. Baseline egg consumption was not significantly associated with cardiovascular events in the total population. Non-diabetic participants who ate on average >4 eggs/week had a hazard ratio (HR) of 0.96 (95% confidence interval, 0.33-2.76) in the fully adjusted multivariable model when compared with non-diabetic participants who reported the lowest egg consumption (<2 eggs/week). Among diabetic participants, the HR was 1.33 (0.72-2.46). There was no evidence of interaction by diabetic status. HRs per 500 eggs of cumulative consumption during follow-up were 0.94 (0.66-1.33) in non-diabetics and 1.18 (0.90-1.55) in diabetics.

CONCLUSIONS

Low to moderated egg consumption was not associated with an increased CVD risk in diabetic or non-diabetic individuals at high cardiovascular risk. This trial was registered at controlled-trials.com as ISRCTN35739639.

Authors+Show Affiliations

Primary Health Care, Servicio Navarro de Salud-Osasunbidea, Pamplona, Navarra, Spain; Department of Preventive Medicine and Public Health, University of Navarra-School of Medicine, Pamplona, Navarra, Spain; The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Navarra, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain.Department of Preventive Medicine and Public Health, University of Navarra-School of Medicine, Pamplona, Navarra, Spain; The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Navarra, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; Department of Endocrinology, Hospital Reina Sofia, Servicio Navarro de Salud-Osasunbidea, Tudela, Navarra, Spain.The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; Human Nutrition Unit, Faculty of Medicine and Health Sciences, Biochemistry Biotechnology Department, Universitat Rovira i Virgili, Spain; Hospital Universitari de Sant Joan de Reus, IISPV, Reus, Spain.Primary Health Care, Servicio Navarro de Salud-Osasunbidea, Pamplona, Navarra, Spain; Department of Preventive Medicine and Public Health, University of Navarra-School of Medicine, Pamplona, Navarra, Spain; The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Navarra, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain.The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain.Ciber Epidemiolgy and Public Health (CIBERESP), Instituto de Salud Carlos III, Spain; Cardiovascular Risk and Nutrition Research Group, IMIM (Hospital del Mar Medical Research Institut), Spain.The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi I Sunyer, Hospital Clinic, University of Barcelona, Barcelona, Spain.The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; Lipid Clinic, Department of Endocrinology and Nutrition, Institutd'Investigacions Biomèdiques August Pi I Sunyer, Hospital Clinic, University of Barcelona, Barcelona, Spain.The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; Department of Preventive Medicine, University of Malaga, Malaga, Spain.The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; University Hospital of Alava, Vitoria, Basque Country, Spain.Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; Instituto de Investigación Sanitaria de Palma (IdISPa), Hospital Universitario Son Espases, Palma de Mallorca, Spain.Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain.The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain.The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge-IDIBELL-UB, Hospitalet de Llobregat, Barcelona, Spain.The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; Human Nutrition Unit, Faculty of Medicine and Health Sciences, Biochemistry Biotechnology Department, Universitat Rovira i Virgili, Spain; Hospital Universitari de Sant Joan de Reus, IISPV, Reus, Spain.Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain.The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; Ciber Epidemiolgy and Public Health (CIBERESP), Instituto de Salud Carlos III, Spain.The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Navarra, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; Department of Nutrition and Food Sciences, University of Navarra, Pamplona, Navarra, Spain.Department of Preventive Medicine and Public Health, University of Navarra-School of Medicine, Pamplona, Navarra, Spain; The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Navarra, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain. Electronic address: etoledo@unav.es.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27448949

