Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Egg consumption and risk of cardiovascular disease in the SUN Project

Abstract

Background/Objectives:

Egg consumption has been associated with the risk of cardiovascular diseases (CVDs), but evidence is scarce and inconsistent. Our aim was to examine the association between egg consumption and incidence of CVD in a prospective dynamic Mediterranean cohort of 14 185 university graduates.

Subjects/Methods:

Egg intake was assessed using a 136-item-validated food-frequency questionnaire. Baseline consumption was categorized into no consumption or <1 egg/week, 1 egg/week, 2–4 eggs/week and >4 eggs/week. The presence of cardiovascular risk factors was assessed by questionnaire at baseline, and the incidence of CVD was assessed using biennial assessments. The median follow-up was 6.1 years. Cox regression models were fitted to estimate multivariable-adjusted hazard ratios (HRs) for CVD (myocardial infarction, revascularization procedures or stroke). Outcomes were confirmed by review of medical records.

Results:

During a median follow-up of 6.1 years, 91 new confirmed cases of CVD were observed. No association was found between egg consumption and the incidence of CVD (HR: 1.10, 95% confidence interval: 0.46–2.63) for the highest versus the lowest category of egg consumption after adjusting for age, sex, total energy intake, adherence to the Mediterranean food pattern and other cardiovascular risk factors. Results were robust to different analytical scenarios.

Conclusions:

No association between egg consumption and the incidence of CVD was found in this Mediterranean cohort.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  • Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ et al. (2000). Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc 32 (Suppl 9), S498–S504.

    Article  CAS  Google Scholar 

  • Alonso A, Beunza JJ, Delgado-Rodríguez M, Martínez-González MA (2005). Validation of self reported diagnosis of hypertension in a cohort of university graduates in Spain. BMC Public Health 5, 94.

    Article  Google Scholar 

  • Barraj L, Tran N, Mink P (2009). A comparison of egg consumption with other modifiable coronary heart disease lifestyle risk factors: a relative risk apportionment study. Risk Anal 29, 401–415.

    Article  Google Scholar 

  • Bes-Rastrollo M, Pérez JR, Sánchez-Villegas A, Alonso A, Martínez-González MA (2005). Validation of self-reported weight and body mass index in a cohort of university graduates in Spain. Rev Esp Obes 3, 352–358.

    Google Scholar 

  • Buckland G, González CA, Agudo A, Vilardell M, Berenguer A, Amiano P et al. (2009). Adherence to the Mediterranean diet and risk of coronary heart disease in the Spanish EPIC Cohort Study. Am J Epidemiol 15, 1518–1529.

    Article  Google Scholar 

  • Burke V, Zhao Y, Lee AH, Hunter E, Spargo RM, Gracey M et al. (2007). Health-related behaviours as predictors of mortality and morbidity in Australian Aborigines. Prev Med 44, 135–142.

    Article  CAS  Google Scholar 

  • Cerdeño M (2008). Evolución de los hábitos de compra y consumo en España. 1987–2007, dos décadas del panel de consumo alimentario. Ministerio de Agricultura, Pesca y Alimentación: Madrid, p 32.

  • Dawber TR, Nickerson RJ, Brand FN, Pool J (1982). Eggs, serum cholesterol, and coronary heart disease. Am J Clin Nutr 36, 617–625.

    Article  CAS  Google Scholar 

  • De la Fuente-Arrillaga C, Vázquez Ruiz Z, Bes-Rastrollo M, Sampson L, Martinez-González MA (2010). Reproducibility of an FFQ validated in Spain. Public Health Nutr 28, 1–9.

    Google Scholar 

  • Djousse L, Gaziano JM (2008). Egg consumption in relation to cardiovascular disease and mortality: the physicians health study. Am J Clin Nutr 87, 964–969.

    Article  CAS  Google Scholar 

  • Djousse L, Gaziano JM, Buring JE, Lee I. (2009). Egg consumption and risk of type 2 diabetes in men and women. Diabetes Care 32, 295–300.

    Article  Google Scholar 

  • Fernández-Ballart JD, Piñol JL, Zazpe I, Corella D, Carrasco P, Toledo E et al. (2010). Relative validity of a semi-quantitative food-frequency questionnaire in an elderly Mediterranean population of Spain. Br J Nutr 103, 1808–1816.

