★  優活 健康網    ★  Living Well Website
  • 首頁
    • ● ER
    • ● 台灣 美食悠遊網
    • ● 台灣旅遊 導覽網
    • ● 生活智慧網
    • ● 台灣 消費者網站
    • ★ 中國 旅遊網
  • 美食
    • 美食
    • ● 火鍋美食 介紹 - Hot Pot
    • ● (麵食)- 牛肉麵、炸醬麵、拉麵 - Noodles
    • ● 豆腐類 美食 - Tofu Dishes
    • ● 香菇類 美食菜餚 - Mushroom
    • ● 馬鈴薯、土豆菜餚 - Potatoes
    • ● 潤餅卷, 春捲- Popiah, Egg Roll
    • ● 台灣便當飲食, 台鐵便當- Boxed meal
    • ● 台灣 滷肉飯 Braised Pork Rice
    • ● 台灣料理- 油飯、糯米 Glutinous oil rice
    • ● 日式料理- 蛋包飯, 關東煮 Japan cuisine
    • ● 日式料理 - 丼物 (蓋澆飯) (Donburi)
  • 購物
    • ▼ 商圈 ===> >
      • ● 台北市 西門町 商圈 Ximending B. District
      • ● 台北市 信義商圈- Taipei 101 Shopping
      • ● 台北市 五分埔商圈- Wufenpu Garment
      • ● 台北 重慶南路書店街 Taipei Bookstores
      • ● 台北光華商場- 數位新天地- Guanghua
    • ▼ 經濟 ===> >
      • ● 懂程式,會美編,在台新金只值21K
      • ● 師大夜市餐廳經營 - 我賺的錢 都給房東了
      • ● 越勞中國月賺900美元,偷渡來台只領22K
      • ● 美國醫療費用世界最昂貴- US medi-cost
      • ● 餐廳我賺的 都給房東了- High Rent
      • ● 經營
    • ● 台北101 購物中心-Taipei 101 shopping
    • ● 團購 -- Group Buying
    • ● 蘋果,宏達電,三星, 手機大戰- htc Apple
    • ● 台灣團購網騙很大 Groupon、Gomaji
    • ● 中國大陸團購分析-Group buying in China
  • 飲食
    • ● 糖份 - Sugar : The Bitter Truth
    • ● 好吃美食與健康危險- 警訊 - Food risk
    • ● 常吃泡麵有害身體健康
    • ● 當心水果食物中毒 - Food Poisoning
    • ● 不安全食物: 壽司被評為第一 - Sushi
    • ● 一舉兩得 - 外食族抗漲帶便當
    • ● 苦茶油 - Tea Seed Oil
    • ● 隔夜菜食用有何可能問題?
    • ● 長期不吃肉竟早衰失智
    • ● 飲食與癌症關係密切 - Diet and Cancer
    • ● 不含麩質飲食法的爭議- Gluten-free diet
    • ● 吃深海魚 小心汞中毒- Mercury poison
    • ● 老人愛管灌飲食, 恐營養失衡- Elderly
    • ● 手搖飲當水喝!兩壯年男中風 半邊癱瘓
  • 保健
    • ▼ 運動 ===> >
      • ● 運動健身好處多- Exercise for Health
      • ● 運動讓你每個細胞都健康 - Exercise
      • ● 慢跑運動 - Jogging Exercise
      • ● 活動:要活就要運動 - Exercise is Key
      • ● 有氧健身操課訓練 - Aerobics for health
    • ● 養生之道- 勿喝冰冷飲料- No cold drink
    • ● 小米, 燕麥, 糙米煮粥吃 改善胃潰瘍, 發炎
    • ● 網傳留言:亂吃東西中年以後會很痛苦
    • ● 葡萄糖胺食品保健?毒物醫師斥無效
    • ● 山竹果汁 - Mangosteen Juice
    • ● 滿街飲料店, 嚴重傷害台灣人健康-Hazard
    • ● 牛初乳奶粉不能直接用作嬰兒主食
    • ● 趁一切還來得及- 養生之道- Not too late
    • ● 國際藥聞- 醫學期刊: 別浪費錢買維他命
    • ● 顧他命可緩化療, 但沒療效- Glutamine
  • 保健
    • ● (三高) - 高血壓, 高血糖, 高血脂
    • ● 油漱法 Oil Pulling - 荒謬的保健法
    • ● 101歲劈腿爺,頭能頂地,腿可繞頸- 101 yr
    • ● 阿金博士減肥法 - Dr. Atkin's Diet
    • ● 最流行九種減肥飲食法- Weight loss diet
    • ● 膳食纖維的功能與重要 - Dietary Biber
    • ● 大燕麥片降膽固醇- Oatmeal
    • ● 清朝 乾隆皇帝的高壽秘訣
    • ● 冥想默思 (Meditation)
    • ● Health Benefits of Meditation
    • ● Unblock cholesterol plaqued arteries
  • 營養
    • ● 維生素缺乏症 - Vitamin Deficiency
    • ● 維生素A 缺乏症 - Vitamin A Deficiency
    • ● 維生素B1 (硫胺)缺乏 - Vitamin B1
    • ● 維生素B2 (核黃素) - Vitamin B2
    • ● 維生素B3 (菸鹼酸) - Vitamin B3
    • ● 維生素B5 (pantothenic acid)
    • ● 維生素B6
