Associations between Cholesterol Intake, Food Sources and Cardiovascular Disease in Chinese Residents.

Cholesterol is a nutrient commonly found in the human diet. The relationship between dietary cholesterol, its sources, and cardiovascular disease (CVD) is still a topic of debate. This study aimed to investigate the association between dietary cholesterol, its sources, and cardiovascular events in a Chinese population. The present study analyzed data from the China Health and Nutrition Survey (CHNS) cohort between 1991 and 2015. This study analyzed data from 3903 participants who were 40 years of age or older at baseline and had no history of cardiovascular disease, diabetes, or hypertension. During a median follow-up of 14 years, 503 cardiovascular disease events were identified through follow-up questionnaires administered every 2-3 years. The events included fatal and nonfatal coronary heart disease, stroke, heart failure, and other cardiovascular disease deaths. Cox regression was used to estimate risk ratios (HR) for CVD events after adjusting for demographic, socioeconomic, and behavioral factors. It was discovered that sources of dietary cholesterol varied among different subgroups of the population. The top three sources of cholesterol among all participants were eggs, red meat, and seafood, accounting for 57.4%, 28.2%, and 9.0% of total daily cholesterol intake, respectively. The present study found that there was a significant association between total dietary cholesterol intake, and the risk of developing cardiovascular disease (adjusted HR [95% CI]: total cholesterol (highest and lowest quartiles compared) 1.57 [1.17-2.11]). Cholesterol from poultry, seafood, and eggs was also significantly associated with a reduced risk of CVD (adjusted HR [95% CI]: poultry 0.18 [0.04-0.82], seafood 0.11 [0.02-0.54], and eggs 0.16 [0.03-0.73]). After adjusting for daily caloric intake, daily fat intake, and daily saturated fat intake, the previously observed association between red meat cholesterol and cardiovascular events (unadjusted HR [95% CI]: 0.44 [0.35-0.55]) was no longer statistically significant (adjusted HR [95% CI]: 0.21 [0.04-1.01]).

The Global Association between Egg Intake and the Incidence and Mortality of Ischemic Heart Disease-An Ecological Study.

The relationship between egg consumption and ischemic heart disease (IHD) remains controversial as there is still no clear answer regarding the relationship, with research limited to a few geographical regions. In the current study, we conducted a longitudinal analysis of the association between egg intake and IHD incidence (IHDi) and mortality (IHDd) using 28 years of international data from 1990 to 2018. Egg intake (g/day/capita) by country was obtained from the Global Dietary Database. Age-standard IHDi and IHDd rates per 100,000 subjects in each country were obtained from the 2019 Global Burden of Disease database. The analysis included a total of 142 countries with populations of at least one million, for which all data were available from 1990 to 2018. Eggs are consumed worldwide, and regional differences in consumption are also shown. Utilizing IHDi and IHDd as objective variables and egg intake as an explanatory variable, the analysis was conducted using linear mixed models, which controlled for inter- and intra-country variation from year to year. The results showed a significant negative association between egg intake, and IHDi (-0.253 ± 0.117, p < 0.05) and IHDd (-0.359 ± 0.137, p < 0.05). The analysis was carried out using R 4.0.5. The results suggest that adequate egg intake might suppress IHDi and IHDd on a global scale.

Association of egg intake with risks of cardiometabolic factors among adults in China.

Objective: To explore the association between egg intake and cardiometabolic factors (CMFs) in Chinese adults. Method: The subjects were 6,182 adults aged 18-64 who had complete survey data and had no CMFs at baseline. Egg intake was assessed with 3 days-24 h dietary recalls in all waves of the China Health and Nutrition Survey (CHNS). Multivariate Cox proportional risk regression model and restricted cubic spline (RCS) model were used to analyze the association and dose-response relationship between egg intake and CMFs. Results: Of the 6,182 participants who did not have metabolic syndrome (MetS) at baseline, 1,921 developed this disease during an average follow-up of 5.71 years, with an incidence of 31.07%. Central obesity, elevated TG, decreased HDL-C, elevated blood pressure and elevated plasma glucose were 38.65, 26.74, 30.21, 40.64, and 30.64%, respectively. After adjusting for demographic characteristics, lifestyle, energy and BMI, using the lowest quintile (Q1) as a reference, the risk of central obesity, elevated TG, decreased HDL-C, and elevated plasma glucose in the highest quintile (Q5) were reduced by 15% (HR = 0.85, 95% CI = 0.73-0.98, P = 0.16), 33% (HR = 0.67, 95% CI = 0.57-0.78), 25% (HR = 0.75, 95% CI = 0.63 0.90, p = 0.05), and 28% (HR = 0.72, 95% CI = 0.63-0.83, p < 0.05), respectively. The risk of elevated blood pressure was reduced by 26% in the fourth quintile (HR = 0.74, 95% CI = 0.64-0.85, P = 0.85). RCS analysis show that the overall correlation and nonlinear relationship between egg intake and CMFs were statistically significant (P < 0.05). When the intake was lower than 20 g/days, the risk of MetS, central obesity, elevated blood pressure and elevated plasma glucose were negatively correlated with egg intake, while elevated TG was negatively correlated with eggs when the intake was lower than 60 g/days. There was no statistically significant association between egg intake and CMFs at higher egg intake. Conclusion: There was a U-shaped association between egg intake and CMFs in Chinese adults.

