Article

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

Received:
Revised:
Accepted:
Published:

Abstract

Background/objective

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.

Subject/methods

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.

Results

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.

Conclusions

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

  • Subscribe to European Journal of Clinical Nutrition for full access:

    $543

    Subscribe

Additional access options:

Already a subscriber?  Log in  now or  Register  for online access.

References

  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.

  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. https://health.gov/dietaryguidelines/2015/guidelines/

  3. 3.

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

  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.

  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.

  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.

  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.

  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.

  9. 9.

    Centre for Clinical Research and Biostatistics. Sample Size Estimation. https://www2.ccrb.cuhk.edu.hk/stat/epistud.htm

  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.

  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.

  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.

  13. 13.

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

  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.

  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.

  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.

  17. 17.

    Scientific-Report-of-the-2015-Dietary-Guidelines-Advisory-Committee.pdf http://health.gov/dietaryguidelines/2015-scientific-report/pdfs/scientific-report-of-the-2015-dietary-guidelines-advisory-committee.pdf

  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.

  19. 19.

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

  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.

  21. 21.

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

  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.

  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.

  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.

  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.

  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.

  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.

  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.

  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.

Download references

Acknowledgements

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

Author information

Affiliations

  1. Department of Food Science and Human Nutrition, Ryukoku University, Otsu, Japan

    • Yasuyuki Nakamura
  2. Department of Public Health, Shiga University of Medical Science, Otsu, Japan

    • Yasuyuki Nakamura
    • , Aya Kadota
    • , Katsuyuki Miura
    •  & Hirotsugu Ueshima
  3. Department of Preventive Medicine and Public Health, Keio University, Tokyo, Japan

    • Tomonori Okamura
  4. Tsuruga City University of Nursing, Tsuruga, Japan

    • Yoshikuni Kita
  5. Department of Health and Nutrition, University of Human Arts and Sciences, Hasuda, Japan

    • Nagako Okuda
  6. Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan

    • Aya Kadota
    • , Katsuyuki Miura
    •  & Hirotsugu Ueshima
  7. Research Center for Lifestyle-related Diseases, Tokyo, Japan

    • Akira Okayama

Authors

  1. Search for Yasuyuki Nakamura in:

  2. Search for Tomonori Okamura in:

  3. Search for Yoshikuni Kita in:

  4. Search for Nagako Okuda in:

  5. Search for Aya Kadota in:

  6. Search for Katsuyuki Miura in:

  7. Search for Akira Okayama in:

  8. Search for Hirotsugu Ueshima in:

Consortia

  1. for the NIPPON DATA90 Research Group

    Conflict of interest

    The authors declare that they have no conflict of interest.

    Corresponding author

    Correspondence to Yasuyuki Nakamura.