    • ● 維生素B9 (葉酸) 缺乏- Folic Acid
    • ● 維生素B12 缺乏症- Vit B12 Deficiency
    • ● 維生素B12 - Vitamin B12
    • ● 維生素C 缺乏症 - Vitamin C Deficiency
    • ● 維生素D 缺乏症 - Vitamin D Deficiency
    • ● 維生素E 缺乏症 - Vitamin E Deficiency
    • ● 維生素 K - Vitamin K
    • ● 補鉀降低心腦血管疾病風險 - Potassium
    • ● 補鈣不能盲目,腎不好補鈣會傷害心臟
  • 營養
    • ● 魚油 - Fish oil
    • ● 魚肝油 - Cod Liver Oil
    • ● 二十二碳六烯酸 - DHA
    • ● 水果的營養 - Fruit Nutrition
    • ● 抗氧化劑 Anti-Oxidant
    • ● 薑黃素(Curcumin) - 咖哩 Curry
    • ● 人體缺乏維生素B2與得患癌症有關
    • ● 中老年人喝牛奶能降低心血管疾病
    • ● Milk Myth - 牛奶迷思
    • ● Nutrition value- Juice vs. Concentrate
    • ● Benefits of Orange Juice
    • ● Nutrition & Food - Google Tech Talks
    • ● Selenium 硒元素
  • 健康
    • ▼ Health ===> >
      • ● Vitamin E Tied to Prostate Cancer Risk
      • ● Nutrition and Immune System
      • ● Our Microbes in Us
      • ● Nutrients that Boost Immunity
      • ● Exercise and Aging
      • ● Leg Cramps While Sleeping
    • ● 營養健康補品 - 初乳 - Colostrum
    • ● 關於蜂蜜 - 一個真實的故事 - Honey Story
    • ● 科學家研究咖啡因, 發現利弊參半-Coffee
    • ● 震驚世界的醫學發現!Awesome discovery
    • ● 十大健康惡習- Top 10 unhealthy habits
    • ● 服用維他命有助健康? 效果具爭議-Vitamin
    • ● 健康飲食就要從飲食中少油做起- Less oil
    • ● 手腳冰冷,恐潛藏健康問題-
    • ● 猛灌紅茶不喝水,壯男中風半癱
    • ● 如何減肥瘦身 - Lose Body Weight
    • ● 肌肉減少症- 骨骼肌減少症- Sarcopeni
    • ● 怎樣測試自己是酸性體質或鹼性體質?
    • ● 烘烤炸澱粉食物易生致癌物
    • ● 枸杞與眼睛健康
    • ● 瀋陽男1夜喝20瓶啤酒, 胰臟溶解只剩一層膜
  • 健康
    • ● 人體胃的生理功能與病症
    • ● 小腸的生理功能與病變
    • ● 大腸的生理功能與病變
    • ● 如何提升人體免疫力 - Enhance Immunity
    • ● 保衛人體健康免疫系統- Immunity
    • ● 穀胱甘肽- Glutathione- (Antioxidant)
    • ● 咳嗽3週才會好 別急吃抗生素
    • ● 如何保持你的腸道健康 - Healthy Guts
    • ● 緩解疼痛的策略: 雙臂交叉?Cross arms
    • ● 睡眠改善高血糖-Sleep lower blood sugar
    • ● 心因性猝死,1個月前會出現徵兆- Cardiac
    • ● 預防髖部骨折,補充鈣與維生素D- Pelvis
    • ● 肉類攝取與罹患癌症的風險
    • ● 雞蛋與第二型糖尿病發生機率
    • ● 鉀離子與身體健康 - K+
    • ● 姿勢性低血壓 Orthostatic Hypotension
  • 檢查
    • ▼ 驗血 ===> >
      • ● 驗血 - 全血細胞計數 - CBC
      • ● 癌症指數的正確閱讀
      • ● 抗體 Antibody (Immunoglobulin)
      • ● Serum Free Light Chains -血清遊離輕鏈
      • ● Beta 2-Microglobulin (β2-M)
    • ● 膀胱(內視)鏡檢查 - Cystoscopy
    • ● 大腸(內視)鏡檢查與結腸瘜肉
    • ● 超音波掃瞄檢查- Ultrasound scan
    • ● 孕婦超音波- Pregnancy ultrasound
    • ● 心臟病檢查
    • ● 肌電圖 檢查- Electromyography
    • ● 腎功能檢查 - Kidney Function Tests
    • ● 紅血球與貧血 (RBC & Anemia)
    • ● 尿液分析檢驗 - Urine Test
    • ● 胸部X光檢查 - Chest X-ray
    • ● 血壓與血壓測量 - Blood Pressure
    • ● 泌尿科常做的檢查
  • 病症
    • ▼ 胃腸病 ===> >
      • ● 胃食道逆流病 - GERD, Reflux Disease
      • ● 慢性胃炎 - Chronic Gastritis
      • ● 胃黏膜-腸上皮化生 Intestinal Metaplasia
      • ● 非潰瘍性消化不良- Nonulcer dyspepsia
      • ● 下一個國民病大腸癌? 如何發現徵兆?
