April 9, 2008 -- The on-again, off-again debate about eggs and health has been cracked open again by a new report on death and egg consumption.
On the one hand, the study shows a higher death rate among U.S. men who eat seven or more eggs per week, especially among diabetic men.
But on the other hand, the study, published in The American Journal of Clinical Nutrition, shows no link between egg consumption and heart attack or stroke. And eating up to six eggs a week didn't affect men's health.
What to make of it all? The higher death rate linked to eating seven or more eggs per week is "surprising" and needs to be confirmed, notes an editorial published with the study.
"Remember: eggs are like all other foods -- they are neither 'good' nor 'bad,' and they can be part of an overall heart-healthy diet," writes editorialist Robert Eckel, MD, of the University of Colorado, Denver.
The study included 21,300 male doctors followed for 20 years, starting when they were about 54 years old, on average.
Every year during the study, the men noted their egg consumption, physical activity, smoking, alcohol use, consumption of vegetables and breakfast cereals, diabetes, high blood pressure, and use of aspirin.
Participants weren't asked to change their diets. The typical participant reported eating one egg per week. Older, heavier, less active men who smoked, had high cholesterol, and had a history of diabetes and high blood pressure tended to eat more eggs.
The researchers -- who included Luc Djousse, MD, MPH, DSc, of Boston's Brigham and Women's Hospital and Harvard Medical School -- counted 5,169 deaths among the men during the follow-up period.
Even after adjusting for other risk factors, men who reported eating seven or more eggs per week were 23% more likely to die of any cause during the study; the risk rose among those with diabetes.
But egg consumption wasn't linked to increased risk of heart attacks or strokes, even among men who ate more than seven eggs per week.
Djousse's team calls for further studies to investigate their findings.
Egg Advocate Responds
Donald McNamara, PhD, is the executive director of the Egg Nutrition Center, which is backed by the American Egg Board and the United Egg Producers. He raises three key points about the study.
"First off is that we don't know what they died of," McNamara says. "We know it wasn't related to cardiovascular disease or strokes. But we don't have any information about what it really was related to."
"I can't imagine that eating more than 6 eggs a week is going to cause you to drive off a bridge or speed," McNamara says. "It doesn't have a rational biological mechanism at this point that I can really put my finger on."
Second, McNamara says the study doesn't include enough information on what else the men were eating. For instance, he notes that in a 1999 study published in The Journal of the American Medical Association, eggs weren't related to men's heart disease risk after adjusting for bacon consumption.
Third, McNamara criticizes the researchers' analysis of other risk factors. He says that the study doesn't consider interaction between risk factors and contradicts previous research.
"I think one, it needs to be reproduced. Two, I'd like to know what they died of and three, I'd like to know what other things are in their diets that might be related to increased risk," McNamara concludes.
Kathleen Zelman, MPH, RD, LD, is WebMD's director of nutrition.
"I'm a huge fan of eggs," says Zelman, who questions whether the study dug deeply enough into the men's diets and lifestyles.
As for the higher death rate among men who ate seven or more eggs per week, "to pin it on eggs would be short-sighted," Zelman says.
Her advice: If you want to have more than one egg on a given day, "have them less often or try adding more egg whites and fewer egg yolks." Anyone with a chronic condition such as diabetes "needs to be more careful about dietary choices and would benefit from a consultation with a registered dietitian," she says.
"By and large, eggs are super nutritious, good-for-you foods. You just need to make sure you don't overdo it," Zelman says.