    Article  Google Scholar 

  • Fraser GE (1999). Associations between diet and cancer, ischemic heart disease, and all-cause mortality in non-Hispanic white California Seventh-day Adventists. Am J Clin Nutr 70, 532S–538S.

    Article  CAS  Google Scholar 

  • Fraser GE. (1994). Diet and coronary heart disease: beyond dietary fats and low-density-lipoprotein cholesterol. Am J Clin Nutr 59, 1117S–1123S.

    Article  CAS  Google Scholar 

  • Herron KL, Fernandez M. (2004). Are the current dietary guidelines regarding egg consumption appropriate? J Nutr 134, 187–190.

    Article  CAS  Google Scholar 

  • Houston DJ, Lee JS, Kanaya AM, Tylavsky FA, Newman AB, Visser M et al. (2010). Dietary fat and cholesterol and risk of cardiovascular disease in older adults: the Health ABC Study. Nutr Metab Cardiovasc Dis [E-pub ahead of print]. PMID: 20338738.

  • Hu FB, Stampfer MJ, Rimm EB, Manson JE, Ascherio A, Colditz GA et al. (1999). A prospective study of egg consumption and risk of cardiovascular disease in men and women. JAMA 281, 1387–1394.

    Article  CAS  Google Scholar 

  • Knekt P, Reunanen A, Järvinen R, Seppänen R, Heliövaara M, Aromaa A. (1994). Antioxidant vitamin intake and coronary mortality in a longitudinal population study. Am J Epidemiol 139, 1180–1189.

    Article  CAS  Google Scholar 

  • Krauss RM, Eckel RH, Howard B, Appel LJ, Daniels SR, Deckelbaum RJ et al. (2000). AHA Dietary Guidelines: revision 2000: a statement for healthcare professionals from the nutrition committee of the American Heart Association. Circulation 102, 2284–2299.

    Article  CAS  Google Scholar 

  • Kritchevsky SB, Kritchevsky D (2000). Egg consumption and coronary heart disease: an epidemiologic overview. J Am Coll Nutr 19, 549S–555S.

    Article  CAS  Google Scholar 

  • Kritchevsky SB (2004). A review of scientific research and recommendations regarding eggs. J Am Coll Nutr 23, 596S–600S.

    Article  Google Scholar 

  • Mann JI, Appleby PN, Key TJ, Thorogood M (1997). Dietary determinants of ischaemic heart disease in health conscious individuals. Heart 78, 450–455.

    Article  CAS  Google Scholar 

  • Martínez- González MA, De la Fuente C, Nuñez JM, Basterra FJ, Beunza JJ, Vazquez Z et al. (2008). Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study. BMJ 14, 1348–1351.

    Article  Google Scholar 

  • Martínez-González MA, García-López M, Bes-Rastrollo M, Toledo E, Martínez-Lapiscina EH, Delgado-Rodriguez M et al. (2010). Mediterranean diet and the incidence of cardiovascular disease: a Spanish cohort. Nutr Metab Cardiovasc Dis [E-pub ahead of print]. PMID:20096543.

    Google Scholar 

  • Martínez-González MA, López-Fontana C, Varo JJ, Sánchez-Villegas A, Martínez JA (2005). Validation of the Spanish version of the physical activity questionnaire used in the nurses ‘health study and the health professionals’ follow-up study. Public Health Nutr 8, 920–927.

    Article  Google Scholar 

  • Martínez-González MA, Sánchez-Villegas A, De Irala J, Marti A, Martínez JA (2002). Mediterranean diet and stroke: objectives and design of the SUN project. Seguimiento Universidad de Navarra. Nutr Neurosci 5, 65–73.

    Article  Google Scholar 

  • Martin-Moreno JM, Boyle P, Gorgojo L, Maisonneuve P, Fernández-Rodriguez JC, Salvini S et al. (1993). Development and validation of a food frequency questionnaire in Spain. Int J Epidemiol 22, 512–519.

    Article  CAS  Google Scholar 

  • Mataix J. (2003). Tabla de Composición de Alimentos (food composition tables). 4th edn. Universidad de Granada: Granada.