      • ● 胰臟炎與胰臟疾病 - Pancreatitis
    • ▼ 癌症 ===> >
      • ● 癌症免疫療法- Cancer Immunotherapy
      • ● 多發性骨髓瘤 - Multiple Myeloma
      • ● 胰臟癌 - Pancreatic Cancer
      • ● 淋巴瘤 - Lymphoma
      • ● 泌尿道癌症
      • ● 膀胱癌 - Bladder Cancer
      • ● 肝癌 - Liver Cancer
      • ● 食道癌 - Esophageal Cancer
    • ▼ 症狀 >
      • ● 血尿
    • ● 阿茲海默氏症 Alzheimer D. (老年癡呆症)
    • ● 如何預防老年癡呆症 -
    • ● 如何預防失智症 -
    • ● 重肌無力症 - Myasthenia Gravis
    • ● What's Causing Your Memory Loss?
    • ● Level of GFR and Anemia
    • ● 低鈉血症 - Hyponatremia
    • ● 體液與血鈉異常之處置
    • ● 低血鉀症 - hypokalemia
    • ● 高血鉀症 - hyperkalemia
    • ● 低鉀血症和高鉀血症
    • ● 酸血症 - Acidemia - 代謝性酸中毒
    • ● 低鈣血症 - Hypocalcemia
  • 醫療
    • ▼ 健保 ===> >
      • ● 中央健康保險署 - 台灣二代健保
      • ● 台灣二代健保
      • ● 台灣全民健保與急診醫療 - ER
      • ● 健保藥費核價離譜- 同成分藥劑,價差逾2倍
      • ● 全民健保老人整合門診,家屬大多不知道
      • ● 台灣的醫療安全問題 -
    • ▼ 心臟病 ===> >
      • ● 心肌梗塞 - Heart Attack Signs
      • ● 心臟病 體外反搏治療- EECP Therapy
      • ● 體外「心臟震波」治療冠心病 - CSWT
    • ▼ 眼科 ===> (眼睛健康與保養) >
      • ● 中老年人眼睛與視力問題- Eye disease
      • ● 眼睛 白內障 (Cataract)
      • ● 眼睛 白內障的治療 - Cataract
    • ● (好書推薦):最新天星英漢百科醫學辭典
    • ● 乳房腫塊以為瘀青, 推拿推到癌細胞擴散
    • ● 葡萄糖胺療效淺,破除維骨力神話
    • ● 腳跟疼痛?千萬別輕忽
    • ● 中醫經方療效不顯,專家: 中藥用量該多大
    • ● 你相信「中醫」有多少療效?
    • ● 多發感覺運動神經病變-polyneuropathy
    • ● 腳麻走不動?你可能需要神經傳導檢查
    • ● 成大揪肝硬化元凶,治肝大突破
    • ● 臨床打針注射技術
    • ● 鼻胃管 - Nasogastric Tube
  • 醫療
    • ● 血尿 Hematuria
    • ● 泌尿道感染 - 膀胱炎- Cystitis
    • ● 憂鬱症 - Depression (Mood)
    • ● 流感重症合併,肺炎感染驟增
    • ● 老人骨質疏鬆症, 逾半數有骨折- Fracture
    • ● 骨質疏鬆症與防治 - Osteoporosis
    • ● 安慰藥效果 - Placebo Effect
    • ● 帕金森氏症 - Parkinson's Disease
    • ● 帕金森氏症治療 - Parkinson Treatment
    • ● 帕金森氏症與睡眠失常
    • ● Glutathione
    • ● 達文西機械手臂手術- da Vinci Surgery
    • ● 高血壓治療
  • 腎病
    • ▼ 腎病藥物 ===> >
      • ● 活性炭 克裏美淨(Kremezin) 效果如何
      • ● 活性炭 克裏美淨(Kremezin)效果不明顯
      • ● 吉多利錠- Keto-analogues for CKD
    • ● Sodium Bicarbonate Heals Kidney D.
