Egg or Cholesterol Intake in Older Adults Not Linked to Risk for Type 2 Diabetes

Laurie Barclay, MD

August 03, 2010

August 3, 2010 — Among older adults with limited egg intake, there is no apparent association between egg consumption or dietary cholesterol and an increased risk for incident type 2 diabetes, according to the results of a prospective study reported in the August issue of the American Journal of Clinical Nutrition.

"Type 2 diabetes (T2D) remains an important public health issue in the United States," write Luc Djoussé, from Brigham and Women's Hospital and Harvard Medical School in Boston, Massachusetts, and colleagues. "There are limited and inconsistent data on the association between egg consumption and fasting glucose or incident diabetes. We assessed the association between egg intake and incident diabetes in older adults."

The study cohort consisted of 3898 men and women who were enrolled in the Cardiovascular Health Study conducted from 1989 to 2007 and who completed annual picture-sorted food questionnaires to determine egg intake. Incident type 2 diabetes was determined from annual data on use of hypoglycemic agents and on plasma glucose levels. Adjusted relative risks were calculated from Cox proportional hazards models.

There were 313 incident cases of type 2 diabetes during a mean follow-up of 11.3 years. In persons who reported egg intake of never, 1 egg per month, 1 to 3 eggs per month, 1 to 4 eggs per week, and almost daily, crude incidence rates of type 2 diabetes were 7.39, 6.83, 7.00, 6.72, and 12.20 per 1000 person-years, respectively. Egg consumption was not associated with an increased risk for type 2 diabetes in either sex or overall, based on multivariable-adjusted models.

Dietary cholesterol was not associated with incident type 2 diabetes in a secondary analysis (P for trend = .47). Although there were small, significant, absolute analytic differences in fasting glucose levels, fasting insulin levels, and measures of insulin resistance associated with egg intake, these differences were not clinically meaningful.

Limitations of this study include small number of participants who consumed eggs daily or more often, possible effects of residual confounding or chance, lack of data on other foods usually consumed with eggs or on methods of egg preparation, and possible dietary and/or diabetes misclassification. In addition, the findings may not be generalizable to younger populations if the biologic effects of egg or dietary cholesterol consumption differ at older ages.

"In this cohort of older adults with limited egg intake, there was no association between egg consumption or dietary cholesterol and increased risk of incident T2D," the study authors write. "...[E]gg consumption was not associated with clinically meaningful differences in fasting glucose or insulin concentrations or measures of insulin resistance despite small absolute analytic differences that were significant."

The National Heart, Lung, and Blood Institute, with additional contribution from the National Institute of Neurological Disorders and Stroke, supported this study. The study authors have disclosed no relevant financial relationships.

Am J Clin Nutr. 2010;92:422-427. Abstract

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