Egg consumption, overall diet quality, and risk of type 2 diabetes and coronary heart disease: A pooling project of US prospective cohorts

Luc Djoussé, Guohai Zhou, Robyn L. McClelland, Nanxun Ma, Xia Zhou, Edmond K. Kabagambe, Sameera A. Talegawkar, Suzanne E. Judd, Mary L. Biggs, Annette L. Fitzpatrick, Cheryl R. Clark, David R. Gagnon, Lyn M. Steffen, J. Michael Gaziano, I. Min Lee, Julie E. Buring, Jo Ann E. Manson

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background and aims: Data on the relation of egg consumption with risk of type 2 diabetes (T2D) and coronary heart disease (CHD) are limited and inconsistent. Few studies have controlled for overall dietary patterns in egg-T2D or egg-CHD analyses, and it is unclear whether any observed elevated risks of T2D and CHD with frequent egg consumption is real or due to confounding by dietary habits. We tested the hypothesis that frequent egg consumption is associated with a higher risk of T2D and CHD risk after adjustment for overall dietary patterns among adults. Design: We used prospective cohort design to complete time-to-event analyses. Methods: We pooled de novo, harmonized, individual-level analyses from nine US cohorts (n = 103,811). Cox regression was used to estimate hazard ratios separately in each cohort adjusting for age, ethnicity, body mass index (BMI), exercise, smoking, alcohol intake, and dietary patterns. We pooled cohort-specific results using an inverse-variance weighted method to estimate summary relative risks. Results: Median age ranged from 25 to 72 years. Median egg consumption was 1 egg per week in most of the cohorts. While egg consumption up to one per week was not associated with T2D risk, consumption of ≥2 eggs per week was associated with elevated risk [27% elevated risk of T2D comparing 7+ eggs/week with none (95% CI: 16%–37%)]. There was little evidence for heterogeneity across cohorts and we observed similar conclusions when stratified by BMI. Overall, egg consumption was not associated with the risk of CHD. However, in a sensitivity analysis, there was a 30% higher risk of CHD (95% CI: 3%–56%) restricted to older adults consuming 5–6 eggs/week. Conclusions: Our data showed an elevated risk of T2D with egg consumption of ≥2 eggs per week but not with <2 eggs/week. While there was no overall association of egg consumption with CHD risk, the elevated CHD observed with consumption of 5–6 eggs/week in older cohorts merits further investigation.

Original languageEnglish (US)
Pages (from-to)2475-2482
Number of pages8
JournalClinical Nutrition
Volume40
Issue number5
DOIs
StatePublished - May 1 2021

Bibliographical note

Funding Information:
The Women's Health Study was supported by grants CA047988 , UM1 CA182913 , HL043851 , HL080467 , and HL099355 from the National Institutes of Health .

Funding Information:
The Coronary Artery Risk Development in Young Adults Study (CARDIA) was conducted and supported by the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with the University of Alabama at Birmingham ( HHSN268201800005I & HHSN268201800007I ), Northwestern University ( HHSN268201800003I ), University of Minnesota ( HHSN268201800006I ), and Kaiser Foundation Research Institute ( HHSN268201800004I ). This manuscript has been reviewed by CARDIA for scientific content.

Funding Information:
The parent REGARDS study was supported by cooperative agreement U01-NS041588 from the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Department of Health and Human Service

Funding Information:
The Atherosclerosis Risk in Communities study has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services , under Contracts ( HHSN268201700001I , HHSN268201700002I , HHSN268201700003I , HHSN268201700005I , HHSN268201700004I ).

Funding Information:
The Multi-Ethnic Study of Atherosclerosis (MESA) was supported by contracts HHSN268201500003I , N01-HC-95159 , N01-HC-95160 , N01-HC-95161 , N01-HC-95162 , N01-HC-95163 , N01-HC-95164 , N01-HC-95165 , N01-HC-95166 , N01-HC-95167 , N01-HC-95168 and N01-HC-95169 from the National Heart, Lung, and Blood Institute , and by grants UL1-TR-000040 , UL1-TR-001079 , and UL1-TR-001420 from NCATS .