Association between Dietary Patterns and Physical Fitness among Chinese Children and Adolescents in Shaanxi Province.

BACKGROUND: This study aims to investigate the associations between dietary patterns (breakfast, egg, dairy products, and sugared beverage intake frequencies) and physical fitness among Chinese children and adolescents in Shaanxi Province. METHODS: Data were extracted from the Chinese National Survey on Students' Constitution and Health (CNSSCH). The study ultimately included 7305 participants (48.4% male, 51.6% female) aged 6-22 in Shaanxi Province, China. Multiple linear regression was used to examine the association of the frequency of breakfast, egg, dairy product, and sugared beverage intakes with physical fitness. RESULTS: The frequency of breakfast, egg, and dairy product intakes were all independently and positively associated with the level of physical fitness. The frequency of sugared beverage intake was negatively associated with the level of physical fitness. CONCLUSION: Healthier dietary patterns (i.e., higher breakfast, egg, and dairy product intakes and lower sugared beverage intake) were associated with greater physical fitness. Specifically, maintaining a healthy dietary pattern of breakfast, egg, and dairy product intakes can positively affect the strength and endurance performance of children and adolescents. Increased dairy product intake plays a crucial part in boosting the physical fitness total scores of children and adolescents.

Association between egg consumption and cognitive function among Chinese adults: long-term effect and interaction effect of iron intake.

The association between egg consumption and cognitive function is inclusive. We aimed to assess the association between egg consumption and cognitive function in Chinese adults and tested the interaction between egg consumption and Fe intake. The data used were from a nationwide sample (n 4852, age ≥ 55 years) from the China Health and Nutrition Survey between 1991 and 2006. Assessment of cognitive function was conducted in 1997, 2000, 2004 and 2006. Dietary egg intake was obtained by 24-h dietary recalls of 3 consecutive days during home visits between 1991 and 2006. Multivariable mixed linear regression and logistic regression were used. Egg intake was positively associated with global cognitive function. In fully adjusted models, across the quartiles of egg intake the regression coefficients were 0, 0·11 (95 % CI -0·28, 0·51), 0·79 (95 % CI 0·36, 1·22) and 0·92 (95 % CI 0·43, 1·41), respectively. There was a significant interaction between egg intake and Fe intake. The association between high egg intake and cognitive function was stronger among those with low Fe intake than those with high Fe intake. In addition, there was a significant interaction between egg consumption and sex, with the association mainly observed in women but not men. Furthermore, compared with non-consumers, those with higher egg consumption (Q4) had the OR of 0·93 (95 % CI 0·74, 1·19), 0·84 (95 % CI 0·69, 1·02) for self-reported poor memory and self-reported memory decline, respectively. Higher egg intake is associated with better cognition in Chinese adults among those with low Fe intake.

Association between egg intake and blood pressure in the USA: the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP).

