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      Egg consumption, cholesterol intake, and risk of incident stroke in men: the Kuopio Ischaemic Heart Disease Risk Factor Study

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          High stored iron levels are associated with excess risk of myocardial infarction in eastern Finnish men.

          Iron can induce lipid peroxidation in vitro and in vivo in humans and has promoted ischemic myocardial injury in experimental animals. We tested the hypothesis that high serum ferritin concentration and high dietary iron intake are associated with an excess risk of acute myocardial infarction. Randomly selected men (n = 1,931), aged 42, 48, 54, or 60 years, who had no symptomatic coronary heart disease at entry, were examined in the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD) in Eastern Finland between 1984 and 1989. Fifty-one of these men experienced an acute myocardial infarction during an average follow-up of 3 years. On the basis of a Cox proportional hazards model adjusting for age, examination year, cigarette pack-years, ischemic ECG in exercise test, maximal oxygen uptake, systolic blood pressure, blood glucose, serum copper, blood leukocyte count, and serum high density lipoprotein cholesterol, apolipoprotein B, and triglyceride concentrations, men with serum ferritin greater than or equal to 200 micrograms/l had a 2.2-fold (95% CI, 1.2-4.0; p less than 0.01) risk factor-adjusted risk of acute myocardial infarction compared with men with a lower serum ferritin. An elevated serum ferritin was a strong risk factor for acute myocardial infarction in all multivariate models. This association was stronger in men with serum low density lipoprotein cholesterol concentration of 5.0 mmol/l (193 mg/dl) or more than in others. Also, dietary iron intake had a significant association with the disease risk in a Cox model with the same covariates. Our data suggest that a high stored iron level, as assessed by elevated serum ferritin concentration, is a risk factor for coronary heart disease.
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            Egg consumption and risk of coronary heart disease and stroke: dose-response meta-analysis of prospective cohort studies

            Objective To investigate and quantify the potential dose-response association between egg consumption and risk of coronary heart disease and stroke. Design Dose-response meta-analysis of prospective cohort studies. Data sources PubMed and Embase prior to June 2012 and references of relevant original papers and review articles. Eligibility criteria for selecting studies Prospective cohort studies with relative risks and 95% confidence intervals of coronary heart disease or stroke for three or more categories of egg consumption. Results Eight articles with 17 reports (nine for coronary heart disease, eight for stroke) were eligible for inclusion in the meta-analysis (3 081 269 person years and 5847 incident cases for coronary heart disease, and 4 148 095 person years and 7579 incident cases for stroke). No evidence of a curve linear association was seen between egg consumption and risk of coronary heart disease or stroke (P=0.67 and P=0.27 for non-linearity, respectively). The summary relative risk of coronary heart disease for an increase of one egg consumed per day was 0.99 (95% confidence interval 0.85 to 1.15; P=0.88 for linear trend) without heterogeneity among studies (P=0.97, I2=0%). For stroke, the combined relative risk for an increase of one egg consumed per day was 0.91 (0.81 to 1.02; P=0.10 for linear trend) without heterogeneity among studies (P=0.46, I2=0%). In a subgroup analysis of diabetic populations, the relative risk of coronary heart disease comparing the highest with the lowest egg consumption was 1.54 (1.14 to 2.09; P=0.01). In addition, people with higher egg consumption had a 25% (0.57 to 0.99; P=0.04) lower risk of developing hemorrhagic stroke. Conclusions Higher consumption of eggs (up to one egg per day) is not associated with increased risk of coronary heart disease or stroke. The increased risk of coronary heart disease among diabetic patients and reduced risk of hemorrhagic stroke associated with higher egg consumption in subgroup analyses warrant further studies.
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              Relation of leisure-time physical activity and cardiorespiratory fitness to the risk of acute myocardial infarction.

              Previous studies have suggested that higher levels of regular physical activity and cardiorespiratory fitness are associated with a reduced risk of coronary heart disease. We investigated the independent associations of physical activity during leisure time and maximal oxygen uptake (a measure of cardiorespiratory fitness) with the risk of acute myocardial infarction. During the period 1984 to 1989, we performed base-line examinations in 1453 men 42 to 60 years old who did not report having cardiovascular disease or cancer. Physical activity was assessed quantitatively with a detailed questionnaire, and maximal oxygen uptake was measured directly by exercise testing. During an average follow-up of 4.9 years, 42 of the 1166 men with normal electrocardiograms at base line had a first acute myocardial infarction. After adjustment for age and the year of examination, the relative hazard (risk) of myocardial infarction in the third of subjects with the highest level of physical activity (> 2.2 hours per week) was 0.31 (95 percent confidence interval, 0.12 to 0.85; P = 0.02), as compared with the third with the lowest level (P = 0.04 for linear trend over all three groups). The relative hazard in the third with the highest maximal oxygen uptake (> 2.7 liters per minute) was 0.26 (95 percent confidence interval, 0.10 to 0.68; P = 0.006) (P = 0.006 for linear trend), after adjustment for age, the year and season when the examination was performed, weight, height, and the type of respiratory-gas analyzer used. After up to 17 confounding variables were controlled for, the relative hazards for the third of subjects with the highest level of physical activity (0.34; 95 percent confidence interval, 0.12 to 0.94; P = 0.04) and maximal oxygen uptake (0.35; 95 percent confidence interval, 0.13 to 0.92; P = 0.03), as compared with the values in the lowest third, were significantly (P < 0.05) less than 1.0. Higher levels of both leisure-time physical activity and cardiorespiratory fitness had a strong, graded, inverse association with the risk of acute myocardial infarction, supporting the idea that lower levels of physical activity and cardiorespiratory fitness are independent risk factors for coronary heart disease.
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                Author and article information

                Journal
                The American Journal of Clinical Nutrition
                Oxford University Press (OUP)
                0002-9165
                1938-3207
                May 16 2019
                May 16 2019
                Affiliations
                [1 ]Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
                [2 ]The Faculty of Medicine, Department of Public Health, University of Helsinki, Helsinki, Finland
                Article
                10.1093/ajcn/nqz066
                31095282
                fa1d9cec-831f-41f5-a26c-f54197e17d45
                © 2019

                https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model

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