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

  • Fei Wu
    Affiliations
    Department of Nutrition, School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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  • Pan Zhuang
    Affiliations
    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
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  • Chuchu Zhan
    Affiliations
    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
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  • Xinyi Shen
    Affiliations
    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
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  • Jingjing Jiao
    Correspondence
    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.
    Affiliations
    Department of Nutrition, School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China

    Department of Clinical Nutrition of Affiliated Second Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
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  • Yu Zhang
    Correspondence
    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.
    Affiliations
    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
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Published:September 07, 2021DOI:https://doi.org/10.1016/j.jand.2021.09.010

      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.

      Keywords

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      Biography

      F. Wu is a research scholar, Department of Nutrition, School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.

      Biography

      P. Zhuang is a research scholar, 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.

      Biography

      C. Zhan is a research scholar, 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.

      Biography

      X. Shen is a research scholar, 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.

      Biography

      J. Jiao is a professor, Department of Nutrition, School of Public Health, Department of Clinical Nutrition of Affiliated Second Hospital Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.

      Biography

      Y. Zhang is a professor, 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.