Re-evaluation of the associations of egg intake with serum total cholesterol and cause-specific and total mortality in Japanese women



Egg intake was associated with serum total cholesterol adjusted for age (aTCH) and total mortality in women, but not in men, using data from NIPPON DATA (ND) 80 which followed up for 14 years. Re-evaluation of these associations in a different cohort is needed.


We analyzed the associations of egg intake with aTCH and cause-specific and total mortality using the ND90 data set with a 15-year follow-up. A nutritional examination was done at the baseline in 1990 using the food-frequency method and by weighed food records. We followed 4686 female participants (ages ≥30 years), with no history of stroke or myocardial infarction (mean age 52.8 years) for 15 years.


The participants were divided into 5 egg intake groups (<1/w, 1–2/w, 1/2d, 1/d, and ≥2/d). There were 203, 1462, 1594, 1387, and 40 women in each group, respectively. Egg intake was not associated with aTCH (P = 0.886). There were 183 cardiovascular disease (CVD), 210 cancer, and 599 total mortality cases during follow-up. Cox analysis, adjusted for background factors, found egg intake was directly associated with total and cancer mortality (HR in the ≥2/d vs. the 1 egg/d group: total, 2.05 (95% CI: 1.20–3.52); cancer, 3.20 (1.51–6.76)), and that cancer mortality in the 1–2/w group was significantly less than that in the 1 egg/d group (0.68 (0.47–0.97)). Egg intake was not associated with CVD mortality.


Egg intake was associated with cancer and total mortality. Reducing egg intake may have some definitive health benefits in women in Japan, at least.

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  1. 1.

    Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285:2486–9.

    Article  Google Scholar 

  2. 2.

    Olson R, Casavale K, Rihane C, Stoody EE, Britten P, Reedy J, et al. Dietary Guidelines for Americans 2015-2020. Eighth Edition. United States Office of Disease Prevention & Health Promotion; 2016.

  3. 3.

    Nestle M. Food industry funding of nutrition research: the relevance of history for current debates. JAMA Intern Med. 2016;176:1685–6.

    Article  Google Scholar 

  4. 4.

    Nakamura Y, Okamura T, Tamaki S, Kadowaki T, Hayakawa T, Kita Y, et al. Egg consumption, serum cholesterol, and cause-specific and all-cause mortality: NIPPON DATA80, 1980–94. Am J Clin Nutr. 2004;80:58–63.

    CAS  Article  Google Scholar 

  5. 5.

    Okamura T, Hayakawa T, Kadowaki T, Kita Y, Okayama A, Ueshima H, et al. The inverse relationship between serum high-density lipoprotein cholesterol and all-cause mortality in a 9.6-year follow up study in the Japanese general population. Atherosclerosis. 2006;184:143–50.

    CAS  Article  Google Scholar 

  6. 6.

    Nakamura K, Okamura T, Hayakawa T, Kadowaki T, Kita Y, Ohnishi H, et al. Chronic kidney disease is a risk factor for cardiovascular death in a community-based population in Japan: NIPPON DATA90. Circ J. 2006;70:954–9.

    Article  Google Scholar 

  7. 7.

    Ueshima H, Choudhury SR, Okayama A, Hayakawa T, Kita Y, Kadowaki T, et al. Cigarette smoking as a risk factor for stroke death in Japan. NIPPON DATA80. Stroke. 2004;35:1836–41.

    CAS  Article  Google Scholar 

  8. 8.

    Nakamura Y, Yamamoto T, Okamura T, Kadowaki T, Hayakawa T, Kita Y, et al. Combined Cardiovascular Risk Factors and Outcome: NIPPON DATA80, 1980-94. Circ J. 2006;70:960–4.

    Article  Google Scholar 

  9. 9.

    Centre for Clinical Research and Biostatistics. Sample Size Estimation.

  10. 10.

    Nakamura M, Sato S, Shimamoto T. Improvement in Japanese clinical laboratory measurements of total cholesterol and HDL cholesterol by the US cholesterol reference method laboratory network. J Atheroscler Thromb. 2003;10:145–53.

    CAS  Article  Google Scholar 

  11. 11.

    Okuda N, Miura K, Yoshita K, Matsumura Y, Okayama A, Nakamura Y, et al. Integration of data from NIPPON DATA80/90 and National Nutrition Survey in Japan: for cohort studies of representative Japanese on nutrition. J Epidemiol. 2010;20:S506–S514.

    Article  Google Scholar 

  12. 12.

    Iwaoka F, Yoshiike N, Date C, Shimada T, Tanaka H. A validation study on a method to estimate nutrient intake by family members through a household-based food-weighing survey. J Nutr Sci Vitaminol (Tokyo). 2001;47:222–7.

    CAS  Article  Google Scholar 

  13. 13.

    Keys A. Serum cholesterol response to dietary cholesterol. Am J Clin Nutr. 1984;40:351–9.

    CAS  Article  Google Scholar 

  14. 14.

