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      Associations of egg consumption with cardiovascular disease in a cohort study of 0.5 million Chinese adults

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          Abstract

          Objective

          To examine the associations between egg consumption and cardiovascular disease (CVD), ischaemic heart disease (IHD), major coronary events (MCE), haemorrhagic stroke as well as ischaemic stroke.

          Methods

          During 2004–2008, over 0.5 million adults aged 30–79 years were recruited from 10 diverse survey sites in China. Participants were asked about the frequency of egg consumption and were followed up via linkages to multiple registries and active investigation. Among 461 213 participants free of prior cancer, CVD and diabetes, a total of 83 977 CVD incident cases and 9985 CVD deaths were documented, as well as 5103 MCE. Stratified Cox regression was performed to yield adjusted hazard ratios for CVD endpoints associated with egg consumption.

          Results

          At baseline, 13.1% of participants reported daily consumption (usual amount 0.76 egg/day) and 9.1% reported never or very rare consumption (usual amount 0.29 egg/day). Compared with non-consumers, daily egg consumption was associated with lower risk of CVD (HR 0.89, 95% CI 0.87 to 0.92). Corresponding multivariate-adjusted HRs (95% CI) for IHD, MCE, haemorrhagic stroke and ischaemic stroke were 0.88 (0.84 to 0.93), 0.86 (0.76 to 0.97), 0.74 (0.67 to 0.82) and 0.90 (0.85 to 0.95), respectively. There were significant dose-response relationships of egg consumption with morbidity of all CVD endpoints (P for linear trend <0.05). Daily consumers also had an 18% lower risk of CVD death and a 28% lower risk of haemorrhagic stroke death compared to non-consumers.

          Conclusion

          Among Chinese adults, a moderate level of egg consumption (up to <1 egg/day) was significantly associated with lower risk of CVD, largely independent of other risk factors.

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          Most cited references17

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          Dietary cholesterol and cardiovascular disease: a systematic review and meta-analysis.

          Dietary cholesterol has been suggested to increase the risk of cardiovascular disease (CVD), which has led to US recommendations to reduce cholesterol intake.
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            High-density lipoprotein as a therapeutic target: a systematic review.

            High-density lipoprotein cholesterol (HDL-C) is a cardiovascular risk factor that is gaining substantial interest as a therapeutic target. To review the current and emerging strategies that modify high-density lipoproteins (HDLs). Systematic search of English-language literature (1965-May 2007) in MEDLINE and the Cochrane database, using the key words HDL-C and apolipoprotein A-I and the subheadings reverse cholesterol transport, CVD [cardiovascular disease] prevention and control, drug therapy, and therapy; review of presentations made at major cardiovascular meetings from 2003-2007; and review of ongoing trials from ClinicalTrials.gov and current guidelines from major cardiovascular societies. Study selection was prioritized to identify randomized controlled trials over meta-analyses over mechanistic studies; identified studies also included proof-of-concept studies and key phase 1 through 3 trials of novel agents. Study eligibility was assessed by 2 authors; disagreements were resolved by consensus with the third. Of 754 studies identified, 31 randomized controlled trials met the inclusion criteria. Currently available therapeutic and lifestyle strategies, when optimized, increase HDL-C levels by 20% to 30%. While basic and small pilot studies have shown promise, proof that increasing HDL-C levels confers a reduction in major cardiovascular outcomes independent of changes in levels of low-density lipoprotein cholesterol or triglycerides has been more elusive. Some novel therapeutic agents in human studies appear to effectively increase HDL-C levels, whereas other novel strategies that target HDL metabolism or function may have minimal effect on HDL-C levels. At present there is modest evidence to support aggressively increasing HDL-C levels in addition to what is achieved by lifestyle modification alone. Ongoing clinical trials that target specific pathways in HDL metabolism may help expand cardiovascular treatment options.
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              Dietary Intake of Carotenoids and Their Antioxidant and Anti-Inflammatory Effects in Cardiovascular Care

              Cardiovascular disease related to atherosclerosis represents nowadays the largest cause of morbidity and mortality in developed countries. Due to inflammatory nature of atherosclerosis, several studies had been conducted in order to search for substances with anti-inflammatory activity on arterial walls, able to exert beneficial roles on health. Researches investigated the role of dietary carotenoids supplementation on cardiovascular disease, due to their free radicals scavenger properties and their skills in improving low-density lipoprotein cholesterol resistance to oxidation. Nevertheless, literature data are conflicting: although some studies found a positive relationship between carotenoids supplementation and cardiovascular risk reduction, others did not find any positive effects or even prooxidant actions. This paper aimed at defining the role of carotenoids supplementation on cardiovascular risk profile by reviewing literature data, paying attention to those carotenoids more present in our diet ( β -carotene, α -carotene, β -cryptoxanthin, lycopene, lutein, zeaxanthin, and astaxanthin).
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                Author and article information

                Journal
                Heart
                Heart
                heartjnl
                heart
                Heart
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                1355-6037
                1468-201X
                November 2018
                21 May 2018
                : 104
                : 21
                : 1756-1763
                Affiliations
                [1 ] departmentDepartment of Epidemiology and Biostatistics, School of Public Health , Peking University Health Science Center , Beijing, China
                [2 ] Chinese Academy of Medical Sciences , Beijing, China
                [3 ] departmentClinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health , University of Oxford , Oxford, UK
                [4 ] Jiangsu Center for Disease Control and Prevention , Nanjing, China
                [5 ] Liuyang Center for Disease Control and Prevention , Liuyang, China
                [6 ] Jili Community Health Service , Liuyang, China
                [7 ] China National Center for Food Safety Risk Assessment , Beijing, China
                Author notes
                [Correspondence to ] Professor Liming Li; lmlee@ 123456vip.163.com and Dr Canqing Yu, Department of Epidemiology and Biostatistics, Peking University Health Science Center, Beijing 100191, China; yucanqing@ 123456bjmu.edu.cn
                Article
                heartjnl-2017-312651
                10.1136/heartjnl-2017-312651
                6241631
                29785957
                bb0f8ede-e60c-452a-8096-743971d028a1
                © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

                This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

                History
                : 31 October 2017
                : 05 March 2018
                : 12 March 2018
                Funding
                Funded by: Kadoorie Charitable Foundation;
                Funded by: FundRef http://dx.doi.org/10.13039/501100002855, Ministry of Science and Technology of the People’s Republic of China;
                Funded by: National Key Research and Development Program of China;
                Funded by: FundRef http://dx.doi.org/10.13039/100004440, Wellcome Trust;
                Funded by: FundRef http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China;
                Categories
                Cardiac Risk Factors and Prevention
                1506
                Original research article
                Custom metadata
                unlocked

                Cardiovascular Medicine
                egg consumption,cardiovascular disease,ischemic heart disease,major coronary events,hemorrhagic stroke,ischemic stroke,prospective study

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