Egg consumption and cardiovascular disease according to diabetic status: The PREDIMED study

Clin Nutr. 2017 Aug;36(4):1015-1021. doi: 10.1016/j.clnu.2016.06.009. Epub 2016 Jun 29.

Abstract

Background: Eggs are a major source of dietary cholesterol and their consumption has been sometimes discouraged. A relationship between egg consumption and the incidence of cardiovascular disease (CVD) has been suggested to be present exclusively among patients with type2 diabetes.

Aims: To assess the association between egg consumption and CVD in a large Mediterranean cohort where approximately 50% of participants had type 2 diabetes.

Methods: We prospectively followed 7216 participants (55-80 years old) at high cardiovascular risk from the PREDIMED (PREvención con DIeta MEDiterránea) study for a mean of 5.8 years. All participants were initially free of CVD. Yearly repeated measurements of dietary information with a validated 137-item food-frequency questionnaire were used to assess egg consumption and other dietary exposures. The endpoint was the rate of major cardiovascular events (myocardial infarction, stroke or death from cardiovascular causes).

Results: A major cardiovascular event occurred in 342 participants. Baseline egg consumption was not significantly associated with cardiovascular events in the total population. Non-diabetic participants who ate on average >4 eggs/week had a hazard ratio (HR) of 0.96 (95% confidence interval, 0.33-2.76) in the fully adjusted multivariable model when compared with non-diabetic participants who reported the lowest egg consumption (<2 eggs/week). Among diabetic participants, the HR was 1.33 (0.72-2.46). There was no evidence of interaction by diabetic status. HRs per 500 eggs of cumulative consumption during follow-up were 0.94 (0.66-1.33) in non-diabetics and 1.18 (0.90-1.55) in diabetics.

Conclusions: Low to moderated egg consumption was not associated with an increased CVD risk in diabetic or non-diabetic individuals at high cardiovascular risk. This trial was registered at controlled-trials.com as ISRCTN35739639.

Keywords: Cardiovascular disease; Diabetes; Egg consumption; PREDIMED study.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control*
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / diet therapy*
  • Diabetes Mellitus, Type 2 / ethnology
  • Diabetic Angiopathies / epidemiology
  • Diabetic Angiopathies / ethnology
  • Diabetic Angiopathies / etiology
  • Diabetic Angiopathies / prevention & control*
  • Diabetic Cardiomyopathies / epidemiology
  • Diabetic Cardiomyopathies / ethnology
  • Diabetic Cardiomyopathies / etiology
  • Diabetic Cardiomyopathies / prevention & control*
  • Diet, Diabetic / adverse effects
  • Diet, Diabetic / ethnology
  • Diet, Fat-Restricted / adverse effects
  • Diet, Fat-Restricted / ethnology
  • Diet, Mediterranean* / adverse effects
  • Diet, Mediterranean* / ethnology
  • Eggs / adverse effects*
  • Female
  • Follow-Up Studies
  • Health Status
  • Humans
  • Incidence
  • Male
  • Mediterranean Region / epidemiology
  • Middle Aged
  • Patient Compliance* / ethnology
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Self Report

Associated data

  • ISRCTN/ISRCTN35739639