J Díez-Espino1, F J Basterra-Gortari2, J Salas-Salvadó3, P Buil-Cosiales1, D Corella4, H Schröder5, R Estruch6, E Ros7, E Gómez-Gracia8, F Arós9, M Fiol10, J Lapetra11, L Serra-Majem12, X Pintó13, N Babio3, L Quiles14, M Fito15, A Marti16, E Toledo17. 1. Primary Health Care, Servicio Navarro de Salud-Osasunbidea, Pamplona, Navarra, Spain; Department of Preventive Medicine and Public Health, University of Navarra-School of Medicine, Pamplona, Navarra, Spain; The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Navarra, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain. 2. Department of Preventive Medicine and Public Health, University of Navarra-School of Medicine, Pamplona, Navarra, Spain; The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Navarra, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; Department of Endocrinology, Hospital Reina Sofia, Servicio Navarro de Salud-Osasunbidea, Tudela, Navarra, Spain. 3. The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; Human Nutrition Unit, Faculty of Medicine and Health Sciences, Biochemistry Biotechnology Department, Universitat Rovira i Virgili, Spain; Hospital Universitari de Sant Joan de Reus, IISPV, Reus, Spain. 4. The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain. 5. Ciber Epidemiolgy and Public Health (CIBERESP), Instituto de Salud Carlos III, Spain; Cardiovascular Risk and Nutrition Research Group, IMIM (Hospital del Mar Medical Research Institut), Spain. 6. The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi I Sunyer, Hospital Clinic, University of Barcelona, Barcelona, Spain. 7. The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; Lipid Clinic, Department of Endocrinology and Nutrition, Institutd'Investigacions Biomèdiques August Pi I Sunyer, Hospital Clinic, University of Barcelona, Barcelona, Spain. 8. The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; Department of Preventive Medicine, University of Malaga, Malaga, Spain. 9. The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; University Hospital of Alava, Vitoria, Basque Country, Spain. 10. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; Instituto de Investigación Sanitaria de Palma (IdISPa), Hospital Universitario Son Espases, Palma de Mallorca, Spain. 11. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain. 12. The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas, Spain. 13. The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge-IDIBELL-UB, Hospitalet de Llobregat, Barcelona, Spain. 14. Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain. 15. The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; Ciber Epidemiolgy and Public Health (CIBERESP), Instituto de Salud Carlos III, Spain. 16. The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Navarra, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain; Department of Nutrition and Food Sciences, University of Navarra, Pamplona, Navarra, Spain. 17. Department of Preventive Medicine and Public Health, University of Navarra-School of Medicine, Pamplona, Navarra, Spain; The PREDIMED (Prevención con Dieta Mediterránea) Research Network (RD 06/0045), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Navarra, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, Madrid, Spain. Electronic address: etoledo@unav.es.
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.
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-diabeticparticipants 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-diabeticparticipants who reported the lowest egg consumption (<2 eggs/week). Among diabeticparticipants, 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.
Authors: Luc Djoussé; Yuk-Lam Ho; Xuan-Mai T Nguyen; Rachel M Quaden; David R Gagnon; J Michael Gaziano; Kelly Cho Journal: Clin Nutr Date: 2019-12-24 Impact factor: 7.324
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Authors: Miguel A Martinez-Gonzalez; Giuseppe Grosso; Justyna Godos; Agnieszka Micek; Tomasz Brzostek; Estefania Toledo; Licia Iacoviello; Arne Astrup; Oscar H Franco; Fabio Galvano Journal: Eur J Nutr Date: 2020-08-31 Impact factor: 5.614
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