LAUSR

BACKGROUND Although the Chinese Dietary Guidelines (2016) removed restrictions on dietary cholesterol intake, evidence of egg and dietary cholesterol intake and cardiometabolic diseases is inconsistent. Associations between egg and cholesterol consumption and metabolic syndrome (MetS) in non-Western populations are still poorly documented. OBJECTIVE To assess egg and dietary cholesterol intake in relation to the prevalence of MetS among participants in a Chinese nationwide study. DESIGN This cross-sectional study used data from the China Health and Nutrition Survey (1991-2009). PARTICIPANTS/SETTING The sample consisted of 8241 healthy Chinese adults aged ≥20. MAIN OUTCOME MEASURES MetS cases were defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria. STATISTICAL ANALYSIS Cumulative averages of egg and cholesterol consumption were calculated in accordance with 3 consecutive 24-h dietary recalls in each examination cycle. Logistic regression models were conducted to assess the associations with prevalent MetS. RESULTS Overall, 2580 (31.3%) participants were identified as MetS cases in 2009. After multivariate adjustment, total egg consumption (>1 egg/d) was associated with 20% higher odds of MetS [odds ratio (OR) (95% confidence interval (CI)): 1.20 (1.06-1.37); P-trend=0.001] compared to consumption of ≤1/2 egg/d. Examining cooking methods, a positive association was observed between fried egg consumption and MetS odds [OR comparing the highest category (>1/2 egg/d) with the lowest category (≤1/7 egg/d) (95% CI): 1.22 (1.08-1.39); P-trend=0.001], whereas non-fried egg intake was not associated with MetS odds (P-trend=0.08). Total dietary intake and egg-sourced cholesterol intake were both positively correlated with MetS odds [1.31 (1.12-1.53), P-trend=0.005, comparing the highest consumption (>371 mg·2000 kcal-1·d-1) with the lowest consumption (≤132 mg·2000 kcal-1·d-1) for total dietary cholesterol; 1.36 (1.17-1.58), P-trend<0.001, comparing the highest consumption (>232 mg·2000 kcal-1·d-1) with the lowest consumption (≤46 mg·2000 kcal-1·d-1) for egg-sourced cholesterol], whereas similar associations were not observed for non-egg-sourced cholesterol consumption (P-trend=0.83). Substituting eggs and fried eggs for other protein sources including low-fat and whole-fat dairy products, nuts and legumes, total red meat, processed meat, poultry meat, or seafood was still associated with higher odds of MetS. CONCLUSIONS Consumption of >1 egg/d and >1/2 fried egg/d was associated with a higher prevalence of MetS than consumption of ≤1/2 egg/d and ≤1/7 fried egg/d, respectively. Future longitudinal cohort studies and randomized controlled trials are needed to further investigate the relationship between egg consumption and MetS and explore possible mechanisms of action.