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    An Egg a Day Raises Risk of Diabetes

    This is one study that I totally disagree with - what do you all think?

    An Egg a Day Raises Risk of Diabetes

    By Crystal Phend, Staff Writer, MedPage Today
    Published: November 21, 2008
    Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston.
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    BOSTON, Nov. 21 -- People who eat eggs every day may substantially increase their risk of type 2 diabetes, researchers here said.

    Men with the highest level of egg consumption -- at seven or more per week -- were 58% more likely to develop type 2 diabetes than those who did not eat eggs, and women were 77% more likely to become diabetic if they ate at least an egg a day, Luc Djoussé, M.D., D.Sc., of Brigham and Women's Hospital and Harvard, and colleagues reported online in Diabetes Care.

    Levels of egg intake above one a week also incrementally increased diabetes risk in both men and women (both P<0.0001 for trend), the researchers said.

    Eggs are a major source of dietary cholesterol (about 200 mg per egg) and add about 1.5 g of saturated fat each to the diet, both of which would be expected to increase diabetes risk, they said. Action Points
    Explain to interested patients that the average one-egg-a-week consumption was not associated with increased diabetes risk.

    Note that eggs may influence glucose metabolism primarily through their effect on cholesterol, although the researchers noted that the observational study could not determine the mechanism.
    But each egg also contributes about 0.7 g of polyunsaturated fat, which may confer a lower risk of type 2 diabetes, the researchers noted.

    The limited, primarily animal model, evidence for an effect of eggs or dietary cholesterol on glucose metabolism has been inconsistent, they added.

    To sort out the effects, the researchers analyzed two large prospective trials that included food frequency questionnaires.

    Their analysis included 20,703 male physicians without baseline diabetes from the Physicians' Health Study I (1982-2007) and 36,295 similarly diabetes-free female health professionals from the Women's Health Study (1992-2007).

    Both studies were originally designed as randomized trials of vitamin supplementation and aspirin for prevention of heart disease.

    Over a mean follow-up of 20.0 years in men and 11.7 years in women, 1,921 men and 2,112 women developed type 2 diabetes.

    Diabetes was more common in men and women who reported eating more than the average one egg a week.

    After adjustment for traditional diabetes risk factors and compared with no egg consumption at the 95% confidence interval, the hazard ratios for type 2 diabetes in men were:

    9% for less than one egg a week (hazard ratio 1.09, 0.87 to 1.37)
    9% for one egg a week (HR 1.09, 0.88 to 1.34)
    18% for two to four eggs a week (HR 1.18, 0.95 to 1.45)
    46% for five to six eggs per week (HR 1.46, 1.14 to 1.86)
    58% for seven or more eggs each week (HR 1.58, 1.25 to 2.01)

    Updating egg consumption with longer follow-up among men strengthened the associations to an almost twofold risk for those in the near daily or higher intake groups (HR 1.77, 95% CI 1.39 to 2.26, and HR 1.99, 95% CI 1.23 to 3.23, respectively).

    For women, the multivariate-adjusted risks, also at the 95% confidence interval, compared with no egg intake were:

    6% for less than one egg per week (HR 1.06, 0.92 to 1.22)
    -3% for one egg a week (HR 0.97, 0.83 to 1.12)
    19% for two to four eggs per week (HR 1.19, 1.03 to 1.38)
    18% for five to six eggs a week (HR 1.18, 0.88 to 1.58)
    77% for seven or more per week (HR 1.77, 1.28 to 2.43)

    Data on dietary cholesterol available in the female health professional study showed higher diabetes risk with rising dietary cholesterol with hazard ratios increasing to 1.28 (95% CI 1.10 to 1.50) in the highest quintile (P<0.0001 for trend).

    Adjustment for dietary cholesterol attenuated the association between diabetes and egg consumption, whereas saturated fat was not associated with type 2 diabetes and did not alter the diabetes-egg link.

    The effects did not appear to be limited to those with high carbohydrate diets, hypercholesterolemia, or high body mass index.

    However, the researchers acknowledged that the data did not include repeat fasting glucose, fasting insulin, and other biomarkers of glucose metabolism to "comprehensively examine possible physiologic mechanisms."

    The observational studies may also have been limited by self-reporting and residual confounding, they noted.

    The generalizablity may have been limited as well by the homogeneous, primarily Caucasian health professional population, which may have different behaviors than the general population, Dr. Djoussé's group said.

