Clinical Question

Is the consumption of eggs associated with an increased risk of cardiovascular disease?

Bottom Line

Egg consumption is not associated with the occurrence of cardiovascular events over an average of 12 years. A meta-analysis found that eating more than one egg per day, on average, was associated with a decreased likelihood of coronary artery disease (approximately 11%). This decrease may be due to a healthy user bias; that is, eating eggs may be associated with healthy habits. (Level of Evidence = 2b)

Synopsis

The authors searched five databases, including the Cochrane Library, and identified 23 observational studies of almost 1.4 million patients with an average follow-up of 12.3 years. One author selected the studies and two investigators independently abstracted the data. The studies' quality, evaluated by two investigators, was moderate to high for observational studies. There was no association between egg consumption and an increased risk of cardiovascular disease events, but there was a high degree of heterogeneity among the studies. Compared with eating no eggs or one egg per day on average, eating more than one egg per day on average was associated with a significantly decreased risk of coronary disease (hazard ratio = 0.89; 95% CI, 0.86 to 0.93) without evidence of heterogeneity, but there was no effect on the risk of stroke (moderate heterogeneity).

Study design: Meta-analysis (other)

Funding source: Self-funded or unfunded

Setting: Various (meta-analysis)

Reference: Krittanawong C, Narasimhan B, Wang Z, et al. Association between egg consumption and risk of cardiovascular outcomes: a systematic review and meta-analysis. Am J Med. 2021;134(1):76–83.e2.

Editor's Note: Dr. Shaughnessy is an assistant medical editor for AFP.