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Frank B. Hu, MD; Meir J. Stampfer, MD; Eric B. Rimm, ScD; JoAnn E. Manson, MD; Alberto Ascherio, MD; Graham A. Colditz, MD; Bernard A. Rosner, PhD; Donna Spiegelman, ScD; Frank E. Speizer, MD; Frank M. Sacks, MD; Charles H. Hennekens, MD; Walter C. Willett, MD

JAMA. 1999;281:1387-1394.

Context  Reduction in egg consumption has been widely recommended to lower blood cholesterol levels and prevent coronary heart disease (CHD). Epidemiologic studies on egg consumption and risk of CHD are sparse.

Objective  To examine the association between egg consumption and risk of CHD and stroke in men and women.

Design and Setting  Two prospective cohort studies, the Health Professionals Follow-up Study (1986-1994) and the Nurses' Health Study (1980-1994).

Participants  A total of 37,851 men aged 40 to 75 years at study outset and 80,082 women aged 34 to 59 years at study outset, free of cardiovascular disease, diabetes, hypercholesterolemia, or cancer.

Main Outcome Measures  Incident nonfatal myocardial infarction, fatal CHD, and stroke corresponding to daily egg consumption as determined by a food-frequency questionnaire.

Results  We documented 866 incident cases of CHD and 258 incident cases of stroke in men during 8 years of follow-up and 939 incident cases of CHD and 563 incident cases of stroke in women during 14 years of follow-up. After adjustment for age, smoking, and other potential CHD risk factors, we found no evidence of an overall significant association between egg consumption and risk of CHD or stroke in either men or women. The relative risks (RRs) of CHD across categories of intake were less than 1 per week (1.0), 1 per week (1.06), 2 to 4 per week (1.12), 5 to 6 per week (0.90), and 1 per day (1.08) (P for trend=.75) for men; and less than 1 per week (1.0), 1 per week (0.82), 2 to 4 per week (0.99), 5 to 6 per week (0.95), and 1 per day (0.82) (P for trend=.95) for women. In subgroup analyses, higher egg consumption appeared to be associated with increased risk of CHD only among diabetic subjects (RR of CHD comparing more than 1 egg per day with less than 1 egg per week among diabetic men, 2.02 [95% confidence interval, 1.05-3.87; P for trend=.04], and among diabetic women, 1.49 [0.88-2.52; P for trend=.008]).

Conclusions  These findings suggest that consumption of up to 1 egg per day is unlikely to have substantial overall impact on the risk of CHD or stroke among healthy men and women. The apparent increased risk of CHD associated with higher egg consumption among diabetic participants warrants further research.

Author Affiliations: Departments of Nutrition (Drs Hu, Stampfer, Rimm, Ascherio, Sacks, and Willet), Epidemiology (Drs Stampfer, Rimm, Manson, Ascherio, Spiegelman, Hennekens, and Willet), and Biostatistics (Drs Spiegelman and Rosner), Harvard School of Public Health; Channing Laboratory (Drs Stampfer, Rimm, Manson, Colditz, Rosner, Speizer, and Willet), and the Division of Preventive Medicine (Drs Manson and Hennekens), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass.

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References
Circulation 2002;106:3373-3421.
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Optimal Diets for Prevention of Coronary Heart Disease
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Importance of Diet in Vascular Prevention: Vastly Underestimated
Spence
Circulation 2002;106 :e133-e133.
FULL TEXT  

Pre-Menopausal Women, Classified as Hypo- or Hyper-Responders, do not Alter their LDL/HDL Ratio Following a High Dietary Cholesterol Challenge
Herron et al.
J. Am. Coll. Nutr. 2002;21:250-258.
ABSTRACT | FULL TEXT  

Prevention Conference VI: Diabetes and Cardiovascular Disease: Writing Group III: Risk Assessment in Persons With Diabetes
Redberg et al.
Circulation 2002;105 :e144-e152.
FULL TEXT  

Eggs and heart disease risk: perpetuating the misperception
McNamara
Am. J. Clin. Nutr. 2002;75:333-334.
FULL TEXT  

Reply to DJ McNamara
Katan et al.
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Evidence-Based Nutrition Principles and Recommendations for the Treatment and Prevention of Diabetes and Related Complications
Franz et al.
Diabetes Care 2002;25:148-198.
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J. Nutr. 2001;131:2358-2363.
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J. Am. Coll. Nutr. 2001;20:5-19.
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Stroke 2000;31:2751-2766.
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J. Am. Coll. Nutr. 2000;19:549S-555.
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Song and Kerver
J. Am. Coll. Nutr. 2000;19:556S-562.
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ANN INTERN MED 2000;132:37-44.
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JWatch Women's Health 1999;1999:2-2.
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JWatch General 1999;1999:4-4.
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