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Moderate egg consumption and all-cause and specific-cause mortality in the Spanish European Prospective into Cancer and Nutrition (EPIC-Spain) study

European Journal of Nutrition volume 58, pages 2003–2010 (2019)Cite this article

Abstract

Purpose

Dietary guidelines for egg consumption for general population differ among public health agencies. Our aim was to investigate the association between egg intake and both all-cause and specific-cause of mortality in a Mediterranean population.

Methods

The European Prospective Investigation into Cancer and Nutrition (EPIC)-Spain cohort included 40,621 men and women aged 29–69 years old in the nineties from 5 Spanish regions. After a mean of 18 years of follow-up, 3,561 deaths were recorded, of which 1,694 were from cancer, 761 from CVD, and 870 from other causes. Data on egg consumption was collected using a validated diet history at recruitment. Cox proportional hazards models, adjusted for confounders, were used in the analyses.

Results

The mean (standard deviation) egg consumption was 22.0 g/day (15.8) and 30.9 g/day (23.1) in women and men, respectively. No association was observed between egg consumption and all-cause mortality for the highest vs the lowest quartile (HR 1.01; 95% CI 0.91–1.11; P trend = 0.96). Likewise, no association was observed with cancer and cardiovascular diseases mortality. However, an inverse association was found between egg consumption and deaths for other causes (HR 0.76; 95% CI 0.63–0.93; P trend = 0.003), particularly for deaths from the nervous system (HR 0.59; 95% CI 0.35–1.00; P trend = 0.036). No interaction was detected with the adherence to Mediterranean diet.

Conclusions

This study shows no association between moderate egg consumption, up to 1 egg per day, and main causes of mortality in a large free-living Mediterranean population.

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Abbreviations

CVD:

Cardiovascular diseases

EPIC:

European Prospective Investigation into Cancer and Nutrition

ICD:

International Classification of Diseases

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Acknowledgements

The authors thank all participants in the EPIC-Spain cohort for their invaluable contribution to the study.

Funding

This work has been awarded with the Spanish Institute for Egg Studies Research Award 2016. This study used data from the EPIC-Spain study, which has received financial support from the Health Research Fund (FIS, 02/0652) of the Spanish Ministry of Health, the ISCIII (RETIC-RD06/0020 and the CIBER en Epidemiología y Salud Pública), the Spanish Regional Government of Andalusia, Asturias, the Basque Country, Murcia and Navarra, and the Catalan Institute of Oncology. Some authors are partners of ECNIS, a network of excellence of the EU 6FP. R.Z.R. would like to thank the “Miguel Servet” program (CP15/00100) from the Institute of Health Carlos III and the European Social Fund (ESF).

Author information

Author notes

  1. Raul Zamora-Ros and Valerie Cayssials contributed equally.

Authors and Affiliations

  1. Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Bellvitge Biomedical Research Institute (IDIBELL), Avda Gran Via 199-203, L’Hospitalet de Llobregat, 08907, Barcelona, Spain

    Raul Zamora-Ros, Valerie Cayssials & Antonio Agudo

  2. Catalan Institute of Oncology (ICO), Barcelona, Spain

    Ramón Cleries

  3. Public Health Directorate, Asturias, Spain

    María Luisa Redondo

  4. Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs, Granada, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain

    Maria-Jose Sánchez, Miguel Rodríguez-Barranco & Jose-Juan Sánchez-Cruz

  5. CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain

    Maria-Jose Sánchez, Miguel Rodríguez-Barranco, Jose-Juan Sánchez-Cruz, Olatz Mokoroa, Leire Gil, Pilar Amiano, Carmen Navarro, María Dolores Chirlaque, José María Huerta, Aurelio Barricarte & Eva Ardanaz

  6. Public Health Division of Gipuzkoa, Regional Government of the Basque Country, Donostia, Spain

    Olatz Mokoroa, Leire Gil & Pilar Amiano

  7. Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain

    Carmen Navarro, María Dolores Chirlaque & José María Huerta

  8. Department of Health and Social Sciences, Universidad de Murcia, Murcia, Spain

    Carmen Navarro & María Dolores Chirlaque

  9. Navarra Public Health Institute, Pamplona, Spain

    Aurelio Barricarte, Eva Ardanaz & Conchi Moreno-Iribas

  10. IdiSNA, Navarra Institute for Health Research, Pamplona, Spain

    Aurelio Barricarte, Eva Ardanaz & Conchi Moreno-Iribas

  11. REDISECC Red de Servicios de Salud Orientados a Enfermedades Crónicas, Madrid, Spain

    Conchi Moreno-Iribas

Authors
  1. Raul Zamora-Ros
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  2. Valerie Cayssials
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  3. Ramón Cleries
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  6. Miguel Rodríguez-Barranco
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  7. Jose-Juan Sánchez-Cruz
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  8. Olatz Mokoroa
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  9. Leire Gil
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  10. Pilar Amiano
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  11. Carmen Navarro
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  12. María Dolores Chirlaque
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  13. José María Huerta
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  14. Aurelio Barricarte
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  15. Eva Ardanaz
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  16. Conchi Moreno-Iribas
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  17. Antonio Agudo
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Contributions

RZ-R designed the research; VC and RC performed the statistical analysis; RZ-R drafted the manuscript; MLR, M-JS, MR-B, J-JS-C, OM, LG, PA, CN, MDC, JMH, AB, EA, CM-I, AA contributed to the design of the study, data collection, and quality control and analysis. All authors read, critically reviewed and approved the final manuscript.

Corresponding author

Correspondence to Raul Zamora-Ros.

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The authors declare no conflict of interest.

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Zamora-Ros, R., Cayssials, V., Cleries, R. et al. Moderate egg consumption and all-cause and specific-cause mortality in the Spanish European Prospective into Cancer and Nutrition (EPIC-Spain) study. Eur J Nutr 58, 2003–2010 (2019). https://doi.org/10.1007/s00394-018-1754-6

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  • DOI: https://doi.org/10.1007/s00394-018-1754-6

Keywords

  • Egg
  • Intake
  • Mortality
  • EPIC-Spain
  • Cohort