Funding Information:
The Multi-Ethnic Study of Atherosclerosis (MESA) was supported by contracts HHSN268201500003I, N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168 and N01-HC-95169 from the National Heart, Lung, and Blood Institute, and by grants UL1-TR-000040, UL1-TR-001079, and UL1-TR-001420 from NCATS.The Atherosclerosis Risk in Communities study has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, under Contracts (HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700005I, HHSN268201700004I).The Coronary Artery Risk Development in Young Adults Study (CARDIA) was conducted and supported by the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with the University of Alabama at Birmingham (HHSN268201800005I & HHSN268201800007I), Northwestern University (HHSN268201800003I), University of Minnesota (HHSN268201800006I), and Kaiser Foundation Research Institute (HHSN268201800004I). This manuscript has been reviewed by CARDIA for scientific content.The Cardiovascular Health Study was supported by contracts HHSN268201200036C, HHSN268200800007C, HHSN268201800001C, N01HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, N01HC85086, and grants U01HL080295 and U01HL130114 from the National Heart, Lung, and Blood Institute (NHLBI), with additional contribution from the National Institute of Neurological Disorders and Stroke (NINDS). Additional support was provided by R01AG023629 from the National Institute on Aging (NIA). A full list of principal CHS investigators and institutions can be found at CHS-NHLBI.org.The Physicians? Health Study was supported by grants CA-34944 and CA-40360, and CA-097193 from the National Cancer Institute and grants HL-26490, HL088081, and HL-34595 from the National Heart, Lung, and Blood Institute, Bethesda, MD.JHS acknowledgement. The Jackson Heart Study (JHS) is supported and conducted in collaboration with Jackson State University (HHSN268201800013I), Tougaloo College (HHSN268201800014I), the Mississippi State Department of Health (HHSN268201800015I) and the University of Mississippi Medical Center (HHSN268201800010I, HHSN268201800011I and HHSN268201800012I) contracts from the National Heart, Lung, and Blood Institute (NHLBI) and the National Institute for Minority Health and Health Disparities (NIMHD). The authors also wish to thank the staffs and participants of the JHS.The parent REGARDS study was supported by cooperative agreement U01-NS041588 from the National Institute of Neurological Disorders and Stroke, National Institutes of Health, Department of Health and Human ServiceThe Women's Health Study was supported by grants CA047988, UM1 CA182913, HL043851, HL080467, and HL099355 from the National Institutes of Health.

Funding Information:
The current data analysis was supported by an investigator-initiated grant from the American Egg Board (Egg Nutrition Center) (Luc Djoussé, PI).

Funding Information:
JHS acknowledgement. The Jackson Heart Study (JHS) is supported and conducted in collaboration with Jackson State University ( HHSN268201800013I ), Tougaloo College ( HHSN268201800014I ), the Mississippi State Department of Health ( HHSN268201800015I ) and the University of Mississippi Medical Center ( HHSN268201800010I , HHSN268201800011I and HHSN268201800012I ) contracts from the National Heart, Lung, and Blood Institute (NHLBI) and the National Institute for Minority Health and Health Disparities (NIMHD) . The authors also wish to thank the staffs and participants of the JHS.

Funding Information:
The Cardiovascular Health Study was supported by contracts HHSN268201200036C , HHSN268200800007C , HHSN268201800001C , N01HC55222 , N01HC85079 , N01HC85080 , N01HC85081 , N01HC85082 , N01HC85083 , N01HC85086 , and grants U01HL080295 and U01HL130114 from the National Heart, Lung, and Blood Institute (NHLBI) , with additional contribution from the National Institute of Neurological Disorders and Stroke (NINDS) . Additional support was provided by R01AG023629 from the National Institute on Aging (NIA) . A full list of principal CHS investigators and institutions can be found at CHS-NHLBI.org.

Funding Information:
The Physicians’ Health Study was supported by grants CA-34944 and CA-40360 , and CA-097193 from the National Cancer Institute and grants HL-26490 , HL088081 , and HL-34595 from the National Heart, Lung, and Blood Institute, Bethesda, MD .

Publisher Copyright:
© 2021

Keywords

  • CHD
  • Diet quality
  • Epidemiology
  • Nutrition
  • Type 2 diabetes

PubMed: MeSH publication types

  • Journal Article
  • Meta-Analysis
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

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