A person's intake of whole eggs and cholesterol was positively associated with their risk of death, while intake of egg whites or egg substitutes was negatively associated with death in a new study published this week in PLOS Medicine by Yu Zhang of Zhejiang University College of Biosystems Engineering and Food Science, Jingjing Jiao of Zhejiang University School of Medicine, China, and colleagues.

Whether consumption of egg and cholesterol is detrimental to cardiovascular health and longevity is highly debated, and data from large-scale cohort studies are scarce. In the new study, researchers used data on 521,120 participants from the NIH-AARP Diet and Health Study. Participants were aged 50-71 years old, 41.2% women, 91.8% non-Hispanic white, and were recruited from 6 states and 2 cities in the US between 1995 and 1996.

During a mean follow-up of 16 years, 129,328 deaths occurred in the cohort. Whole egg consumption, as reported in a food questionnaire, was significantly associated with higher all-cause mortality after adjusting for demographic characteristics and dietary factors (P<0.001), but not after further adjusting for cholesterol intake (P=0.64). Every intake of an additional 300 mg dietary cholesterol intake per day was associated with a 19% higher all-cause mortality (95% CI 1.16-1.22) and each additional half a whole egg per day was associated with a 7% higher all-cause mortality (95% CI 1.06-1.08). In contrast, egg whites/substitutes consumption was significantly associated with lower all-cause mortality (P<0.001). Replacing half a whole egg with an equivalent amount of egg whites/substitutes was associated with a reduction of 3% in cardiovascular disease mortality.

"Our findings suggest limiting cholesterol intake and replacing whole eggs with egg whites/substitutes or other alternative protein sources for facilitating cardiovascular health and long-term survival," the authors say.