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Meta-analysis of Egg Consumption and Risk of Coronary Heart Disease and Stroke.
J Am Coll Nutr. 2016 Nov-Dec; 35(8):704-716.JA

Abstract

The possible relationship between dietary cholesterol and cardiac outcomes has been scrutinized for decades. However, recent reviews of the literature have suggested that dietary cholesterol is not a nutrient of concern. Thus, we conducted a meta-analysis of egg intake (a significant contributor to dietary cholesterol) and risk of coronary heart disease (CHD) and stroke. A comprehensive literature search was conducted through August 2015 to identify prospective cohort studies that reported risk estimates for egg consumption in association with CHD or stroke. Random-effects meta-analysis was used to generate summary relative risk estimates (SRREs) for high vs low intake and stratified intake dose-response analyses. Heterogeneity was examined in subgroups where sensitivity and meta regression analyses were conducted based on increasing egg intake. A 12% decreased risk (SRRE = 0.88, 95% confidence interval [CI], 0.81-0.97) of stroke was observed in the meta-analysis of 7 studies of egg intake (high vs low; generally 1/d vs <2/wk), with little heterogeneity (p-H = 0.37, I2 = 7.50). A nonstatistically significant SRRE of 0.97 (95% CI, 0.88-1.07, p-H = 0.67, I2 = 0.00) was observed in the meta-analysis of 7 studies of egg consumption and CHD. No clear dose-response trends were apparent in the stratified intake meta-analyses or the meta regression analyses. Based on the results of this meta-analysis, consumption of up to one egg daily may contribute to a decreased risk of total stroke, and daily egg intake does not appear to be associated with risk of CHD. Key Teaching Points: • The role of egg consumption in the risk of stroke and coronary heart disease has come under scrutiny over many years. • A comprehensive meta-analysis of prospective cohort studies that reported risk estimates for egg consumption in association with CHD or stroke was performed on the peer-reviewed epidemiologic literature through August 2015. • Overall, summary associations indicate that intake of up to 1 egg daily may be associated with reduced risk of total stroke. • Overall, summary associations show no clear association between egg intake and increased or decreased risk of CHD. • Eggs are a relatively low-cost and nutrient-dense whole food that provides a valuable source of protein, essential fatty acids, antioxidants, choline, vitamins, and minerals.

Authors+Show Affiliations

a EpidStat Institute , Ann Arbor , Michigan. b EpidStat Institute , Seattle , Washington.a EpidStat Institute , Ann Arbor , Michigan.a EpidStat Institute , Ann Arbor , Michigan.c DLW Consulting Services, Salt Lake City , Utah.a EpidStat Institute , Ann Arbor , Michigan.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27710205

Citation

Alexander, Dominik D., et al. "Meta-analysis of Egg Consumption and Risk of Coronary Heart Disease and Stroke." Journal of the American College of Nutrition, vol. 35, no. 8, 2016, pp. 704-716.
Alexander DD, Miller PE, Vargas AJ, et al. Meta-analysis of Egg Consumption and Risk of Coronary Heart Disease and Stroke. J Am Coll Nutr. 2016;35(8):704-716.
Alexander, D. D., Miller, P. E., Vargas, A. J., Weed, D. L., & Cohen, S. S. (2016). Meta-analysis of Egg Consumption and Risk of Coronary Heart Disease and Stroke. Journal of the American College of Nutrition, 35(8), 704-716.
Alexander DD, et al. Meta-analysis of Egg Consumption and Risk of Coronary Heart Disease and Stroke. J Am Coll Nutr. 2016 Nov-Dec;35(8):704-716. PubMed PMID: 27710205.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Meta-analysis of Egg Consumption and Risk of Coronary Heart Disease and Stroke. AU - Alexander,Dominik D, AU - Miller,Paula E, AU - Vargas,Ashley J, AU - Weed,Douglas L, AU - Cohen,Sarah S, Y1 - 2016/10/06/ PY - 2016/10/7/pubmed PY - 2017/11/29/medline PY - 2016/10/7/entrez KW - coronary heart disease KW - diet KW - epidemiology KW - meta-analysis KW - stroke SP - 704 EP - 716 JF - Journal of the American College of Nutrition JO - J Am Coll Nutr VL - 35 IS - 8 N2 - The possible relationship between dietary cholesterol and cardiac outcomes has been scrutinized for decades. However, recent reviews of the literature have suggested that dietary cholesterol is not a nutrient of concern. Thus, we conducted a meta-analysis of egg intake (a significant contributor to dietary cholesterol) and risk of coronary heart disease (CHD) and stroke. A comprehensive literature search was conducted through August 2015 to identify prospective cohort studies that reported risk estimates for egg consumption in association with CHD or stroke. Random-effects meta-analysis was used to generate summary relative risk estimates (SRREs) for high vs low intake and stratified intake dose-response analyses. Heterogeneity was examined in subgroups where sensitivity and meta regression analyses were conducted based on increasing egg intake. A 12% decreased risk (SRRE = 0.88, 95% confidence interval [CI], 0.81-0.97) of stroke was observed in the meta-analysis of 7 studies of egg intake (high vs low; generally 1/d vs <2/wk), with little heterogeneity (p-H = 0.37, I2 = 7.50). A nonstatistically significant SRRE of 0.97 (95% CI, 0.88-1.07, p-H = 0.67, I2 = 0.00) was observed in the meta-analysis of 7 studies of egg consumption and CHD. No clear dose-response trends were apparent in the stratified intake meta-analyses or the meta regression analyses. Based on the results of this meta-analysis, consumption of up to one egg daily may contribute to a decreased risk of total stroke, and daily egg intake does not appear to be associated with risk of CHD. Key Teaching Points: • The role of egg consumption in the risk of stroke and coronary heart disease has come under scrutiny over many years. • A comprehensive meta-analysis of prospective cohort studies that reported risk estimates for egg consumption in association with CHD or stroke was performed on the peer-reviewed epidemiologic literature through August 2015. • Overall, summary associations indicate that intake of up to 1 egg daily may be associated with reduced risk of total stroke. • Overall, summary associations show no clear association between egg intake and increased or decreased risk of CHD. • Eggs are a relatively low-cost and nutrient-dense whole food that provides a valuable source of protein, essential fatty acids, antioxidants, choline, vitamins, and minerals. SN - 1541-1087 UR - https://www.unboundmedicine.com/medline/citation/27710205/Meta_analysis_of_Egg_Consumption_and_Risk_of_Coronary_Heart_Disease_and_Stroke_ L2 - http://www.tandfonline.com/doi/full/10.1080/07315724.2016.1152928 DB - PRIME DP - Unbound Medicine ER -