    "Given the societal burden of type 2 diabetes," they concluded, "confirmation of these findings in other populations and exploration of possible underlying biological mechanisms are warranted."

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  2. Back To Top    #2
    Mecca V.I.P. tim290280's Avatar
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    Jul 2006
    Western Australia
    The research abstracts below.

    I wouldn't be too concerned. Have a look at who they were measuring and how they did it. People that are having health issues already aren't exactly people we take dietry advice from anyway.
    Quote Quote
    American Journal of Clinical Nutrition, Vol. 87, No. 4, 964-969, April 2008
    © 2008 American Society for Nutrition
    Egg consumption in relation to cardiovascular disease and mortality: the Physicians' Health Study1,2,3
    Luc Djoussé and J Michael Gaziano

    1 From the Divisions of Aging (LD and JMG) and Preventive Medicine (JMG), the Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA

    Background: A reduction in dietary cholesterol is recommended to prevent cardiovascular disease (CVD). Although eggs are important sources of cholesterol and other nutrients, limited and inconsistent data are available on the effects of egg consumption on the risk of CVD and mortality.

    Objective: We aimed to examine the association between egg consumption and the risk of CVD and mortality.

    Design: In a prospective cohort study of 21 327 participants from Physicians' Health Study I, egg consumption was assessed with an abbreviated food questionnaire. Cox regression was used to estimate relative risks.

    Results: In an average follow-up of 20 y, 1550 new myocardial infarctions (MIs), 1342 incident strokes, and 5169 deaths occurred. Egg consumption was not associated with incident MI or stroke in a multivariate Cox regression. In contrast, adjusted hazard ratios (95% CI) for mortality were 1.0 (reference), 0.94 (0.87, 1.02), 1.03 (0.95, 1.11), 1.05 (0.93, 1.19), and 1.23 (1.11, 1.36) for the consumption of <1, 1, 2–4, 5–6, and ≥7 eggs/wk, respectively (P for trend < 0.0001). This association was stronger among diabetic subjects, in whom the risk of death in a comparison of the highest with the lowest category of egg consumption was twofold (hazard ratio: 2.01; 95% CI: 1.26, 3.20; P for interaction = 0.09).

    Conclusions: Infrequent egg consumption does not seem to influence the risk of CVD in male physicians. In addition, egg consumption was positively related to mortality, more strongly so in diabetic subjects, in the study population.
    Quote Quote
    American Journal of Clinical Nutrition, Vol. 87, No. 4, 799-800, April 2008
    © 2008 American Society for Nutrition
    Egg consumption in relation to cardiovascular disease and mortality: the story gets more complex1,2
    Robert H Eckel1

    1 From the University of Colorado Denver, Aurora, CO

    See corresponding article on page 964.

    2 Reprints not available. Address correspondence to RH Eckel, University of Colorado Denver, PO Box 6511, Mail Stop 8106, 12801 East 17th Avenue, Aurora, CO 80045. E-mail: Robert.eckel@uchsc.edu.

    More egg on our faces? It's really hard to say at this point, but it still seems, if you're a middle-aged male physician and enjoy eggs more than once a day, that having some of the egg left on your face may be better than having it go down your gullet. In this issue of the Journal, Djoussé and Gaziano (1) have calculated an adjusted hazard ratio of 1.41 for all-cause mortality over a 20-y span in 21 327 Harvard-educated male physicians who ate ≥1 egg/d. It is important that a pattern of less frequent intake did not influence risk. However, if diabetes was coexistent in these health care professionals, a trend existed across a broader range of egg consumption. The egg intake pattern in this study population was extremely low: only 8% of participants were eating ≥1 egg/d. For comparison, 36% of the men in the Framingham study (2) and 37% of men in a Japanese study (3) with similar outcome assessments ate ≥1 egg/d. However, in both of those other cohorts, there was no association between egg consumption and myocardial infarction, cardiovascular disease (CVD) death, or all-cause mortality. Yet, this much higher consumption pattern may have confounded a graded effect that occurred at lower egg intakes.

