Egg Consumption and Risk of All-Cause and Cause-Specific Mortality: A Systematic Review and Dose-Response Meta-analysis of Prospective Studies

Seyed Mohammad Mousavi; Nikan Zargarzadeh; Somaye Rigi; Emma Persad; Ana Beatriz Pizarro; Shirin Hasani-Ranjbar; Bagher Larijani; Walter C Willett; Ahmad Esmaillzadeh

doi:10.1093/advances/nmac040

Egg Consumption and Risk of All-Cause and Cause-Specific Mortality: A Systematic Review and Dose-Response Meta-analysis of Prospective Studies

Adv Nutr. 2022 Oct 2;13(5):1762-1773. doi: 10.1093/advances/nmac040.

Authors

Seyed Mohammad Mousavi^{1

2}, Nikan Zargarzadeh³, Somaye Rigi², Emma Persad⁴, Ana Beatriz Pizarro⁵, Shirin Hasani-Ranjbar^{1

6}, Bagher Larijani⁶, Walter C Willett^{7

8}, Ahmad Esmaillzadeh^{1

2

9}

Affiliations

¹ Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
² Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
³ School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
⁴ Department for Evidence-based Medicine and Evaluation, Danube University Krems, Krems, Austria.
⁵ Clinical Research Center, Fundación Valle del Lili, Cali, Colombia.
⁶ Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁷ Departments of Nutrition and Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA.
⁸ Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
⁹ Food Security Research Center, Department of Community Nutrition, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

The association between egg consumption and mortality is extremely debatable. This study aimed to investigate the potential dose-response association of egg consumption with risk of mortality from all causes and cause-specific in the general population. The primary comprehensive literature search was conducted in PubMed/Medline, Scopus, ISI Web of Science, and Embase up to March 2021, as well as reference lists of relevant original papers and key journals. We calculated summary RRs and their 95% CIs for the highest and lowest categories, as well as the linear trend estimation of egg intake, using the random-effects model. Thirty-three (32 publications) cohort studies were included. These studies enrolled 2,216,720 participants and recorded 232,408 deaths from all causes. Comparing highest versus lowest egg intake categories was not associated with the risk of mortality from all causes (RR: 1.02; 95% CI: 0.94, 1.11; n = 25), cardiovascular disease (CVD) (RR: 1.04; 95% CI: 0.87, 1.23, n = 11), coronary heart disease (CHD) (RR: 0.98; 95% CI: 0.84, 1.16; n = 10), stroke (RR: 0.81; 95% CI: 0.64, 1.02; n = 9), and respiratory disease (RR: 0.96; 95% CI: 0.53, 1.71; n = 3); however, it was associated with a higher risk of cancer mortality (RR: 1.20; 95% CI: 1.04, 1.39; n = 13). In the linear dose-response analysis, an additional intake of 1 egg per week was associated with a 2% and 4% increased risk of all-cause and cancer mortality, respectively, and a 4% decreased risk of stroke mortality. The certainty of the evidence was rated as low to moderate. Higher egg consumption was not associated with an increased risk of mortality from all causes, CVD, CHD, stroke, or respiratory disease, whereas an elevated risk was observed for cancer mortality. These findings suggest that eggs be consumed in low to moderate amounts (≤1 egg/d) as part of a healthy diet.

Keywords: all-cause mortality; cancer; cardiovascular disease; egg; mortality; stroke.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Cardiovascular Diseases*
Cause of Death
Coronary Disease* / epidemiology
Humans
Neoplasms*
Prospective Studies
Stroke* / epidemiology