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Egg and Dietary Cholesterol Consumption and the Prevalence of Metabolic Syndrome: Findings from a Population-Based Nationwide Cohort - 17/03/22

Doi : 10.1016/j.jand.2021.09.010 
Fei Wu, MD 1, Pan Zhuang, PhD 2, Chuchu Zhan, BS 2, Xinyi Shen, BS 2, Jingjing Jiao, PhD 1, 3, , Yu Zhang, PhD 2,
1 Department of Nutrition, School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China 
2 Zhejiang Key Laboratory for Agro-Food Processing, Department of Food Science and Nutrition, College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou, Zhejiang, China 
3 Department of Clinical Nutrition of Affiliated Second Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China 

Address correspondence to: Yu Zhang, PhD, Department of Food Science and Nutrition, College of Biosystems Engineering and Food Science, Zhejiang University, 866 Yuhangtang Rd, Hangzhou 310058, Zhejiang, China.Department of Food Science and NutritionCollege of Biosystems Engineering and Food ScienceZhejiang University866 Yuhangtang RdHangzhouZhejiang310058China∗∗Jingjing Jiao, PhD, Department of Nutrition, School of Public Health, Department of Clinical Nutrition of Affiliated Second Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Rd, Hangzhou 310058, Zhejiang, China.Department of NutritionSchool of Public HealthDepartment of Clinical Nutrition of Affiliated Second HospitalZhejiang University School of Medicine866 Yuhangtang RdHangzhouZhejiang310058China

Abstract

Background

Although the Chinese Dietary Guidelines (2016) removed restrictions on dietary cholesterol intake, evidence of egg and dietary cholesterol intake and cardiometabolic diseases is inconsistent. Associations between egg and cholesterol consumption and metabolic syndrome (MetS) in non-Western populations are still poorly documented.

Objective

Our aim was to assess egg and dietary cholesterol intake in relation to the prevalence of MetS among participants in a Chinese nationwide study.

Design

This cross-sectional study used data from the China Health and Nutrition Survey (1991-2009).

Participants/setting

The sample consisted of 8,241 healthy Chinese adults (20 years and older).

Main outcome measures

MetS cases were defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria.

Statistical analysis

Cumulative means of egg and cholesterol consumption were calculated in accordance with 3 consecutive 24-hour dietary recalls in each examination cycle. Logistic regression models were conducted to assess the associations with prevalent MetS.

Results

Overall, 2,580 (31.3%) participants were identified as MetS cases in 2009. After multivariate adjustment, total egg consumption (>1 egg/d) was associated with 20% higher odds of MetS (odds ratio [OR] 1.20, 95% CI 1.06 to 1.37; P trend = .001) compared with consumption of ≤1/2 egg/d. Examining cooking methods, a positive association was observed between fried egg consumption and MetS odds (OR comparing the highest category [>1/2 egg/d] with the lowest category [≤1/7 egg/d] 1.22, 95% CI 1.08 to 1.39; P trend = .001), and nonfried egg intake was not associated with MetS odds (P trend = .08). Total dietary intake and egg-sourced cholesterol intake were both positively correlated with MetS odds (OR 1.31, 95% CI 1.12 to 1.53; P trend = .005) comparing the highest consumption (>371 mg · 2,000 kcal–1 · d–1) with the lowest consumption (≤132 mg · 2,000 kcal–1 · d–1) for total dietary cholesterol (OR 1.36; 95% CI 1.17 to 1.58; P trend < .001) and comparing the highest consumption (>232 mg · 2,000 kcal–1 · d–1) with the lowest consumption (≤46 mg · 2,000 kcal–1 · d–1) for egg-sourced cholesterol; similar associations were not observed for non–egg-sourced cholesterol consumption (P trend = .83). Substituting eggs and fried eggs for other protein sources, including low-fat and whole-fat dairy products; nuts and legumes; total red meat; processed meat; poultry meat; or seafood, was still associated with higher odds of MetS.

Conclusions

Consumption of >1 egg/d and >1/2 fried egg/d was associated with a higher prevalence of MetS than consumption of ≤1/2 egg/d and ≤1/7 fried egg/d. Future longitudinal cohort studies and randomized controlled trials are needed to further investigate the relationship between egg consumption and MetS and explore possible mechanisms of action.

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Keywords : Eggs, Fried eggs, Nonfried eggs, Cholesterol, Metabolic syndrome


Plan


 Supplementary materials:Table 2, Table 4, and Table 6, Table 7, Table 8, Table 9 are available at www.jandonline.org
 STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
 FUNDING/SUPPORT This work was supported by the National Key Research and Development Program of China (grant no. 2017YFC1600500) and the China National Program for Support of Top-Notch Young Professionals. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. This research uses data from China Health and Nutrition Survey (CHNS). We are grateful to research grant funding from the National Institute for Health (NIH), the Eunice Kennedy Shriver National Institute of Child Health and Human Development for R01 HD30880, National Institute of Diabetes and Digestive and Kidney Diseases for R01DK104371 and R01HL108427, the NIH Fogarty grant D43 TW009077 for financial support for the CHNS data collection and analysis files since 1989, and the China-Japan Friendship Hospital, Ministry of Health for support for CHNS 2009, Chinese National Human Genome Center at Shanghai since 2009.
 This study was registered at ClinicalTrials.gov (NCT04104308).


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