    Ueshima H, Iida M, Shimamoto T, Konishi M, Tanigaki M, Doi M, et al. Dietary intake and serum total cholesterol level: their relationship to different lifestyles in several Japanese populations. Circulation. 1982;66:519–26.

    CAS  Article  Google Scholar 

  15. 15.

    Ministry of Health and Welfare. Manual for Health Examination under Health and Medical Service Law for the Elderly (in Japanese). Tokyo: Japan Public Health Association; 1987.

    Google Scholar 

  16. 16.

    McNamara DJ. The impact of egg limitations on coronary heart disease risk: do the numbers add up? J Am Coll Nutr. 2000;19(Suppl 5):540S–548S.

    Article  Google Scholar 

  17. 17.


  18. 18.

    Tse G, Eslick G. Egg consumption and risk of GI neoplasms: dose–response meta-analysis and systematic review. Eur J Nutr. 2014;53:1581–90.

    CAS  Article  Google Scholar 

  19. 19.

    Steinmetz KA, Potter JD. Egg consumption and cancer of the colon and rectum. Eur J Cancer Prev. 1994;3:237–45.

    CAS  Article  Google Scholar 

  20. 20.

    Block G, Dresser CM, Hartman AM, Carroll MD. Nutrient sources in the American diet: quantitative data from the NHANES II survey. II. Macronutrients and fats. Am J Epidemiol. 1985;122:27–40.

    CAS  Article  Google Scholar 

  21. 21.

    Cruse P, Lewin M, Clark CG. Dietary cholesterol is cocarcinogenic for human colon cancer. Lancet. 1979;1:752–5.

    CAS  Article  Google Scholar 

  22. 22.

    Sakaguchi M, Minoura T, Hiramatsu Y, Takada H, Yamamura M, Hioki K, et al. Effects of dietary saturated and unsaturated fatty acids on fecal bile acids and colon carcinogenesis induced by azoxymethane in rats. Cancer Res. 1986;46:61–65.

    CAS  PubMed  Google Scholar 

  23. 23.

    Bidoli E, Franceschi S, Talamini R, Barra S, La Vecchia C. Food consumption and cancer of the colon and rectum in Northeastern Italy. Int J Cancer. 1992;50:223–9.

    CAS  Article  Google Scholar 

  24. 24.

    Bernstein H, Bernstein C, Payne CM, Dvorakova K, Garewal H. Bile acids as carcinogens in human gastrointestinal cancers. Mutat Res. 2005;589:47–65.

    CAS  Article  Google Scholar 

  25. 25.

    Zeisel SH, Mar MH, Howe JC, Holden JM. Concentrations of choline-containing compounds and betaine in common foods. J Nutr. 2003;133:1302–7.

    CAS  Article  Google Scholar 

  26. 26.

    Chandar N, Lombardi B. Liver cell proliferation and incidence of hepatocellular carcinomas in rats fed consecutively a choline-devoid and a choline-supplemented diet. Carcinogenesis. 1988;9:259–63.

    CAS  Article  Google Scholar 

  27. 27.

    Nakagami K, Uchida T, Ohwada S, Koibuchi Y, Morishita Y. Increased choline kinase activity in 1,2-dimethylhydrazine-induced rat colon cancer. Jpn J Cancer Res. 1999;90:1212–7.

    CAS  Article  Google Scholar 

  28. 28.

    Stallone DD, Brunner EJ, Bingham SA, Marmot MG. Dietary assessment in Whitehall II: the influence of reporting bias on apparent socioeconomic variation in nutrient intakes. Eur J Clin Nutr. 1997;51:815–25.

    CAS  Article  Google Scholar 

  29. 29.

    Nakamura Y, Kiyohara Y, Okuda N, Okamura T, Higashiyama A, Watanabe M, et al. Fatty acid intakes and coronary heart disease mortality in Japan: NIPPON DATA90, 1990-2005. Curr Nutr Food Sci. 2013;9:26–32.

    CAS  Google Scholar 

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We thank the members of the NIPPON DATA90 Research Group as listed in the last reference.



This study was supported by a grant-in-aid from the Ministry of Health, Labor and Welfare under the auspices of the Japanese Association for Cerebro-cardiovascular Disease Control, a Research Grant for Cardiovascular Diseases (7A-2) from the Ministry of Health, Labor and Welfare, and a Health and Labor Sciences Research Grant, Japan (Comprehensive Research on Aging and Health (H11-Chouju-046, H14-Chouju-003, H17-Chouju-012, H19-Chouju-Ippan-014) and Comprehensive Research on Life-Style Related Diseases including Cardiovascular Diseases and Diabetes Mellitus (H22-Jyunkankitou-Seisyu- Sitei-017)).

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Correspondence to Yasuyuki Nakamura.

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Nakamura, Y., Okamura, T., Kita, Y. et al. Re-evaluation of the associations of egg intake with serum total cholesterol and cause-specific and total mortality in Japanese women. Eur J Clin Nutr 72, 841–847 (2018).

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