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. 2021 Oct;60(7):3691-3702.
doi: 10.1007/s00394-021-02536-w. Epub 2021 Mar 24.

Egg consumption and risk of all-cause and cause-specific mortality in an Italian adult population

Emilia Ruggiero  1 , Augusto Di Castelnuovo  2 , Simona Costanzo  1 , Mariarosaria Persichillo  1 , Amalia De Curtis  1 , Chiara Cerletti  1 , Maria Benedetta Donati  1 , Giovanni de Gaetano  1 , Licia Iacoviello  3   4 , Marialaura Bonaccio  1 ; Moli-sani Study Investigators
Collaborators, Affiliations

Egg consumption and risk of all-cause and cause-specific mortality in an Italian adult population

Emilia Ruggiero et al. Eur J Nutr. 2021 Oct.

Abstract

Purpose: Dietary guidelines recommend to limit egg consumption to 4 servings per week but the relation between egg intake and health outcomes is still controversial. To evaluate the association of egg consumption and mortality risk in Italian adults and to investigate nutritional factors and serum lipids as potentially explaining such associations.

Methods: Longitudinal analysis on 20,562 men and women aged ≥ 35y, free from cardiovascular disease (CVD) and cancer belonging to the Moli-sani Study cohort (enrolled 2005-2010) followed up for a median of 8.2 years.

Results: In multivariable-adjusted analysis as compared to low intake (> 0 ≤ 1 egg/week), eating > 4 eggs/week led to an increased risk of all-cause (Hazard ratio [HR] = 1.50; 95%CI 1.13-1.99), CVD (HR = 1.75; 1.07-2.87) and cancer mortality (HR = 1.52; 0.99-2.33). Similarly, an intake of 2-4 eggs/week was associated with higher all-cause (HR = 1.22; 1.01-1.46) and CVD mortality risk (HR = 1.43; 1.03-1.97). An increase of 1 egg per week was associated with higher mortality risk among high-risk individuals, such as those with hypertension and hyperlipidaemia. Dietary cholesterol explained about 43.0% and 39.3% (p values < 0.0001) of the association of eggs with all-cause and CVD mortality, respectively, while serum lipids (e.g., total cholesterol) accounted for a small proportion of egg-mortality relation.

Conclusions: Among Italian adults, high egg consumption leads to an increased risk of all-cause and CVD mortality, with the risk being evident even at the recommended intake of 2-4 eggs per week. A substantial part of this association was likely due to the egg contribution to dietary cholesterol. Our findings suggest limiting the consumption of eggs in the diet and these results should be considered in the development of dietary guidelines and updates.

Keywords: Dietary cholesterol; Eggs; Mediterranean diet; Mortality risk.

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Conflict of interest statement

None of the authors has conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1
Multivariable adjusted Kaplan–Meier estimates for all-cause (a) and cardiovascular mortality (b) for increasing number of weekly egg consumption in the Moli-sani Study cohort (n = 20,562). Estimates were obtained from the multivariable-adjusted model including age, sex, energy intake, educational level, household income, residence, smoking, leisure-time PA, BMI, presence at baseline of diabetes, hyperlipidaemia, hypertension, and the Mediterranean diet score
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