Egg consumption and risk of type 2 diabetes: a prospective study and dose-response meta-analysis

Alice Wallin, Nita G Forouhi, Alicja Wolk, Susanna C Larsson, Alice Wallin, Nita G Forouhi, Alicja Wolk, Susanna C Larsson

Abstract

Aims/hypothesis: In this study, we aimed to investigate the association between egg consumption and type 2 diabetes risk in the Cohort of Swedish Men and to conduct a meta-analysis to summarise available prospective evidence on this association.

Methods: We followed 39,610 men (aged 45-79 years) from 1998 up to 2012 for incident type 2 diabetes. Egg consumption was assessed at baseline using a food frequency questionnaire. HRs (95% CIs) were estimated using Cox proportional hazards regression models. We searched PubMed (up to 14 December 2015) and reference lists of retrieved articles to identify eligible studies for meta-analysis.

Results: During the 15 years of follow up, 4,173 men were diagnosed with type 2 diabetes. Compared with men who consumed eggs <1 time/week, the multivariable-adjusted HRs were 0.98 (95% CI 0.92, 1.05), 1.11 (95% CI 0.99, 1.24) and 1.11 (95% CI 0.95, 1.29) for egg consumption 1-2, 3-4 and ≥5 times/week, respectively (p trend = 0.06). In a random-effects dose-response meta-analysis, heterogeneity in the overall estimate was partly explained by differences across regions. The overall HRs for type 2 diabetes for each 3 times/week increment in consumption were 1.18 (95% CI 1.13, 1.24) in five US studies (I (2) = 0%) and 0.97 (95% CI 0.90, 1.05) in seven non-US studies.

Conclusions/interpretation: Our findings in Swedish men do not support an association between egg consumption and risk of type 2 diabetes. In a meta-analysis, frequent egg consumption was associated with a higher risk of type 2 diabetes in US studies only. Egg consumption habits and associated overall dietary patterns may differ between populations and could potentially explain the discrepancies between reported results. Given the inconsistent results, this relationship warrants further study.

Keywords: Cohort study; Diabetes; Eggs; Meta-analysis; Prospective study.

Figures

Fig. 1
Fig. 1
HRs for type 2 diabetes for each 3 times/week increment in egg consumption. HRs were combined using a random-effects model. Squares represent study-specific HR estimates (size of the square reflects the study-specific statistical weight); horizontal lines represent 95% CIs; diamonds represent the combined HRs with their 95% CIs. AHS, Adventist Health Study; AMS, Adventist Mortality Study; CHS, Cardiovascular Health Study; E3N, The E3N study; FMCHES, Finnish Mobile Clinic Health Examination Survey; JHS, Jackson Heart Study; JPHC, Japan Public Health Center-based Prospective Study; KIHDS, Kuopio Ischaemic Heart Disease Risk Factor Study; MDC, Malmö Diet and Cancer; PHS I, Physicians’ Health Study I; SUN, Sun Project; WHS, Women’s Health Study; M, men; W, women

