title: Egg consumption and cardiovascular disease according to diabetic status: The PREDIMED study.
abstract: 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.
  
  
  
  To assess the association between egg consumption and CVD in a large Mediterranean cohort where approximately 50% of participants had type 2 diabetes.
  
  
  
  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).
  
  
  
  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.
  
  
  
  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.affiliation: 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.
authors.forename: J
authors.initials: J
authors.lastname: Díez-Espino
authors.affiliation: 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.
authors.forename: F J
authors.initials: FJ
authors.lastname: Basterra-Gortari
authors.affiliation: 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.
authors.forename: J
authors.initials: J
authors.lastname: Salas-Salvadó
authors.affiliation: 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.
authors.forename: P
authors.initials: P
authors.lastname: Buil-Cosiales
authors.affiliation: 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.
authors.forename: D
authors.initials: D
authors.lastname: Corella
authors.affiliation: 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.
authors.forename: H
authors.initials: H
authors.lastname: Schröder
authors.affiliation: 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.
authors.forename: R
authors.initials: R
authors.lastname: Estruch
authors.affiliation: 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.
authors.forename: E
authors.initials: E
authors.lastname: Ros
authors.affiliation: 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.
authors.forename: E
authors.initials: E
authors.lastname: Gómez-Gracia
authors.affiliation: 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.
authors.forename: F
authors.initials: F
authors.lastname: Arós
authors.affiliation: 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.
authors.forename: M
authors.initials: M
authors.lastname: Fiol
authors.affiliation: 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.
authors.forename: J
authors.initials: J
authors.lastname: Lapetra
authors.affiliation: 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.
authors.forename: L
authors.initials: L
authors.lastname: Serra-Majem
authors.affiliation: 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.
authors.forename: X
authors.initials: X
authors.lastname: Pintó
authors.affiliation: 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.
authors.forename: N
authors.initials: N
authors.lastname: Babio
authors.affiliation: 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.
authors.forename: L
authors.initials: L
authors.lastname: Quiles
authors.affiliation: 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.
authors.forename: M
authors.initials: M
authors.lastname: Fito
authors.affiliation: 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.
authors.forename: A
authors.initials: A
authors.lastname: Marti
authors.affiliation: 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.
authors.forename: E
authors.initials: E
authors.lastname: Toledo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000178:diet therapy* / Q000208:ethnology; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control*; D058065:Diabetic Cardiomyopathies / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology / Q000517:prevention & control*; D003927:Diet, Diabetic / Q000009:adverse effects / Q000208:ethnology; D018752:Diet, Fat-Restricted / Q000009:adverse effects / Q000208:ethnology; D038441:Diet, Mediterranean / Q000009:adverse effects / Q000208:ethnology; D004531:Eggs / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D015994:Incidence; D008297:Male; D019083:Mediterranean Region / Q000453:epidemiology; D008875:Middle Aged; D010349:Patient Compliance / Q000208:ethnology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D057566:Self Report
keywords: Cardiovascular disease; Diabetes; Egg consumption; PREDIMED study