European Journal of Nutrition

, Volume 58, Issue 2, pp 785–796 | Cite as

Egg consumption and the risk of cardiovascular disease and all-cause mortality: Guangzhou Biobank Cohort Study and meta-analyses

  • Lin Xu
  • Tai Hing LamEmail author
  • Chao Qiang JiangEmail author
  • Wei Sen Zhang
  • Feng Zhu
  • Ya Li Jin
  • Jean Woo
  • Kar Keung Cheng
  • G. Neil Thomas
Original Contribution



Eggs are highly nutritious but concerns over their cholesterol content have led to dietary avoidance among many. There are also important international differences in relevant dietary guidance. We conducted the first prospective study in China investigating the association of egg consumption, cardiovascular disease (CVD) mortality, and a meta-analysis.


We included 28,024 participants without CVD at baseline (2003-8) in Guangzhou Biobank Cohort Study. All-cause and CVD mortality were identified through record linkage. We used Cox proportional hazards regression. We followed the Meta-analysis Of Observational Studies in Epidemiology reporting guidelines.


During 275,343 person-years follow-up (average 9.8 years), we found 2685 all-cause and 873 CVD deaths. We found no significant difference in all-cause mortality between higher (7+ eggs/week) and low consumption (< 1 egg/week) [adjusted hazard ratio (HR) 1.08, 95% confidence interval (CI) 0.93–1.24], and mortality from CVD (0.99, 95% CI 0.76–1.27), ischemic heart disease (IHD) (0.92, 95% CI 0.63–1.36), or stroke (0.88, 95% CI 0.57–1.35). The updated meta-analyses including our results showed that 7+ eggs/week was not associated with all-cause mortality (HR 1.09, 95% CI 0.997–1.200) or IHD (HR 0.97, 95% CI 0.90–1.05), but associated with a small reduction in stroke (HR 0.91. 95% CI 0.85–0.98).


Eating one egg daily is not associated with increase in CVD or all-cause mortality. The small observed reduction in stroke risk needs to be confirmed. Our findings support current guidelines recommending eggs as part of a healthy diet, and should be considered in other dietary recommendations.


Egg consumption Cardiovascular disease Ischemic heart disease Mortality Stroke 


Author contributions

Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work: LX, CQJ, THL, KKC, JW, WSZ, FZ, YLJ, GNT. Drafting the work or revising it critically for important intellectual content: LX, CQJ, THL, KKC, GNT, JW. Final approval of the version to be published: LX, CQJ, THL, KKC, WSZ, FZ, YLJ, GNT, JW. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: LX, CQJ, THL, KKC, JW, WSZ, FZ, YLJ, GNT.


This work was supported by the University of Hong Kong Foundation for Educational Development and Research (SN/1f/HKUF-DC;C20400.28505200), the Health Medical Research Fund (Grant number: HMRF/13143241) in Hong Kong; the Guangzhou Public Health Bureau (201102A211004011) and the Guangzhou Science and Technology Bureau, Guangzhou, China (2002Z2-E2051; 2012J5100041; 2013J4100031); and the University of Birmingham, UK.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

394_2018_1692_MOESM1_ESM.docx (330 kb)
Supplementary material 1 (DOCX 330 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of Public HealthSun Yat-sen UniversityGuangzhouChina
  2. 2.School of Public HealthThe University of Hong KongHong KongChina
  3. 3.Guangzhou No. 12 HospitalGuangzhouChina
  4. 4.Institute of Applied Health ResearchUniversity of BirminghamBirminghamUK
  5. 5.Department of Medicine and TherapeuticsThe Chinese University of Hong KongHong KongChina

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