OBJECTIVES: To investigate associations of egg intake with blood pressure (BP) and the role of dietary variables and other macro- and micro-nutrients in the association. DESIGN: We used cross-sectional data for the USA as part of the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP). INTERMAP was surveyed between 1996 and 1999, including four 24-h dietary recalls, two 24-h urine collections and eight measurements of systolic BP and diastolic BP (SBP, DBP). Average egg intake (g/d) was calculated. Multivariable linear regression models were used to estimate the association between egg intake (per each 50 g/d or per quintile) and BP. The roles of dietary variables and other macro- and micro-nutrients in this association were also investigated. SETTING: In the USA. PARTICIPANTS: In total, 2195 US INTERMAP men and women aged 40-59 years. RESULTS: Participants were 50 % female, 54 % non-Hispanic White and 16 % non-Hispanic Black. Mean egg intake (sd) in men and women was 30·4(29·8) and 21·6(20·5) g/d, respectively. Adjusting for demographics, socio-economics, lifestyle and urinary Na:K excretion ratios, we found non-linear associations with BP in non-obese women (P-quadratic terms: 0·004 for SBP and 0·035 for DBP).The associations remained after adjusting for dietary variables, macro/micro nutrients or minerals. Dietary cholesterol was highly correlated with egg intake and may factor in the association. No association was found in obese women and in obese or non-obese men. CONCLUSION: Egg intake was non-linearly associated with SBP and DBP in non-obese women, but not in obese women or men. Underlying mechanisms require additional study regarding the role of obesity and sex.

Cholesterol and Egg Intakes with Cardiometabolic and All-Cause Mortality among Chinese and Low-Income Black and White Americans.

We examined the associations of dietary cholesterol and egg intakes with cardiometabolic and all-cause mortality among Chinese and low-income Black and White Americans. Included were 47,789 Blacks, 20,360 Whites, and 134,280 Chinese aged 40-79 years at enrollment. Multivariable Cox models with restricted cubic splines were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality outcomes using intakes of 150 mg cholesterol/day and 1 egg/week as the references. Cholesterol intake showed a nonlinear association with increased all-cause mortality and a linear association with increased cardiometabolic mortality among Black Americans: HRs (95% CIs) associated with 300 and 600 mg/day vs. 150 mg/day were 1.07 (1.03-1.11) and 1.13 (1.05-1.21) for all-cause mortality (P-linearity = 0.04, P-nonlinearity = 0.002, and P-overall < 0.001) and 1.10 (1.03-1.16) and 1.21 (1.08-1.36) for cardiometabolic mortality (P-linearity = 0.007, P-nonlinearity = 0.07, and P-overall = 0.005). Null associations with all-cause or cardiometabolic mortality were noted for White Americans (P-linearity ≥ 0.13, P-nonlinearity ≥ 0.06, and P-overall ≥ 0.05 for both). Nonlinear inverse associations were observed among Chinese: HR (95% CI) for 300 vs. 150 mg/day was 0.94 (0.92-0.97) for all-cause mortality and 0.91 (0.87-0.95) for cardiometabolic mortality, but the inverse associations disappeared with cholesterol intake > 500 mg/day (P-linearity ≥ 0.12; P-nonlinearity ≤ 0.001; P-overall < 0.001 for both). Similarly, we observed a positive association of egg intake with all-cause mortality in Black Americans, but a null association in White Americans and a nonlinear inverse association in Chinese. In conclusion, the associations of cholesterol and egg intakes with cardiometabolic and all-cause mortality may differ across ethnicities who have different dietary patterns and cardiometabolic risk profiles. However, residual confounding remains possible.

Egg, cholesterol and protein intake and incident type 2 diabetes mellitus: Results of repeated measurements from a prospective cohort study.

BACKGROUND & AIMS: Epidemiological evidence on the associations of egg, cholesterol and protein intake with risk of type 2 diabetes is inconsistent. Therefore, we conducted this study to explore these associations among Chinese adults. METHODS: Data from 4 waves (2004, 2006, 2009 and 2011) of the China Health and Nutrition Survey were used. A multistage random-cluster sampling method was employed to recruit the participants in both rural and urban areas. We included individuals who participated in 2004 and any waves afterwards. Those 1) below 18 years of age; 2) with diabetes at baseline; or 3) with extreme energy intake (men: <800 kcal or >6000 kcal; women: <600 kcal or >4000 kcal) were excluded. Respondents were classified into four groups according to quartiles of egg, cholesterol and protein intake per day. Numbers of eggs per day were calculated by dividing egg intake in grams by 50 g. Diagnosis of type 2 diabetes was self-reported. Logistic generalized estimation equation models were employed. RESULTS: There were 7312 individuals included in 2004, 6390 in 2006, 4826 in 2009 and 4963 in 2011. The mean age of participants at baseline was 48.3 years and 47.2% were men. Over an average of 5.8-y follow-up, 209 developed type 2 diabetes. After adjustment for demographic, lifestyle and dietary confounders, the odds ratio of type 2 diabetes for those in the highest compared with the lowest protein intake quartile was 2.38 (95% CI: 1.43, 3.98). The odds ratio of individuals with ≥3 eggs/day versus none was 3.76 (95% CI, 2.05, 6.90). Cholesterol intake was not associated with type 2 diabetes. CONCLUSIONS: Individuals with the highest protein intake had over a 2-fold increased risk of type 2 diabetes compared with those with the lowest protein intake. A high intake of egg, but not dietary cholesterol, was associated with type 2 diabetes. This association warrants further investigation.