References

    1. Whiting DR, Guariguata L, Weil C, Shaw J. IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract. 2011;94:311–321. doi: 10.1016/j.diabres.2011.10.029.
    1. Salmeron J, Hu FB, Manson JE, et al. Dietary fat intake and risk of type 2 diabetes in women. Am J Clin Nutr. 2001;73:1019–1026.
    1. Meyer KA, Kushi LH, Jacobs DR, Folsom AR. Dietary fat and incidence of type 2 diabetes in older Iowa women. Diabetes Care. 2001;24:1528–1535. doi: 10.2337/diacare.24.9.1528.
    1. van Nielen M, Feskens EJ, Mensink M, et al. Dietary protein intake and incidence of yype 2 diabetes in Europe: The EPIC-INTERACT Case-Cohort Study. Diabetes Care. 2014;37:1854–1862. doi: 10.2337/dc13-2627.
    1. Ericson U, Sonestedt E, Gullberg B, et al. High intakes of protein and processed meat associate with increased incidence of type 2 diabetes. Br J Nutr. 2013;109:1143–1153. doi: 10.1017/S0007114512003017.
    1. Vang A, Singh PN, Lee JW, Haddad EH, Brinegar CH. Meats, processed meats, obesity, weight gain and occurrence of diabetes among adults: findings from Adventist Health Studies. Ann Nutr Metab. 2008;52:96–104. doi: 10.1159/000121365.
    1. Djoussé L, Gaziano JM, Buring JE, Lee IM. Egg consumption and risk of type 2 diabetes in men and women. Diabetes Care. 2009;32:295–300. doi: 10.2337/dc08-1271.
    1. Djoussé L, Kamineni A, Nelson TL, et al. Egg consumption and risk of type 2 diabetes in older adults. Am J Clin Nutr. 2010;92:422–427. doi: 10.3945/ajcn.2010.29406.
    1. Zazpe I, Beunza JJ, Bes-Rastrollo M, Basterra-Gortari FJ, Mari-Sanchis A, Martinez-Gonzalez MA. Egg consumption and risk of type 2 diabetes in a Mediterranean cohort; the sun project. Nutr Hosp. 2013;28:105–111.
    1. Lajous M, Bijon A, Fagherazzi G, Balkau B, Boutron-Ruault MC, Clavel-Chapelon F (2015) Egg and cholesterol intake and incident type 2 diabetes among French women. Br J Nutr 114:1667–1673
    1. Kurotani K, Nanri A, Goto A, et al. Cholesterol and egg intakes and the risk of type 2 diabetes: The Japan Public Health Center-based Prospective Study. Br J Nutr. 2014;112:1636–1643. doi: 10.1017/S000711451400258X.
    1. Djoussé L, Petrone AB, Hickson DA, et al. Egg consumption and risk of type 2 diabetes among African-Americans: The Jackson Heart Study. Clin Nutr. 2015
    1. Virtanen JK, Mursu J, Tuomainen TP, Virtanen HE, Voutilainen S. Egg consumption and risk of incident type 2 diabetes in men: the Kuopio Ischaemic Heart Disease Risk Factor Study. Am J Clin Nutr. 2015;101:1088–1096. doi: 10.3945/ajcn.114.104109.
    1. Montonen J, Jarvinen R, Heliovaara M, Reunanen A, Aromaa A, Knekt P. Food consumption and the incidence of type 2 diabetes mellitus. Eur J Clin Nutr. 2005;59:441–448. doi: 10.1038/sj.ejcn.1602094.
    1. Ericson U, Hellstrand S, Brunkwall L, et al. Food sources of fat may clarify the inconsistent role of dietary fat intake for incidence of type 2 diabetes. Am J Clin Nutr. 2015;101:1065–1080. doi: 10.3945/ajcn.114.103010.
    1. Shi Z, Yuan B, Zhang C, Zhou M, Holmboe-Ottesen G. Egg consumption and the risk of diabetes in adults, Jiangsu, China. Nutrition. 2011;27:194–198. doi: 10.1016/j.nut.2010.01.012.
    1. Radzeviciene L, Ostrauskas R. Egg consumption and the risk of type 2 diabetes mellitus: a case–control study. Public Health Nutr. 2012;15:1437–1441. doi: 10.1017/S1368980012000614.
    1. Shin JY, Xun P, Nakamura Y, He K. Egg consumption in relation to risk of cardiovascular disease and diabetes: a systematic review and meta-analysis. Am J Clin Nutr. 2013;98:146–159. doi: 10.3945/ajcn.112.051318.
    1. Li Y, Zhou C, Zhou X, Li L. Egg consumption and risk of cardiovascular diseases and diabetes: a meta-analysis. Atherosclerosis. 2013;229:524–530. doi: 10.1016/j.atherosclerosis.2013.04.003.
    1. Bergström L, Kylberg E, Hagman U, Erikson H, Bruce A. The food composition database KOST: the National Administration’s information system for nutritive values of food. Vår Föda. 1991;43:439–447.
    1. Willett WC, Howe GR, Kushi LH. Adjustment for total energy intake in epidemiologic studies. Am J Clin Nutr. 1997;65:1220S–1228S.
