Egg consumption and coronary heart disease: An epidemiologic overview

Serum cholesterol has been established as a modifiable risk factor for coro nary heart disease. Experimental feeding studies show that saturated fat an d cholesterol increase serum cholesterol levels; thus, dietary recommendati ons for lowering the risk of heart disease proscribe the intake of both sub stances. Recommendations have also included limits on the intake of eggs be cause of their high cholesterol content. In free-living populations, diet r eflects a pattern of associated choices. Increases in one food may lead to changes in the consumption of other foods that may modulate disease risk. E pidemiologic data are helpful in assessing the importance of foods and nutr ients in the context in which they are actually consumed. We review epidemi ologic data relating dietary cholesterol and eggs to coronary disease risk. Cholesterol intake was associated with a modest increase in the risk of co ronary events. The true magnitude of the association is difficult to estima te because most studies fail to account for potential confounding by other features of the diet. When a full-range of confounding factors was consider ed, the association between cholesterol intake and heart disease risk was s mall (6% increase in risk for 200mg/1,000kcal/day difference in cholesterol intake). Several studies have examined egg intake and its relationship wit h coronary outcomes. All but one failed to consider the role of other poten tially confounding dietary factors. When dietary confounders were considere d, no association was seen between egg consumption at levels up to 1+ egg p er day and the risk of coronary heart disease in non-diabetic men and women .