The provision of recipes and single-use herb/spice packets to increase egg and protein intake in community-dwelling older adults: a randomised controlled trial.

OBJECTIVE: This study investigated the impact of recipe and single-use herb/spice packet provision on egg intake and protein intake in community-dwelling individuals aged over 55 years. DESIGN: Using a randomised-controlled intervention design, 100 older adults were randomised to receive (n 53) or not receive (n 47) high-protein egg-based recipes and herb/spice packets through the post for 12 weeks, from June to December 2016. Egg intake, protein intake, adverse events, lean body mass and functional measures of lean body mass were measured at baseline, after the 12 weeks and after a further 12 weeks. SETTING: Bournemouth, UK. PARTICIPANTS: Community-dwelling older adults. RESULTS: Intention-to-treat data were analysed using regression, controlling for various demographic and lifestyle characteristics. Ninety-three individuals (intervention, n 50; control, n 43) completed assessments at all three time points. Egg intakes increased by end of intervention in both groups (mean: 4-5 eggs/month). After a further 12 weeks, higher egg intakes were sustained in the intervention group, while egg intakes in the control group returned to baseline levels (between-group difference: ß = -0·124, P = 0·047). No differences were found in other measures (largest ß = -0·106, P = 0·12). CONCLUSIONS: The provision of high-protein egg-based recipes and single-use herb/spice packets over 12 weeks increased egg intakes up to 12 weeks after end of intervention. Other factors may explain increased egg intakes during the intervention, but the sustained effects most plausibly result directly from recipe provision. Limited effects in other measures suggest that the recipes may have replaced as opposed to added to existing protein intakes.

Association between daily egg intake and lipid profiles in adults from the Henan rural cohort study.

BACKGROUND AND AIMS: The association between daily egg intake and dyslipidemia remains a contentious issue. Therefore, our study was aimed to explore the relation of daily egg intake to lipid profile; and whether the association was mediated by body mass index (BMI). METHODS AND RESULTS: A total of 39,021 participants (18-79 years) were enrolled from the Henan Rural Cohort Study. Data on egg consumptions and blood lipid indices were collected with standardized processes. Logistic regression and restricted cubic splines were used to estimate the odds ratio (OR) and 95% confidence intervals (95% CI). Mediation analysis using bootstrap was performed to examine the contribution of BMI to daily egg intake and HDL-C. The participants were divided into 3 egg intake groups (＜26.79 g/d, 26.79-62.50 g/d, ＞62.5 g/d). According to our results, comparing with the low daily egg consumption group, medium and high egg intake tertiles were related with increased high-TC (ORmedium = 1.546, 95%CI (1.417,1.688); ORhigh = 1.902,95%CI (1.703, 2.124)), high LDL-C (ORmedium = 1.224, 95%CI (1.121, 1.337); ORhigh = 1.368,95%CI (1.220, 1.534)) and non-HDL-C(ORmedium = 1.486,95%CI(1.358,1.625); ORhigh = 1.715,95%CI (1.499, 1.888)), as well as inversely associated with high-TG (ORmedium = 0.825, 95% CI(0.778, 0.875); ORhigh = 0.778,95%CI(0.718,0.844)) and low HDL-C (ORmedium = 0.914, 95%CI (0.858, 0.973); ORhigh = 0.756,95%CI(0.693,0.825)). Moreover, mediation analysis showed that both of BMI and WC partly mediated the relationship between daily egg intake and HDL-C. CONCLUSIONS: Our results suggested that the daily egg intake may have a role in effect on lipid profiles, and the effect of daily egg intake on HDL-C may be partly mediated by BMI and WC.

Body Fat Mass, Fat Distribution and Egg Consumption: a Population-Based Study in Chinese Adults.

