Eating more than an egg daily will increases the risk of death?

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Eating more than an egg daily will increases the risk of death?

Eating more than an egg daily will increases the risk of death? 520,000 research data: eating half an egg more daily increases the risk of death by 7%.

Eggs are a good source of high-quality protein, vitamins and other biologically active nutrients (such as lecithin and carotenoids) and are recommended as part of a healthy diet in the 2015-2020 American Dietary Guidelines.

However, due to the high cholesterol content of eggs (approximately 186mg cholesterol per egg), in the past few decades, it has been recommended to limit the intake of cholesterol in the diet to 300mg/day to prevent cardiovascular disease. Therefore, many people choose not to eat eggs (each egg is about 50g) or egg yolk, but some people say that it is okay to eat a few more eggs.

Who is right?

Although in recent years there have been many studies on the fact that eating eggs can increase cholesterol levels in the body and increase the risk of cardiovascular disease, there are few data from large-scale cohort studies.

Today we are going to introduce this NIH-AARP Diet and Health Study published in PLOS MEDICINE, which assesses the association between egg and dietary cholesterol intake and all-cause mortality and cardiovascular disease mortality.

Next, let us look at this research together.

A study of 520,000 people tells you, is it really good to eat more eggs?

The NIH-AARP study is a large-scale prospective study, from 1995 to 1996 from six US states (California, Florida, Louisiana, New Jersey, North Carolina and Pennsylvania) and two other large Urban areas (Atlanta, Georgia and Detroit, Michigan) recruited 521,120 participants (mean age 62.2 years, 41.2% women) and were followed up to the end of 2011.

The study assessed the intake of whole eggs, protein/substitutes and cholesterol through a validated food frequency questionnaire, and stratified energy intake according to quintiles.

Research data showed that the total median intake of whole eggs and cholesterol of participants was 8g/2,000kcal/day and 208mg/2,000kcal/day, respectively. At baseline, participants with a higher consumption of whole eggs had higher BMI levels and lower household incomes.

Table 1: NIH-AARP Diet and Health Study Participants’ baseline characteristics based on whole egg intake.

Eating more than an egg daily will increases the risk of death?

Not only that, they are also less educated, less physically active, more likely to smoke, higher cholesterol levels, and higher intake of red meat; intake of fruits, dairy products, and sugar-sweetened beverages The amount is even less.

Research data shows that during an average follow-up of 16 years, a total of 129,328 deaths occurred. In the age- and gender-adjusted model, eating whole eggs was closely related to higher all-cause mortality (model 1, P<0.001).

After further adjusting other demographic characteristics and dietary factors (P<0.001), the positive correlation between eating whole eggs and higher all-cause mortality is still significant. However, after further adjusting the cholesterol factor (P=0.64), the positive correlation between the consumption of whole eggs and the risk of death from all causes was not significant.

From this point of view, whole eggs will lead to an increase in all-cause mortality, which does have a certain relationship with cholesterol. In contrast to eating whole eggs, in the multivariate adjusted model, the consumption of egg white/egg substitutes was significantly associated with lower all-cause mortality (P<0.001).

Figure 1. Multivariate adjustments for all-cause and cause-specific mortality of whole egg intake, egg white/egg substitutes, and cholesterol.

Let’s take a look at Figure 1. Figure 1 shows that for every additional half an egg/day, egg white/substitute/day, or every additional 300 mg cholesterol/day, the mortality changes due to different causes such as cardiovascular disease.

In combination with Table 3, it can be seen that in the multivariate adjustment model, an additional intake of 300 mg of dietary cholesterol per day will increase the risk of all-cause mortality by 19% (HR=1.19; 95% CI: 1.16-1.22; P<0.001) ; An additional intake of half an egg increases the risk of all-cause death by 7% (HR=1.07; 95% CI: 1.06-1.08; P＜0.001), while all-cause deaths among participants who consume more egg whites/egg substitutes The rate was reduced by 7% (HR=0.93; 95%CI 0.91-0.95; P<0.001).

That said, eating less eggs and cholesterol, and increasing your intake of egg whites or egg substitutes is beneficial.

Table 2: Data source of Figure 1. According to changes in the intake of eggs and cholesterol, all-cause deaths and other deaths.

After reading all-cause mortality, let’s talk about the risk of death from cardiovascular disease.