    So why was egg consumption in the study by Djoussé and Gaziano related to all-cause mortality, but not to myocardial infarction or stroke? Is there any reason why egg consumption should predict all-cause mortality but not CVD mortality? Because the existing literature has focused on CVD events and CVD-related mortality, this surprising finding requires validation. There is one report of an association between egg consumption and non-Hodgkin lymphoma (4), but confirmation is lacking. Presumably, the relation to all-cause mortality in the physicians studied by Djoussé and Gaziano still reflects atherosclerotic disease. Even if the causes of death in their cohort cannot be made certain, there is no reason to posit causes other than CVD. Perhaps the effect of higher egg consumption on coronary artery disease death was related to fatal arrhythmias. An antiarrhythmic effect of fish or fish-oil consumption on coronary artery disease mortality has been proposed (5).

    The historical and current concerns about egg consumption and atherosclerotic risk have to do with the cholesterol content of eggs. However, when one considers the effect of diet on CVD risk, the effect of cholesterol intake on CVD risk is less consistent than is that of saturated and trans fatty acid intakes (6). As pointed out by Djoussé and Gaziano, higher intakes of saturated and trans fats typically raise LDL-cholesterol concentrations more than do higher amounts of cholesterol in the diet. It is of interest that the trend to higher risk in subjects with diabetes begins at lower egg (yolk cholesterol) intakes. The expected effect on plasma LDL cholesterol would be expected to be small. It is noteworthy that this relation between egg consumption and CVD risk in patients with diabetes is not a novel finding (7, 8). Cholesterol absorption has been shown to be higher in patients with type 1 diabetes (9) but not in patients with type 2 diabetes (10). It is not stated—but may be presumed—that most of the subjects with diabetes in the study by Djoussé and Gaziano had type 2, not type 1, diabetes.

    Unfortunately, data for LDL cholesterol and many other important covariates that relate to CVD risk were not available in the sample in their study. The study also suffers from the lack of detailed dietary information that may confound the interpretation, such as patterns of dietary intake of saturated and trans fats, fruit and vegetables, whole grains and other fiber, and fish. In the male physicians without diabetes, the trend analysis was weak, and significance was achieved only at consumption patterns of >1 egg/d (hazard ratio: 1.22). At this level of intake above the average ({approx}200 mg) for {approx}2000 kcal/d, a maximum increase in total cholesterol would be 40 mg/dL (11). Of course, this value is likely an overestimate, and it fails to take into consideration the subject's overall lifestyle, including dietary composition.

    It is important to note that Djoussé and Gaziano assessed egg intake every 2 y for 10 y. It is not clear how these data were analyzed with the time-dependent Cox model the authors used. We are told that, because egg intake values at 2 y were similar to those at baseline, data at 2 y were substituted for baseline data in the 113 participants without baseline data. One would assume that the overall lifestyle of subjects with higher egg consumption would have predicted more CVD. That is, the physicians with higher egg intake were older, smoked more cigarettes, were less physically active, ate breakfast cereal less often, and had a higher prevalence of hypertension and diabetes than did those with lower egg intake.

    So, if you are a male physician and are going to eat ≥1 egg/d, why not eat the whites only? Just think—with all of the trimmings, that 3-white egg omelet is almost indistinguishable by taste from an omelet enriched with 600 mg cholesterol, and the whites-only omelet also remains a very good source of protein, riboflavin, and selenium. If you cannot do without the yolks, go ahead and enjoy them, but why eat them >3–4 d/wk? If you are a man with diabetes, a more limited egg intake pattern seems prudent. But, remember: eggs are like all other foods—they are neither "good" nor "bad," and they can be part of an overall heart-healthy diet.


    RHE is 1 of 4 co-chairs of the Cardiometabolic Health Congress; co-chair of the Committee on Cardiovascular and Metabolic Diseases; and a consultant to Sanofi-Aventis. He has lectured for Takeda Chemical Industries and received a research grant from Sanofi-Aventis.