Citation

Díez-Espino, J, et al. "Egg Consumption and Cardiovascular Disease According to Diabetic Status: the PREDIMED Study." Clinical Nutrition (Edinburgh, Scotland), vol. 36, no. 4, 2017, pp. 1015-1021.
Díez-Espino J, Basterra-Gortari FJ, Salas-Salvadó J, et al. Egg consumption and cardiovascular disease according to diabetic status: The PREDIMED study. Clin Nutr. 2017;36(4):1015-1021.
Díez-Espino, J., Basterra-Gortari, F. J., Salas-Salvadó, J., Buil-Cosiales, P., Corella, D., Schröder, H., Estruch, R., Ros, E., Gómez-Gracia, E., Arós, F., Fiol, M., Lapetra, J., Serra-Majem, L., Pintó, X., Babio, N., Quiles, L., Fito, M., Marti, A., & Toledo, E. (2017). Egg consumption and cardiovascular disease according to diabetic status: The PREDIMED study. Clinical Nutrition (Edinburgh, Scotland), 36(4), 1015-1021. https://doi.org/10.1016/j.clnu.2016.06.009
Díez-Espino J, et al. Egg Consumption and Cardiovascular Disease According to Diabetic Status: the PREDIMED Study. Clin Nutr. 2017;36(4):1015-1021. PubMed PMID: 27448949.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Egg consumption and cardiovascular disease according to diabetic status: The PREDIMED study. AU - Díez-Espino,J, AU - Basterra-Gortari,F J, AU - Salas-Salvadó,J, AU - Buil-Cosiales,P, AU - Corella,D, AU - Schröder,H, AU - Estruch,R, AU - Ros,E, AU - Gómez-Gracia,E, AU - Arós,F, AU - Fiol,M, AU - Lapetra,J, AU - Serra-Majem,L, AU - Pintó,X, AU - Babio,N, AU - Quiles,L, AU - Fito,M, AU - Marti,A, AU - Toledo,E, AU - ,, Y1 - 2016/06/29/ PY - 2015/08/25/received PY - 2016/06/09/revised PY - 2016/06/15/accepted PY - 2016/7/28/pubmed PY - 2018/3/27/medline PY - 2016/7/25/entrez KW - Cardiovascular disease KW - Diabetes KW - Egg consumption KW - PREDIMED study SP - 1015 EP - 1021 JF - Clinical nutrition (Edinburgh, Scotland) JO - Clin Nutr VL - 36 IS - 4 N2 - BACKGROUND: Eggs are a major source of dietary cholesterol and their consumption has been sometimes discouraged. A relationship between egg consumption and the incidence of cardiovascular disease (CVD) has been suggested to be present exclusively among patients with type2 diabetes. AIMS: To assess the association between egg consumption and CVD in a large Mediterranean cohort where approximately 50% of participants had type 2 diabetes. METHODS: We prospectively followed 7216 participants (55-80 years old) at high cardiovascular risk from the PREDIMED (PREvención con DIeta MEDiterránea) study for a mean of 5.8 years. All participants were initially free of CVD. Yearly repeated measurements of dietary information with a validated 137-item food-frequency questionnaire were used to assess egg consumption and other dietary exposures. The endpoint was the rate of major cardiovascular events (myocardial infarction, stroke or death from cardiovascular causes). RESULTS: A major cardiovascular event occurred in 342 participants. Baseline egg consumption was not significantly associated with cardiovascular events in the total population. Non-diabetic participants who ate on average >4 eggs/week had a hazard ratio (HR) of 0.96 (95% confidence interval, 0.33-2.76) in the fully adjusted multivariable model when compared with non-diabetic participants who reported the lowest egg consumption (<2 eggs/week). Among diabetic participants, the HR was 1.33 (0.72-2.46). There was no evidence of interaction by diabetic status. HRs per 500 eggs of cumulative consumption during follow-up were 0.94 (0.66-1.33) in non-diabetics and 1.18 (0.90-1.55) in diabetics. CONCLUSIONS: Low to moderated egg consumption was not associated with an increased CVD risk in diabetic or non-diabetic individuals at high cardiovascular risk. This trial was registered at controlled-trials.com as ISRCTN35739639. SN - 1532-1983 UR - https://www.unboundmedicine.com/medline/citation/27448949/Egg_consumption_and_cardiovascular_disease_according_to_diabetic_status:_The_PREDIMED_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0261-5614(16)30141-8 DB - PRIME DP - Unbound Medicine ER -