Egg Consumption, Cardiovascular Disease and Cardiometabolic Risk Factors: The Interaction with Saturated Fatty Acids. Results from the ATTICA Cohort Study (2002–2012)
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Sample
2.2. Bioethics
2.3. Dietary Assessment
2.4. Other Measurements
2.5. Endpoint and Follow-Up Evaluation
2.5.1. Hard Endpoints
2.5.2. Intermediate Cardiometabolic Conditions
2.5.3. Statistical Analysis
3. Results
4. Discussion
4.1. Limitations
4.2. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Baseline Characteristics | Egg Consumption Categories | |||
---|---|---|---|---|
Never/Rare Consumption (<1 Egg/Week) | Low/Moderate Consumption (1–3 Eggs/Week) | Frequent Consumption (4–7 Eggs/Week) | p-Value | |
n | 443 | 839 | 738 | - |
Sociodemographic factors | ||||
Age, years | 42 (11) | 40 (10) | 38 (10) | 0.523 |
Male sex, % | 57 | 54 | 52 | 0.519 |
Anthropometric factors | ||||
Body mass index, kg/m2 | 26.17 (4.39) | 26.10 (4.50) | 25.41 (4.60) | 0.736 |
Waist circumference, cm | 92 (21) | 89 (22) | 88 (23) | 0.052 |
Lifestyle factors | ||||
Physical activity, % | 34.08 | 36.17 | 39.25 | 0.419 |
MedDietScore, range 0–55 | 23.9 (3.0) | 26.6 (3.2) | 27.0 (3.3) | 0.002 |
Total daily saturated fatty acid intake, g/day | 27.40 (18.20) | 30.31 (19.20) | 38.52 (23.33) | <0.001 |
Current smoking, % | 44 | 46 | 45 | 0.918 |
Clinical factors | ||||
History of hypertension, % | 33 | 27 | 23 | 0.029 |
History of diabetes mellitus, % | 7 | 4 | 3 | 0.155 |
History of hypercholesterolemia, % | 44 | 31 | 23 | <0.0001 |
Family CVD history, % | 38 | 34 | 36 | 0.706 |
Inflammation/coagulation markers | ||||
C-Reactive Protein, mg/L | 1.12 (1.91) | 1.02 (1.80) | 0.84 (1.85) | 0.092 |
Interleukin 6, pg/dL | 1.39 (0.30) | 1.34 (0.32) | 1.29 (0.30) | 0.009 |
Tumor necrosis factor-alpha, pg/mL | 6.04 (3.32) | 6.39 (3.07) | 5.91 (3.25) | 0.143 |
Amyloid A, mg/L | 2.8 (3) | 2.9 (3) | 2.6 (2.7) | 0.639 |
Homocysteine, μmol/L | 10.22 (3.97) | 10.38 (4.28) | 10.41 (4.15) | 0.527 |
Fibrinogen, mg/dL | 309 (79) | 299.5 (81.5) | 289 (69) | 0.004 |
Glucose/insulin homeostasis markers | ||||
HOMA-IR | 2.91 (1.14) | 2.81 (0.96) | 2.76 (0.93) | 0.08 |
Renal function markers | ||||
Creatinine clearance, mL/min/1.73 m2 | 94.02 (32.00) | 95.95 (33.82) | 95.03 (32.39) | 0.648 |
10-Year Endpoint, % | Egg Consumption Categories | p-Value | ||
---|---|---|---|---|
Never/Rare Consumption (<1 Egg/Week) | Low/Moderate Consumption (1–3 Eggs/Week) | Frequent Consumption (4–7 Eggs/Week) | ||
Fatal/non-fatal CVD event | 18 | 9 | 8 | 0.004 |
Hypertension | 24 | 20 | 15 | 0.174 |
Hypercholesterolemia | 36 | 31 | 31 | 0.724 |
Diabetes mellitus | 7 | 9 | 5 | 0.221 |
CVD | Hypertension | Hypercholesterolemia | Diabetes Mellitus | ||
---|---|---|---|---|---|