    1. Djoussé L, Gaziano JM. Egg consumption in relation to cardiovascular disease and mortality: the Physicians' Health Study. Am J Clin Nutr 2008;87:964–9.[Abstract/Free Full Text]
    2. Dawber TR, Nickerson RJ, Brand FN, Pool J. Eggs, serum cholesterol, and coronary heart disease. Am J Clin Nutr 1982;36:617–25.[Abstract/Free Full Text]
    3. Nakamura Y, Okamura T, Tamaki S, et al. Egg consumption, serum cholesterol, and cause-specific and all-cause mortality: the National Integrated Project for Prospective Observation of Non-communicable Disease and Its Trends in the Aged, 1980 (NIPPON DATA80). Am J Clin Nutr 2004;80:58–63.[Abstract/Free Full Text]
    4. Purdue MP, Bassani DG, Klar NS, Sloan M, Kreiger N. Dietary factors and risk of non-Hodgkin lymphoma by histologic subtype: a case-control analysis. Cancer Epidemiol Biomarkers Prev 2004;13:1665–76.[Abstract/Free Full Text]
    5. Brouwer IA, Geelen A, Katan MB. n–3 Fatty acids, cardiac arrhythmia and fatal coronary heart disease. Prog Lipid Res 2006;45:357–67.[Medline]
    6. Kratz M. Dietary cholesterol, atherosclerosis and coronary heart disease. Handb Exp Pharmacol 2005;(170):195–213.[Medline]
    7. Hu FB, Stampfer MJ, Rimm EB, et al. A prospective study of egg consumption and risk of cardiovascular disease in men and women. JAMA 1999;281:1387–94.[Abstract/Free Full Text]
    8. Qureshi AI, Suri FK, Ahmed S, Nasar A, Divani AA, Kirmani JF. Regular egg consumption does not increase the risk of stroke and cardiovascular diseases. Med Sci Monit 2007;13:CR1–8.[Medline]
    9. Gylling H, Laaksonen DE, Atalay M, Hallikainen M, Niskanen L, Miettinen TA. Markers of absorption and synthesis of cholesterol in men with type 1 diabetes. Diabetes Metab Res Rev 2007;23:372–7.[Medline]
    10. Miettinen TA, Gylling H, Tuominen J, Simonen P, Koivisto V. Low synthesis and high absorption of cholesterol characterize type 1 diabetes. Diabetes Care 2004;27:53–8.[Abstract/Free Full Text]
    11. Hegsted DM. Serum-cholesterol response to dietary cholesterol: a re-evaluation. Am J Clin Nutr 1986;44:299–305.[Abstract/Free Full Text]
    Quote Quote
    Circulation. 2008;117:512-516.
    © 2008 American Heart Association, Inc.
    Egg Consumption and Risk of Heart Failure in the Physicians’ Health Study
    Luc Djoussé, MD, MPH, DSc; J. Michael Gaziano, MD, MPH

    From the Divisions of Aging (L.D., J.M.G.) and Preventive Medicine (J.M.G.), Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Mass.

    Correspondence to Luc Djoussé, MD, MPH, DSc, Division of Aging, Brigham and Women’s Hospital and Harvard Medical School, 1620 Tremont St, Third Floor, Boston MA 02120. E-mail ldjousse@rics.bwh.harvard.edu

    Received August 13, 2007; accepted November 8, 2007.

    Background— Reduction in dietary cholesterol is widely recommended for the prevention of cardiovascular disease. Although eggs are important sources of dietary cholesterol and other nutrients, little is known about the association between egg consumption and heart failure (HF) risk.

    Methods and Results— In a prospective cohort study of 21 275 participants from the Physicians’ Health Study I, we examined the association between egg consumption and the risk of HF. Egg consumption was assessed with the use of a simple abbreviated food questionnaire, and we used Cox regression to estimate relative risks of HF. After an average follow-up of 20.4 years, a total of 1084 new HF cases occurred in this cohort. Although egg consumption up to 6 times per week was not associated with incident HF, egg consumption of ≥7 per week was associated with an increased risk of HF. Compared with subjects who reported egg consumption of <1 per week, hazard ratios (95% confidence intervals) for HF were 1.28 (1.02 to 1.61) and 1.64 (1.08 to 2.49) for egg consumption of 1 per day and ≥2 per day, respectively, after adjustment for age, body mass index, smoking, alcohol consumption, exercise, and history of atrial fibrillation, hypertension, valvular heart disease, and hypercholesterolemia. Similar results were obtained for HF without antecedent myocardial infarction.

    Conclusions— Our data suggest that infrequent egg consumption is not associated with the risk of HF. However, egg consumption of ≥1 per day is related to an increased risk of HF among US male physicians.

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  3. Back To Top    #3
    i just skimmed the article but basically they are attacking the sat fats and bad cholesterol in the eggs. Easy solution buy omega 3 eggs.

    Like i said i only skimmed the article so i could be completely wrong, but it seemed like they were blaming the risk of diabetes in the sat fat and bad cholesterol in the eggs.




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