Objective: Egg is the vital source for many nutrients. The present study aimed to evaluate how egg consumption contributes to body fat mass and fat distribution in general Chinese adults.Methods: In a representative study of Chinese adults, 2241 rural adults aged 18-80 years completed physical measurements and semi quantitative food frequency questionnaire (FFQ). Body fat percentage (BF%) was estimated through validated Chinese-specific equations including age, body mass index (BMI), waist circumference (WC), gender and their interaction.Results: The prevalence of excessive body fat and central obesity in males were 44.2% and 31.3%, lower than that in females (60.7% and 36.1%, p < 0.05). 37.3% of lean or normal-weight individuals by BMI experienced excessive body fat given their BF% and 43.5% were central obesity according to WC. In females, egg consumption was associated with better body fat mass and its distribution. Compared with non-consumers, individuals consumed egg >50 g/d had a 34% lower risk of central obesity (OR:0.66, 0.39-0.99) and 38% lower risk of excessive body fat (OR:0.62, 0.37-1.00). There were significant dose-response relationships between egg consumption and overweight with excessive body fat/central obesity (p for linear trend <0.05). However, these associations were not significant in males.Conclusion: Our findings underscore the necessity for future public health guidelines to assess body fat mass and distribution simultaneously in Chinese adults. Egg consumption might be beneficial for weight regulation, especially for overweight with excessive body fat/central obesity in females. Further research is warrant to establish the causal inference.

Association of egg intake with blood lipids, cardiovascular disease, and mortality in 177,000 people in 50 countries.

BACKGROUND: Eggs are a rich source of essential nutrients, but they are also a source of dietary cholesterol. Therefore, some guidelines recommend limiting egg consumption. However, there is contradictory evidence on the impact of eggs on diseases, largely based on studies conducted in high-income countries. OBJECTIVES: Our aim was to assess the association of egg consumption with blood lipids, cardiovascular disease (CVD), and mortality in large global studies involving populations from low-, middle-, and high-income countries. METHODS: We studied 146,011 individuals from 21 countries in the Prospective Urban Rural Epidemiology (PURE) study. Egg consumption was recorded using country-specific validated FFQs. We also studied 31,544 patients with vascular disease in 2 multinational prospective studies: ONTARGET (Ongoing Telmisartan Alone and in Combination with Ramipril Global End Point Trial) and TRANSCEND (Telmisartan Randomized Assessment Study in ACEI Intolerant Subjects with Cardiovascular Disease). We calculated HRs using multivariable Cox frailty models with random intercepts to account for clustering by study center separately within each study. RESULTS: In the PURE study, we recorded 14,700 composite events (8932 deaths and 8477 CVD events). In the PURE study, after excluding those with history of CVD, higher intake of egg (≥7 egg/wk compared with <1 egg/wk intake) was not significantly associated with blood lipids, composite outcome (HR: 0.96; 95% CI: 0.89, 1.04; P-trend = 0.74), total mortality (HR: 1.04; 95% CI: 0.94, 1.15; P-trend = 0.38), or major CVD (HR: 0.92; 95% CI: 0.83, 1.01; P-trend = 0.20). Similar results were observed in ONTARGET/TRANSCEND studies for composite outcome (HR 0.97; 95% CI: 0.76, 1.25; P-trend = 0.09), total mortality (HR: 0.88; 95% CI: 0.62, 1.24; P-trend = 0.55), and major CVD (HR: 0.97; 95% CI: 0.73, 1.29; P-trend = 0.12). CONCLUSIONS: In 3 large international prospective studies including ∼177,000 individuals, 12,701 deaths, and 13,658 CVD events from 50 countries in 6 continents, we did not find significant associations between egg intake and blood lipids, mortality, or major CVD events. The ONTARGET and TRANSCEND trials were registered at clinicaltrials.gov as NCT00153101. The PURE trial was registered at clinicaltrials.gov as NCT03225586.

Association between egg consumption and elevated fasting glucose prevalence in relation to dietary patterns in selected group of Polish adults.

