Egg intake and cardiometabolic diseases: an update, Part 1

Peer-reviewed / Manuscript (overview) received: December 06, 2018 / Revision accepted: July 11, 2019

Introduction

Egg intake and its effects on human health has long been the subject of scientific research and discussion. Eggs can on the one hand be a good source of nutrients, but are also controversially discussed due to their high cholesterol content. The particular focus here is cardiovascular diseases [1, 2], which are among the most common causes of death in Germany. In 2016 they were the cause of a total of 37.0% of all deaths [3].

Cardiovascular risk factors include, inter alia, raised concentrations of total cholesterol and low-density lipoprotein (LDL) cholesterol [4]. In the evidence-based guideline of the German Nutrition Society (Deutsche Gesellschaft für Ernährung, DGE): fat intake and prevention of selected nutrition-related diseases [5] the intake of dietary cholesterol was linked to an increase in the ratio of total cholesterol to high density lipoprotein (HDL) cholesterol with probable evidence and to a small increase in the ratio of total and LDL cholesterol with convincing evidence, although this latter is probably more pronounced in what are known as responders than non-responders.1 Studies on specific foods, such as eggs, were not considered in the guidelines on fat intake since their effects are based on the overall food matrix and it is therefore not possible to derive definitive statements on the effects of fat or cholesterol in the diet.

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¹ Classification as (non-)responders is based on the effect of dietary cholesterol intake on LDL cholesterol concentration, which is not comparable in everyone [6, 7].

Abstract

Although eggs are a valuable source of nutrients, the role of egg intake has been controversially discussed due to eggs´ high content of cholesterol. Currently there is no consensus in the recommendations of (inter) national nutrition and cardiological scientific bodies on egg and cholesterol intake. Meta-analyses, systematic reviews and recent cohort studies predominantly show no association between egg intake and the risk of cardiovascular diseases in the general population. As regards people with type 2 diabetes mellitus, study results mainly indicate an increased risk for cardiovascular diseases in relation to egg intake. Controlled intervention studies are required to confirm these associations. The current knowledge on the effects of egg intake on cardiometabolic risk factors and the risk of type 2 diabetes mellitus are presented and reviewed in a second article.

Keywords: egg intake, cardiovascular diseases, type 2 diabetes mellitus, cholesterol

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