n, cases | 2020/317 | 1154/320 | 1044/352 | 1485/191 | |
HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | Models adjusted for | |
Model with egg consumption intake as continuous variable | Crude model | ||||
per 1 egg/day | 0.80 (0.62, 1.05) | 0.81 (0.61, 1.07) | 1.00 (0.81, 1.23) | 0.70 (0.46, 1.05) | |
Model with egg consumption intake as categorical variable | |||||
Never/rare consumption (<1 egg/week) | Ref | Ref | Ref | Ref | |
Low/moderate consumption (1–3 eggs/week) | 0.40 (0.21, 0.75) | 0.78 (0.41, 1.49) | 0.8 (0.44, 1.43) | 1.25 (0.53, 2.93) | |
Frequent consumption (4–7 eggs/week) | 0.25 (0.08, 0.75) | 0.53 (0.27, 1.06) | 0.80 (0.45, 1.44) | 0.63 (0.24, 1.66) | |
Model with egg consumption intake as continuous variable | Model 1: Age, sex | ||||
per 1 egg/day | 0.94 (0.73, 1.23) | 0.87 (0.65, 1.16) | 1.04 (0.84, 1.29) | 0.86 (0.59, 1.26) | |
Model with egg consumption intake as categorical variable | |||||
Never/rare consumption (<1 egg/week) | Ref | Ref | Ref | Ref | |
Low/moderate consumption (1–3 eggs/week) | 0.53 (0.29, 0.95) | 1.04 (0.51, 2.09) | 0.91 (0.49, 1.68) | 1.92 (0.78, 4.76) | |
Frequent consumption (4–7 eggs/week) | 0.56 (0.29, 1.06) | 0.71 (0.34, 1.50) | 0.96 (0.52, 1.76) | 1.05 (0.38, 2.90) | |
Model with egg consumption intake as continuous variable | Model 2: Model 1 plus body mass index, physical activity, current smoking, MedDietScore | ||||
per 1 egg/day | 0.97 (0.74, 1.26) | 0.84 (0.62, 1.13) | 1.03 (0.83, 1.28) | 0.87 (0.58, 1.31) | |
Model with egg consumption intake as categorical variable | |||||
Never/rare consumption (<1 egg/week) | Ref | Ref | Ref | Ref | |
Low/moderate consumption (1–3 eggs/week) | 0.50 (0.27, 0.93) | 1.14 (0.54, 2.41) | 0.94 (0.50, 1.76) | 1.74 (0.68, 4.45) | |
Frequent consumption (4–7 eggs/week) | 0.57 (0.30, 1.10) | 0.75 (0.34, 1.65) | 0.94 (0.50, 1.76) | 1.09 (0.38, 3.12) | |
Model with egg consumption intake as continuous variable | Model 3: Model 2 plus history of (hypertension, hypercholesterolemia and diabetes mellitus), family history of CVD | ||||
per 1 egg/day | 0.94 (0.71, 1.25) | 0.81 (0.59, 1.11) | 1.03 (0.82, 1.30) | 0.87 (0.57, 1.33) | |
Model with egg consumption intake as categorical variable | |||||
Never/rare consumption (<1 egg/week) | Ref | Ref | Ref | Ref | |
Low/moderate consumption (1–3 eggs/week) | 0.53 (0.28, 1.00) | 1.19 (0.56, 2.52) | 0.97 (0.50, 1.87) | 1.83 (0.70, 4.77) | |
Frequent consumption (4–7 eggs/week) | 0.57 (0.29, 1.15) | 0.74 (0.33, 1.67) | 0.90 (0.46, 1.73) | 1.13 (0.38, 3.41) | |
Model with egg consumption intake as continuous variable | Model 4: Model 3 plus total daily saturated fatty acid intake | ||||
per 1 egg/day | 1.01 (0.76, 1.36) | 0.76 (0.54, 1.07) | 1.22 (0.85, 1.76) | 0.90 (0.58, 1.38) | |
