title: Meta-analysis of Egg Consumption and Risk of Coronary Heart Disease and Stroke.
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.affiliation: a EpidStat Institute , Ann Arbor , Michigan.|b EpidStat Institute , Seattle , Washington.
authors.forename: Dominik D
authors.initials: DD
authors.lastname: Alexander
authors.affiliation: a EpidStat Institute , Ann Arbor , Michigan.
authors.forename: Paula E
authors.initials: PE
authors.lastname: Miller
authors.affiliation: a EpidStat Institute , Ann Arbor , Michigan.
authors.forename: Ashley J
authors.initials: AJ
authors.lastname: Vargas
authors.affiliation: c DLW Consulting Services, Salt Lake City , Utah.
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Weed
authors.affiliation: a EpidStat Institute , Ann Arbor , Michigan.
authors.forename: Sarah S
authors.initials: SS
authors.lastname: Cohen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002791:Cholesterol, Dietary / Q000008:administration & dosage* / Q000009:adverse effects; D003327:Coronary Disease / Q000453:epidemiology*; D004032:Diet; D004531:Eggs; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*
chemical_list: D002791:Cholesterol, Dietary
keywords: coronary heart disease; diet; epidemiology; meta-analysis; stroke