At the Kahn Center, we teach a plant-based, whole food diet for heart prevention and reversal. A common question from patients is the role of egg consumption in a health diet. Admittedly, there is controversy over this topic. Egg yolks contain high amounts of dietary cholesterol and saturated fat and also can raise levels of TMAO due to their high choline content.
Despite this, many health experts advise eggs and praise them as "nature's perfect food". But could eggs potentially raise the risk of death? A new study says this may be possible and even 1 egg a day has risk. The study has no funding conflicts.
The authors conducted a prospective cohort analysis of 1367 stroke survivors recruited across the United States between 1999 and 2018. Dietary information was evaluated by a 24-h dietary recall at baseline obtained from NHANES while mortality data were derived from the National Death Index with follow-up through 2019.
After a follow-up of 79 months, for each 100 mg/1000 kcal/day elevation in cholesterol intake there was a raised risk of all-cause and cardiovascular mortality. A greater risk of all-cause mortality was shown in participants consuming > 1 egg/day.
The dose-response analysis highlighted the lowest risk of all-cause mortality when egg consumption was around 33.3 g/day. The observed correlations of dietary cholesterol intake or egg consumption with all-cause and cardiovascular mortality were stronger in the subgroups with cardiometabolic diseases (obesity, hypertension, diabetes mellitus, hyperlipidemia) or risk factors for cardiometabolic diseases (advanced age).
Among stoke survivors, greater dietary cholesterol connects to an escalated risk of all-cause and cardiovascular mortality in a linear manner. Moderate egg consumption (≤ 1 egg/day) is relatively safe and excessive consumption links to an elevated risk of all-cause mortality.
This study, a classic nutritional epidemiology study, reports an association between dietary cholesterol, egg consumption, and an increased risk of premature death in survivors of a stroke. Of course, this does not prove causation, but the findings are consistent with prior studies on the topic.
The association was true for all the subsets looked at like gender, age, and pre-existing comorbidities to stroke.
The study could not identify why their might be a higher risk of death but the increased burden of saturated fat and choline (raising TMAO levels) are reasonable suspicions.
At the Kahn Center, we will continue to advise patients to avoid whole eggs. Whether egg whites alone have the same association with premature death was not studied in this research paper.