    1. Messerer M, Johansson SE, Wolk A. The validity of questionnaire-based micronutrient intake estimates is increased by including dietary supplement use in Swedish men. J Nutr. 2004;134:1800–1805.
    1. Norman A, Bellocco R, Bergström A, Wolk A. Validity and reproducibility of self-reported total physical activity—differences by relative weight. Int J Obes Relat Metab Disord. 2001;25:682–688. doi: 10.1038/sj.ijo.0801597.
    1. Swedish National Diabetes Register (2013) Annual Report 2013: Results. Available from , accessed 14 Dec 2015
    1. Larsson SC, Orsini N. Coffee consumption and risk of stroke: a dose–response meta-analysis of prospective studies. Am J Epidemiol. 2011;174:993–1001. doi: 10.1093/aje/kwr226.
    1. Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21:1539–1558. doi: 10.1002/sim.1186.
    1. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629–634. doi: 10.1136/bmj.315.7109.629.
    1. Applegate E. Introduction: nutritional and functional roles of eggs in the diet. J Am Coll Nutr. 2000;19:495S–498S. doi: 10.1080/07315724.2000.10718971.
    1. McNamara DJ. The impact of egg limitations on coronary heart disease risk: do the numbers add up? J Am Coll Nutr. 2000;19:540S–548S. doi: 10.1080/07315724.2000.10718978.
    1. Song Y, Manson JE, Buring JE, Liu S. A prospective study of red meat consumption and type 2 diabetes in middle-aged and elderly women: the women’s health study. Diabetes Care. 2004;27:2108–2115. doi: 10.2337/diacare.27.9.2108.
    1. Sluijs I, Beulens JW, van der AD, Spijkerman AM, Grobbee DE, van der Schouw YT (2010) Dietary intake of total, animal, and vegetable protein and risk of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC)-NL study. Diabetes Care 33:43–48
    1. Halton TL, Liu S, Manson JE, Hu FB. Low-carbohydrate-diet score and risk of type 2 diabetes in women. Am J Clin Nutr. 2008;87:339–346.
    1. Colditz GA, Manson JE, Stampfer MJ, Rosner B, Willett WC, Speizer FE. Diet and risk of clinical diabetes in women. Am J Clin Nutr. 1992;55:1018–1023.
    1. Alhazmi A, Stojanovski E, McEvoy M, Garg ML. Macronutrient intake and type 2 diabetes risk in middle-aged Australian women. Results from the Australian Longitudinal Study on Women’s Health. Public Health Nutr. 2014;17:1587–1594. doi: 10.1017/S1368980013001870.
    1. Fuller NR, Caterson ID, Sainsbury A, et al. The effect of a high-egg diet on cardiovascular risk factors in people with type 2 diabetes: the Diabetes and Egg (DIABEGG) study-a 3-mo randomized controlled trial. Am J Clin Nutr. 2015;101:705–713. doi: 10.3945/ajcn.114.096925.
    1. Blesso CN, Andersen CJ, Barona J, Volek JS, Fernandez ML. Whole egg consumption improves lipoprotein profiles and insulin sensitivity to a greater extent than yolk-free egg substitute in individuals with metabolic syndrome. Metabolism. 2013;62:400–410. doi: 10.1016/j.metabol.2012.08.014.
    1. Pearce KL, Clifton PM, Noakes M. Egg consumption as part of an energy-restricted high-protein diet improves blood lipid and blood glucose profiles in individuals with type 2 diabetes. Br J Nutr. 2011;105:584–592. doi: 10.1017/S0007114510003983.
    1. Mutungi G, Ratliff J, Puglisi M, et al. Dietary cholesterol from eggs increases plasma HDL cholesterol in overweight men consuming a carbohydrate-restricted diet. J Nutr. 2008;138:272–276.
    1. Yang M, Kenfield SA, Van Blarigan EL, et al. Dietary patterns after prostate cancer diagnosis in relation to disease-specific and total mortality. Cancer Prev Res (Phila) 2015;8:545–551. doi: 10.1158/1940-6207.CAPR-14-0442.
    1. Nanri A, Shimazu T, Takachi R, et al. Dietary patterns and type 2 diabetes in Japanese men and women: the Japan Public Health Center-based Prospective Study. Eur J Clin Nutr. 2013;67:18–24. doi: 10.1038/ejcn.2012.171.
    1. Pan A, Sun Q, Bernstein AM, et al. Red meat consumption and risk of type 2 diabetes: 3 cohorts of US adults and an updated meta-analysis. Am J Clin Nutr. 2011;94:1088–1096. doi: 10.3945/ajcn.111.018978.

Source: PubMed

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