BACKGROUND: The safety of high egg intake in view of its impact on glucose metabolism remains inconclusive. The aim of the study was to assess the relationship between egg intake, dietary patterns and elevated fasting glucose (FG) level in a selected group of Polish adults. METHODS: The study group consisted of 1630 adults who participated in the Polish arm of the Prospective Urban Rural Epidemiological Study. Dietary intake, including egg intake, was assessed based on the data from the Additional file 2 Food Frequency Questionnaire previously validated for the population of Lower Silesia. DPs were derived using principal component analysis. FG levels ≥100 mg/dl were considered elevated. Subjects who used antidiabetic drugs were included in the group with elevated FG levels. RESULTS: Egg consumption increased in higher quartiles of "Western" and "traditional" DPs in both men and women (p < 0.0001). In a crude model each 10 g of eggs consumed per day was associated with 7% increased risk (OR 1.07; 95% CI: 1.01-1.15) of elevated glucose level in the overall group and 10% increased risk (OR 1.10; 95% CI: 1.01-1.21) of elevated glucose level in the group of men. Men who consumed at least five eggs per week had higher risk for elevated FG level compared to men who consumed at most one egg per week (OR 1.79; 95% CI 1.13-2.84), but this relationship became insignificant when the data were adjusted for DPs. In the group of women no association between egg intake and elevated FG level was observed. CONCLUSIONS: Higher egg intake may be associated with the overall unhealthy dietary habits, which is why the number of eggs consumed daily should not be considered an independent risk factor for elevated fasting glucose level.

Egg Intake in Chronic Kidney Disease.

Patients with chronic kidney disease (CKD) are often instructed to adhere to a renal-specific diet depending on the severity and stage of their kidney disease. The prescribed diet may limit certain nutrients, such as phosphorus and potassium, or encourage the consumption of others, such as high biological value (HBV) proteins. Eggs are an inexpensive, easily available and high-quality source of protein, as well as a rich source of leucine, an essential amino acid that plays a role in muscle protein synthesis. However, egg yolk is a concentrated source of both phosphorus and the trimethylamine N-oxide precursor, choline, both of which may have potentially harmful effects in CKD. The yolk is also an abundant source of cholesterol which has been extensively studied for its effects on lipoprotein cholesterol and the risk of cardiovascular disease. Efforts to reduce dietary cholesterol to manage dyslipidemia in dialysis patients (already following a renal diet) have not been shown to offer additional benefit. There is a paucity of data regarding the impact of egg consumption on lipid profiles of CKD patients. Additionally, egg consumption has not been associated with the risk of developing CKD based on epidemiological studies. The egg yolk also contains bioactive compounds, including lutein, zeaxanthin, and vitamin D, which may confer health benefits in CKD patients. Here we review research on egg intake and CKD, discuss both potential contraindications and favorable effects of egg consumption, and describe the need for further research examining egg intake and outcomes in the CKD and end-stage renal disease population.

Egg intake and cancers of the breast, ovary and prostate: a dose-response meta-analysis of prospective observational studies.

Evidence suggests that egg intake may be implicated in the aetiology of sex hormone-related cancers. However, dose-response relationships between egg intake and such cancers are unclear. Thus, we conducted a dose-response meta-analysis to summarise the dose-response relationships between egg consumption and the risk of breast, prostate and gynaecological cancers. A literature search was performed using PubMed and Embase up to April 2015 to identify relevant prospective observational studies. Summary relative risk (RR) and 95% CI were estimated using a random-effects model. For breast cancer, the linear dose-response meta-analysis found a non-significantly increased risk (RR for an increase of 5 eggs consumed/week: 1·05, 95% CI 0·99, 1·11, n 16,023 cases). Evidence for non-linearity was not statistically significant (P non-linearity= 0·50, n 15,415 cases) but consuming ≥ 5 eggs/week was significantly associated with an increased risk of breast cancer compared with no egg consumption, with the summary RR being 1·04 (95% CI 1·01, 1·07) for consuming 5 eggs/week and 1·09 (95% CI 1·03, 1·15) for consuming about 9 eggs/week. For other cancers investigated, the summary RR for an increase of 5 eggs consumed/week was 1·09 (95% CI 0·96, 1·24, n 2636 cases) for ovarian cancer; 1·47 (95% CI 1·01, 2·14, n 609 cases) for fatal prostate cancer, with evidence of small-study effects (P Egger= 0·04). No evidence was found for an association with the risk of total prostate cancer. While our conclusion was tempered by the potential for publication bias and confounding, high egg intake may be associated with a modestly elevated risk of breast cancer, and a positive association between egg intake and ovarian and fatal prostate cancers cannot be ruled out.