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Review
. 2013 Jan 7:346:e8539.
doi: 10.1136/bmj.e8539.

Egg consumption and risk of coronary heart disease and stroke: dose-response meta-analysis of prospective cohort studies

Ying Rong  1 , Li Chen, Tingting Zhu, Yadong Song, Miao Yu, Zhilei Shan, Amanda Sands, Frank B Hu, Liegang Liu
Affiliations
Review

Egg consumption and risk of coronary heart disease and stroke: dose-response meta-analysis of prospective cohort studies

Ying Rong et al. BMJ. .

Abstract

Objective: To investigate and quantify the potential dose-response association between egg consumption and risk of coronary heart disease and stroke.

Design: Dose-response meta-analysis of prospective cohort studies.

Data sources: PubMed and Embase prior to June 2012 and references of relevant original papers and review articles.

Eligibility criteria for selecting studies: Prospective cohort studies with relative risks and 95% confidence intervals of coronary heart disease or stroke for three or more categories of egg consumption.

Results: Eight articles with 17 reports (nine for coronary heart disease, eight for stroke) were eligible for inclusion in the meta-analysis (3,081,269 person years and 5847 incident cases for coronary heart disease, and 4,148,095 person years and 7579 incident cases for stroke). No evidence of a curve linear association was seen between egg consumption and risk of coronary heart disease or stroke (P=0.67 and P=0.27 for non-linearity, respectively). The summary relative risk of coronary heart disease for an increase of one egg consumed per day was 0.99 (95% confidence interval 0.85 to 1.15; P=0.88 for linear trend) without heterogeneity among studies (P=0.97, I(2)=0%). For stroke, the combined relative risk for an increase of one egg consumed per day was 0.91 (0.81 to 1.02; P=0.10 for linear trend) without heterogeneity among studies (P=0.46, I(2)=0%). In a subgroup analysis of diabetic populations, the relative risk of coronary heart disease comparing the highest with the lowest egg consumption was 1.54 (1.14 to 2.09; P=0.01). In addition, people with higher egg consumption had a 25% (0.57 to 0.99; P=0.04) lower risk of developing hemorrhagic stroke.

Conclusions: Higher consumption of eggs (up to one egg per day) is not associated with increased risk of coronary heart disease or stroke. The increased risk of coronary heart disease among diabetic patients and reduced risk of hemorrhagic stroke associated with higher egg consumption in subgroup analyses warrant further studies.

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Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; and no other relationships or activities that could appear to have influenced the submitted work.

Figures

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Fig 1 Flow diagram of literature search and study selection
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Fig 2 Dose-response analyses of egg consumption and risk of coronary heart disease
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Fig 3 Forest plot of egg consumption and risk of coronary heart disease
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Fig 4 Dose-response analyses of egg consumption and risk of stroke
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Fig 5 Forest plot of egg consumption and risk of stroke
See this image and copyright information in PMC

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