A Comparison of Egg Consumption with Other Modifiable Coronary Heart Disease Lifestyle Risk Factors: A Relative Risk Apportionment Study
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Abstract
Guidelines from the American Heart Association (AHA) recommend that healthy adults limit their intake of dietary cholesterol to less than 300 mg per day. Since a large egg contains about 71% of that amount, the AHA recommends restricting egg consumption unless dietary cholesterol intakes from other sources are limited. We applied a risk apportionment approach to estimate the contribution of egg consumption and other modifiable lifestyle risk factors (e.g., smoking, poor diet, minimal exercise, and alcohol intake) to coronary heart disease (CHD) risk at the population level. Specifically, we categorized the U.S. adult population ages 25+ into distinct risk groups based on the prevalence of modifiable lifestyle risk factors and applied an apportionment model, typically used to assess risk contribution at the individual level, to estimate the contribution of egg intake to CHD risk. Our analysis shows that the combination of modifiable lifestyle risk factors accounts for less than 40% of the population CHD mortality. For the majority of U.S. adults age 25+, consuming one egg a day accounts for <1% of CHD risk. Hence, focusing on decreasing egg intake as an approach to modify CHD risk would be expected to yield minimal results relative to changing other behaviors such as smoking and other dietary habits.
Number of times cited: 17
- Mohammad Hossein Rouhani, Nafiseh Rashidi-Pourfard, Amin Salehi-Abargouei, Majid Karimi and Fahimeh Haghighatdoost, Effects of Egg Consumption on Blood Lipids: A Systematic Review and Meta-Analysis of Randomized Clinical Trials, Journal of the American College of Nutrition, 37, 2, (99), (2018).
- Bruce A. Griffin, Eggs: good or bad?, Proceedings of the Nutrition Society, 75, 03, (259), (2016).
- Dominik D. Alexander, Paula E. Miller, Ashley J. Vargas, Douglas L. Weed and Sarah S. Cohen, Meta-analysis of Egg Consumption and Risk of Coronary Heart Disease and Stroke, Journal of the American College of Nutrition, 35, 8, (704), (2016).
- K.S. Kubena, 7. Metabolic syndrome in adolescents: role of cholesterol sources, eggs, and others, Handbook of eggs in human function, 10.3920/978-90-8686-804-9_7, (109-132), (2015).
- Catherine Andersen, Bioactive Egg Components and Inflammation, Nutrients, 7, 12, (7889), (2015).
- Yuni Choi, Yoosoo Chang, Jung Eun Lee, Sohyun Chun, Juhee Cho, Eunju Sung, Byung-Seong Suh, Sanjay Rampal, Di Zhao, Yiyi Zhang, Roberto Pastor-Barriuso, Joao A.C. Lima, Hocheol Shin, Seungho Ryu and Eliseo Guallar, Egg consumption and coronary artery calcification in asymptomatic men and women, Atherosclerosis, 241, 2, (305), (2015).
- T. Dylan Olver, Graeme W.R. Thomas, Craig D. Hamilton and Nicholas Spence, Putting eggs and cigarettes in the same basket; are you yolking?, Atherosclerosis, 227, 1, (184), (2013).
- Jang Yel Shin, Pengcheng Xun, Yasuyuki Nakamura and Ka He, Egg consumption in relation to risk of cardiovascular disease and diabetes: a systematic review and meta-analysis, The American Journal of Clinical Nutrition, 98, 1, (146), (2013).
- Antonio Gilberto Bertechini and Helenice Mazzuco, The table egg: a review, Ciência e Agrotecnologia, 37, 2, (115), (2013).
- Maria L. Fernandez, Rethinking dietary cholesterol, Current Opinion in Clinical Nutrition and Metabolic Care, 15, 2, (117), (2012).
- I Zazpe, J J Beunza, M Bes-Rastrollo, J Warnberg, C de la Fuente-Arrillaga, S Benito, Z Vázquez and M A Martínez-González, Egg consumption and risk of cardiovascular disease in the SUN Project, European Journal of Clinical Nutrition, 65, 6, (676), (2011).
- Carolyn G Scrafford, Nga L Tran, Leila M Barraj and Pamela J Mink, Egg consumption and CHD and stroke mortality: a prospective study of US adults, Public Health Nutrition, 14, 02, (261), (2011).
- B.A. Griffin, Eggs, dietary cholesterol and disease: facts and folklore, Improving the Safety and Quality of Eggs and Egg Products, 10.1533/9780857093929.3.237, (237-253), (2011).
- David C. Nieman, You Asked For It, ACSM's Health & Fitness Journal, 14, 5, (5), (2010).
- Maria Luz Fernandez and Mariana Calle, Revisiting Dietary Cholesterol Recommendations: Does the Evidence Support a Limit of 300 mg/d?, Current Atherosclerosis Reports, 12, 6, (377), (2010).
- C.H.S. Ruxton, E. Derbyshire and S. Gibson, The nutritional properties and health benefits of eggs, Nutrition & Food Science, 40, 3, (263), (2010).
- Patricia T. Alpert, Heart Healthy Eating, Home Health Care Management & Practice, 10.1177/1084822309341251, 22, 1, (57-60), (2009).