Model with egg consumption intake as categorical variable | |||||
Never/rare consumption (<1 egg/week) | Ref | Ref | Ref | Ref | |
Low/moderate consumption (1–3 eggs/week) | 0.54 (0.28, 1.03) | 1.16 (0.54, 2.47) | 0.65 (0.26, 1.62) | 1.86 (0.71, 4.85) | |
Frequent consumption (4–7 eggs/week) | 0.64 (0.31, 1.32) | 0.67 (0.29, 1.54) | 1.67 (0.62, 4.5) | 1.22 (0.40, 3.73) |
CVD | Hypertension | Hypercholesterolemia | Diabetes Mellitus | |||||
---|---|---|---|---|---|---|---|---|
n, Cases | 2020/317 | 1154/320 | 1044/352 | 1485/191 | ||||
Low saturated fat intake * | High saturated fat intake * | Low saturated fat intake * | High saturated fat intake * | Low saturated fat intake * | High saturated fat intake * | Low saturated fat intake * | High saturated fat intake * | |
HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | |
Model with egg consumption intake as continuous variable | ||||||||
per 1 egg/day | 0.55 (0.32, 0.93) | 1.09 (0.61, 1.95) | 0.68 (0.38, 1.19) | 0.84 (0.46, 1.59) | 0.97 (0.62, 1.52) | 0.97 (0.59, 1.58) | 1.11 (0.54, 2.30) | 0.89 (0.39, 2.00) |
Model with egg consumption intake as categorical variable | ||||||||
Never/rare consumption (<1 egg/week) | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref |
Low/moderate consumption (1–3 eggs/week) | 0.68 (0.30, 1.49) | 0.29 (0.08, 1.00) | 1.41 (0.55, 3.61) | 0.76 (0.19, 2.96) | 0.81 (0.34, 1.95) | 1.08 (0.37, 3.15) | 1.61 (0.46, 5.64) | 1.65 (0.30, 9.09) |
Frequent consumption (≥4 eggs/week) | 0.25 (0.07, 0.86) | 0.87 (0.29, 2.57) | 0.37 (0.09, 1.37) | 0.71 (0.19, 2.63) | 0.92 (0.37, 2.25) | 0.98 (0.34, 2.80) | 1.21 (0.26, 5.62) | 0.94 (0.16, 5.53) |
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Kouvari, M.; Damigou, E.; Florentin, M.; Kosti, R.I.; Chrysohoou, C.; Pitsavos, C.S.; Panagiotakos, D.B. Egg Consumption, Cardiovascular Disease and Cardiometabolic Risk Factors: The Interaction with Saturated Fatty Acids. Results from the ATTICA Cohort Study (2002–2012). Nutrients 2022, 14, 5291. https://doi.org/10.3390/nu14245291
Kouvari M, Damigou E, Florentin M, Kosti RI, Chrysohoou C, Pitsavos CS, Panagiotakos DB. Egg Consumption, Cardiovascular Disease and Cardiometabolic Risk Factors: The Interaction with Saturated Fatty Acids. Results from the ATTICA Cohort Study (2002–2012). Nutrients. 2022; 14(24):5291. https://doi.org/10.3390/nu14245291
Chicago/Turabian StyleKouvari, Matina, Evangelia Damigou, Matilda Florentin, Rena I. Kosti, Christina Chrysohoou, Christos S. Pitsavos, and Demosthenes B. Panagiotakos. 2022. "Egg Consumption, Cardiovascular Disease and Cardiometabolic Risk Factors: The Interaction with Saturated Fatty Acids. Results from the ATTICA Cohort Study (2002–2012)" Nutrients 14, no. 24: 5291. https://doi.org/10.3390/nu14245291