  • McNamara DJ. (2000). The impact of egg limitations on coronary heart disease risk: do the numbers add up? J Am Coll Nutr 19, 540S–548S.

    Article  CAS  Google Scholar 

  • Moreiras O (2009). Tablas de Composición de Alimentos (Food Composition Tables). 7th edn. Ediciones Madrid Pirámide: Madrid.

    Google Scholar 

  • Nakamura Y, Iso H, Kita Y, Ueshima H, Okada K, Konishi M et al. (2006). Egg consumption, serum total cholesterol concentrations and coronary heart disease incidence: Japan public health center-based prospective study. Br J Nutr 96, 921–928.

    Article  CAS  Google Scholar 

  • National Cholesterol Education Program (1994). Second report of the expert panel on detection, evaluation. Circulation 89, 1333–1445.

    Article  Google Scholar 

  • Nettleton JA, Steffen LM, Loehr LR, Rosamond WD (2008). Incident heart failure is associated with lower whole-grain intake and greater high-fat dairy and egg intake in the Atherosclerosis Risk in Communities (ARIC) study. J Am Diet Assoc 108, 1881–1887.

    Article  Google Scholar 

  • Qureshi AI, Suri FK, Ahmed S, Nasar A, Divani AA (2007). Regular egg consumption does not increase the risk of stroke and cardiovascular diseases. Med Sci Monit 13, CR1–CR8.

    PubMed  Google Scholar 

  • Seguí-Gómez M, de la Fuente C, Vázquez Z, de Irala J, Martínez-González MA (2006). Cohort profile: the ‘Seguimiento Universidad de Navarra (SUN) study’. Int J Epidemiol 35, 1417–1422.

    Article  Google Scholar 

  • Sofi F, Cesari F, Abbate R, Gensini GF, Casini A (2008). Adherence to Mediterranean diet and health status: meta-analysis. BMJ 11, 337–344.

    Google Scholar 

  • Thygesen K, Alpert JS, White HD (2007). Joint ESC/ACCF/AHA/WHF task force for the redefinition of myocardial infarction. Universal definition of myocardial infarction. Eur Heart J 28, 2525–2538.

    Article  Google Scholar 

  • Trichopoulou A, Kouris-Blazos A, Wahlquivist M, Gnardellis D, Lagiou P, Polychronopoulos E et al. (1995). Diet and overall survival in elderly peope. BMJ 311, 1457–1460.

    Article  CAS  Google Scholar 

  • Willett WC (1998). Issues in Analysis and Presentation of Dietary Data. Nutritional Epidemiology. Oxford Univ Press: New York, pp321–345.

    Book  Google Scholar 

  • World Health Organization (2008). World Health Statistics. WHO: Ginebra.

Download references

Acknowledgements

We thank the enthusiastic collaboration and participation of the SUN cohort participants. We also thank the other members of the SUN Study Group: Alonso A, de Irala J, Delgado-Rodríguez M, Guillén-Grima F, Krafka J, Llorca J, Lopez del Burgo C, Marti A, Martínez JA, Nuñez-Córdoba JM, Pimenta A, Sánchez D, Sánchez–Villegas A, Seguí-Gómez C, Serrano-Martínez M and Toledo E. We are also grateful to the members of the Department of Nutrition of Harvard School of Public Health (A Ascherio, W Willett and FB Hu), who helped us design the SUN Study. The SUN Study has received funding from Instituto de Salud Carlos III, Oficial Agency of the Spanish Government for biomedical research (Grants PI01/0619, PI030678, PI040233, PI042241, PI050976, PI070240, PI070312, PI081943, PI080819, PI1002293, PI1002658, RD06/0045, and G03/140), the Navarra Regional Government (36/2001, 43/2002, 41/2005 and 36/2008) and the University of Navarra.

Author information

Authors and Affiliations

Authors

Consortia

Corresponding author

Correspondence to M A Martínez-González.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zazpe, I., Beunza, J., Bes-Rastrollo, M. et al. Egg consumption and risk of cardiovascular disease in the SUN Project. Eur J Clin Nutr 65, 676–682 (2011). https://doi.org/10.1038/ejcn.2011.30

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ejcn.2011.30

Keywords

This article is cited by

Search

Quick links