Table 3: The relationship between whole egg intake and cardiovascular disease mortality

Note: The multivariate models in the text are:

Model 1: Model after adjusting age and gender,
Model 2: On the basis of Model 1, other demographic characteristics and dietary factors are further adjusted;
Model 3: A model that adjusts the total energy and intake of cholesterol-containing foods (eggs, red meat, fish, poultry, and dairy products) on the basis of Model 2; a model for cholesterol-containing foods;
Model 4: Based on Model 2, a model that adjusts the intake of total energy and non-cholesterol foods (fruits, vegetables, potatoes, nuts/beans, whole grains, refined grains, coffee and sugary beverages);
Model 5: Based on Model 2, the total energy is adjusted and the overall diet model is adjusted according to the Healthy Eating Index 2015;
Model 6: Based on Model 2, a model that adjusts the intake of total energy and saturated fat, polyunsaturated fat, monounsaturated fat, trans fat, animal protein, fiber and sodium.

Table 4: The relationship between intake of 300mg/2000kcal/day cholesterol and cardiovascular disease mortality
Eating more tahn an egg daily will increases the risk of death?

After multivariate adjustment, the intake of whole eggs and cholesterol was positively correlated with CVD mortality (P trend <0.001), while the correlation between intake of egg white/egg substitutes and cardiovascular death did not seem to be significant (P= 0.40). So it seems that egg whites and egg substitutes dominate.

Returning to Figure 1, you can see that eating half an egg a day with one egg a day can increase the risk of CVD death by 7%.

Table 5: Data source of Figure 1. According to changes in the intake of eggs and cholesterol, all-cause deaths and other deaths.

And every 300 mg of dietary cholesterol intake per day can increase CVD mortality by 16%. The intermediary analysis showed that the role of cholesterol intake in all-cause death, CVD death and cancer death accounted for 63.2% (95% CI: 49.6%-75.0%) and 62.3% (95% CI: 39.5%-80.7%), respectively And 49.6% (95% CI: 31.9%-67.4%).

Replacing half an egg every day can reduce the risk of all-cause and cardiovascular death!

In the hypothetical substitution analysis, the researchers found that replacing half a whole egg (25 g/day) with equal amounts of egg white/egg substitutes, poultry, fish, dairy products, nuts, and beans can reduce 6% and 8%. %, 9%, 7%, 13%, and 10% all-cause mortality (Figure 2).

Figure 2: By substituting the same amount of other protein sources for a whole egg, adjust: the multivariable risk ratio of all-cause and cardiovascular death

From the perspective of cardiovascular disease, replacing half an egg with the same amount of protein/egg substitute can reduce CVD mortality by 3%, and replacing half an egg with an equal amount of nuts or beans can reduce CVD mortality 9%.

When half an egg was replaced with the same amount of poultry, fish or dairy products, the CVD mortality rate also changed significantly.

Intake of protein can be a different way, don’t eat more eggs!

For this finding, the researchers concluded: In this large cohort, the intake of whole eggs and cholesterol was associated with higher all-cause and cardiovascular disease mortality, while the intake of egg white/egg substitutes was associated with lower Related to death rates. The all-cause of eating whole eggs, the increase in CVD mortality is largely affected by cholesterol intake.

Replacing whole eggs with the same amount of egg white/egg substitutes or alternative protein sources can reduce all-cause mortality and cardiovascular disease mortality to a certain extent.

The results of this study are also consistent with the results of a recent joint study of 6 potential US cohorts (n=29,615). The study reported that for every half an egg a day, an increase of 6%, 8%, and 8%, respectively The risk of cardiovascular disease, the risk of death from cardiovascular disease, and the risk of death from all causes.

According to the researcher, this study is currently the largest cohort study on the topic of “eggs, cholesterol and the risk of death from disease”. The researcher has a follow-up rate of ≥99% during the 16-year follow-up period. But the researchers also pointed out that the results of this study may not be generalized to people outside the United States due to different nutrition and diet patterns and different prevalence of chronic diseases.

In addition, despite extensive adjustments to recognized diet and lifestyle risk factors, we cannot rule out the possibility of remaining confounding factors among other confounding factors that cannot be measured.

Therefore, due to the observational nature of the study, it is impossible to explain the relationship between egg intake and the risk of death by causation.

So, how many eggs do you usually eat every day? After reading the research, would you consider trying other protein sources to replace part of your egg intake?

(source:internet, reference only)

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