European Journal of Clinical Nutrition (2018) 72:841–847
https://doi.org/10.1038/s41430-017-0051-4
ARTICLE
Lipids and cardiovascular health
Re-evaluation of the associations of egg intake with serum total
cholesterol and cause-specific and total mortality in Japanese
women
Yasuyuki Nakamura
1,2
●
Tomonori Okamura
3
●
Yoshikuni Kita
4
●
Nagako Okuda
5
●
Aya Kadota
2,6
●
Katsuyuki Miura
2,6
●
Akira Okayama
7
●
Hirotsugu Ueshima
2,6
for the NIPPON DATA90 Research Group
Received: 16 July 2017 / Revised: 22 October 2017 / Accepted: 7 November 2017 / Published online: 29 December 2017
© Macmillan Publishers Limited, part of Springer Nature 2018
Abstract
Background/objective Egg intake was associated with serum total cholesterol adjusted for age (aTCH) and total mortality in
women, but not in men, using data from NIPPON DATA (ND) 80 which followed up for 14 years. Re-evaluation of these
associations in a different cohort is needed.
Subject/methods We analyzed the associations of egg intake with aTCH and cause-specific and total mortality using the
ND90 data set with a 15-year follow-up. A nutritional examination was done at the baseline in 1990 using the food-
frequency method and by weighed food records. We followed 4686 female participants (ages ≥30 years), with no history of
stroke or myocardial infarction (mean age 52.8 years) for 15 years.
Results The participants were divided into 5 egg intake groups ( o1/w, 1–2/w, 1/2d, 1/d, and ≥2/d). There were 203, 1462,
1594, 1387, and 40 women in each group, respectively. Egg intake was not associated with aTCH (P = 0.886). There were
183 cardiovascular disease (CVD), 210 cancer, and 599 total mortality cases during follow-up. Cox analysis, adjusted for
background factors, found egg intake was directly associated with total and cancer mortality (HR in the ≥2/d vs. the 1 egg/d
group: total, 2.05 (95% CI: 1.20–3.52); cancer, 3.20 (1.51–6.76)), and that cancer mortality in the 1–2/w group was
significantly less than that in the 1 egg/d group (0.68 (0.47–0.97)). Egg intake was not associated with CVD mortality.
Conclusions Egg intake was associated with cancer and total mortality. Reducing egg intake may have some definitive
health benefits in women in Japan, at least.
Introduction
Egg yolks are high in cholesterol, and thus reducing egg
intake used to be recommended to lower serum cholesterol
levels and to help prevent coronary heart disease (CHD) [1].
However, the most recent US guideline said that there were
insufficient data to recommend specific daily limits to
cholesterol intake as in the past (e.g., o300 mg/day), but it
went on to recommend that dietary cholesterol intake
should be as low as possible within the recommended eating
pattern [2]. People in some parties might have managed to
focus the attention of the press on the first paragraph of the
press releases, obscuring the recommendation that choles-
terol intake be limited [3]. We previously reported that egg
intake was associated with serum total cholesterol (TCH)
adjusted for age (aTCH), and total mortality in the 1 to 2
eggs per week group was significantly less than that in the 1
egg per day group in women. However, no such associa-
tions were observed in men, using NIPPON DATA80
* Yasuyuki Nakamura
nakamury@agr.ryukoku.ac.jp
1
Department of Food Science and Human Nutrition, Ryukoku
University, Otsu, Japan
2
Department of Public Health, Shiga University of Medical
Science, Otsu, Japan
3
Department of Preventive Medicine and Public Health, Keio
University, Tokyo, Japan
4
Tsuruga City University of Nursing, Tsuruga, Japan
5
Department of Health and Nutrition, University of Human Arts
and Sciences, Hasuda, Japan
6
Center for Epidemiologic Research in Asia, Shiga University of
Medical Science, Otsu, Japan
7
Research Center for Lifestyle-related Diseases, Tokyo, Japan
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