To explore the association between egg consumption and metabolic syndrome (MetS) in the adult population.

The PubMed, Web of Science and Embase electronic databases were searched up to December 2021 for observational studies on the association between egg consumption and MetS in the adult population. The pooled relative risk (RR) of MetS for the highest versus lowest category of egg consumption, and the standard mean difference (SMD) of egg consumption for MetS versus control subjects were calculated. Egg consumption was assessed by a food-frequency questionnaire (FFQ) and the 24-hour recall method. The criteria for MetS were National Cholesterol Education Program-Adult Treatment Panel III (NCEP ATP III), International Diabetes Federation (IDF), Joint Interim Statement (JIS) and American Heart Association (AHA).

A total of 19 articles with 20 observational studies (331667 participants) were included in this meta-analysis. The overall multivariable adjusted RR (18 studies included) demonstrated that higher egg consumption was associated with a lower probability of having MetS (RR=0.92, 95%CI: 0.88 to 0.96; P<0.001). Subgroup analysis confirmed these findings in cross-sectional studies (RR=0.91, 95% CI: 0.88 to 0.95; P<0.001), studies that used the NCEP ATP III criteria (RR=0.94, 95% CI: 0.89 to 0.99; P=0.02), Asia (RR=0.92, 95% CI: 0.86 to 0.99; P=0.02), studies with samples sizes >5000 (RR=0.92, 95% CI: 0.86 to 0.96; P<0.001), studies that adjusted body mass index (BMI) (RR=0.90, 95% CI: 0.86 to 0.95; P<0.001) and energy intake (RR=0.89, 95% CI: 0.83 to 0.94; P<0.001) and high-quality studies (RR=0.91, 95% CI: 0.88 to 0.95; P<0.001). Moreover, the overall combined SMD (5 studies included) showed that the level of egg consumption in subjects with MetS was also lower than that in control subjects. (SMD=−0.22, 95% CI: −0.25 to −0.20; P<0.001). Sensitivity analysis demonstrated that this finding only existed in studies with samples sizes >5000 (SMD=-0.21, 95% CI: −0.29 to −0.12; P<0.001) and high-quality studies (SMD=−0.23, 95% CI: −0.26 to −0.20; P<0.001).

Our results suggest that higher egg consumption is associated with a lower probability of having MetS in the adult population. However, due to the limited evidence, more global well-designed prospective cohort studies are still needed.