Egg consumption and risk of type 2 diabetes in older adults123

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Background: Type 2 diabetes (T2D) remains an important public health issue in the United States. There are limited and inconsistent data on the association between egg consumption and fasting glucose or incident diabetes.

Objectives: We assessed the association between egg intake and incident diabetes in older adults.

Design: In this prospective study of 3898 men and women from the Cardiovascular Health Study (1989–2007), we assessed egg consumption by using a picture-sorted food questionnaire and ascertained incident T2D annually by using information on hypoglycemic agents and plasma glucose. We used Cox proportional hazards models to estimate adjusted relative risks.

Results: During a mean follow-up of 11.3 y, 313 new cases of T2D occurred. Crude incidence rates of T2D were 7.39, 6.83, 7.00, 6.72, and 12.20 per 1000 person-years in people who reported egg consumption of never, <1 egg/mo, 1–3 eggs/mo, 1–4 eggs/wk, and almost daily, respectively. In multivariable-adjusted models, there was no association between egg consumption and increased risk of T2D in either sex and overall. In a secondary analysis, dietary cholesterol was not associated with incident diabetes (P for trend = 0.47). In addition, egg consumption was not associated with clinically meaningful differences in fasting glucose, fasting insulin, or measures of insulin resistance despite small absolute analytic differences that were significant.

Conclusion: 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.

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1

From the Division of Aging (LD) and the Division of Cardiovascular Medicine and Channing Laboratory (DM), Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA; the Massachusetts Veterans Epidemiology and Research Information Center and Geriatric Research, Education, and Clinical Center, Boston Veterans Affairs Healthcare System, Boston, MA (LD); the Departments of Biostatistics (AK) and Epidemiology (DS), School of Public Health and Community Medicine, and the Department of Medicine, School of Medicine (DS), University of Washington, Seattle, WA; the Colorado School of Public Health and Department of Health and Exercise Science, Colorado State University, Fort Collins, CO (TLN); the Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (MC); the Departments of Epidemiology and Nutrition, Harvard School of Public Health, Boston, MA (DM); and the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (KJM).

2

Supported by contracts N01-HC-85079 through N01-HC-85086, N01-HC-35129, N01 HC-15103, N01 HC-55222, U01 HL080295, 5K01- HL70444, and R01 HL094555-01A1 from the National Heart, Lung, and Blood Institute with additional contribution from the National Institute of Neurological Disorders and Stroke.

3

Address correspondence to L Djoussé, Division of Aging, Brigham and Women’s Hospital and Harvard Medical School, 1620 Tremont Street, 3rd Floor, Boston, MA 02120. E-mail: [email protected].