    • ● Sodium Bicarbonate Cures Cancer
    • ● 腎血管肌肉脂肪瘤
    • ● 泌尿道感染 尿道炎 基本知識
    • ● 如何保護你的腎臟-Protect your kidneys
    • ● 腎臟微循環與其內在調節 (急診醫學)
    • ● 人體內水與電解質的平衡 (急診醫學)
    • ● 腎臟炎的(飲食)治療處理
    • ● 腎臟病患者飲食原則與禁忌- Kidney D.
    • ● 腎臟病與蛋白質的攝取
    • ● 如何保護腎臟?遠離慢性腎臟病
    • ● 腎衰竭患者的飲食
    • ● 逆轉腎!低蛋白搭酮酸胺延緩洗腎
    • ● 洗腎病患營養與飲食原則
    • ● (腎臟) 透析 (Dialysis) -- 洗腎
    • ● Pentoxifylline 與慢性腎臟病
    • ● Healthy Foods for Kidney Disease
    • ● How to delay the onset of dialysis
  • 貧血
    • ● 貧血與診斷 - Anemia and Diagnosis
    • ● 貧血與治療 - Anemia and Treatment
    • ● 搶救貧血大作戰 - Fighting Anemia
    • ● 缺鐵性貧血與治療- Iron-Defici anemia
    • ● 貧血與慢性腎臟病- Anemia in CKD
    • ● 貧血可能的疾病風險
    • ● 輸血 相關知識- Blood Transfusion
    • ● Anemia and EPO Treatment
  • RA
    • ● 類風濕性關節炎 - Rheumatoid Arthritis
    • ● 類風濕性關節炎- Rheumatoid Arthritis
    • ● 過敏免疫風濕科- 常用藥物- A.I.R. Drug
    • ● 免疫調節藥- Methotrexate, MTX 至善錠
    • ● Methotrexate Toxicity- Treatment
    • ● 免疫調節藥- 磺胺藥- Sulfasalazine, SSZ
    • ● 免疫調節藥- Hydroxychloroquine, HCQ
    • ● 類固醇 藥物 - Steroids
    • ● 生物製劑 - Anti-TNF Biologic Agents
    • ● 生物製劑- 復邁 (Humira, Adalimumab)
    • ● 懷孕與類風濕關節炎藥物
    • ● C反應蛋白 C-Reactive Protein- CRP
    • ● 紅血球沉降率 - ESR
    • ● 類風濕因子 Rheumatoid Factor (RF)?
    • ● 抗環瓜氨酸抗體 - Anti-CCP
    • ● 食物療法與類風濕關節炎-Diet & RA
    • ● 食物與類風濕關節炎- Food & RA
    • ● Natural Remedies for RA
    • ● Vitamins, Minerals, and RA
  • 藥物
    • ● Acetylcysteine-富泌舒Fluimucil, Actein
    • ● 家庭常備藥物 - Family Kept Medicine
    • ● 小護士 - 曼秀雷敦 - Mentholatum
    • ● 乙醯胺酚-普拿疼止痛藥-Acetaminophen
    • ● 撒隆巴斯類 鎮痛貼片- Salonpas
    • ● 抗生素藥品 - Antibiotics
    • ● 麥格斯口服液- Megestrol Acetate
    • ● 萬靈藥 - 阿斯匹靈 - Aspirin
    • ● 藥物不良反應 - Adverse Drug Reaction
    • ● 葡萄柚汁可能對藥物的影響- Grapefruit
    • ● 藥物含鈉造成的不良作用
    • ● 瀉劑 - Bisacodyl
    • ● 毒物 戴奧辛 - Dioxin
    • ● Beware of the Prolia (injection) Drug.
    • ● 7 Drugs Whose Dangerous Risks
  • 藥物
    • ● 抗生素 賜復力生 Ceflexin - Cephalosporin
    • ● 抗生素 - Levofloxacin (Cravit)
    • ● 雙嘧達莫 - 潘生丁- Persantine
    • ● 諾安命 Novamin (Prochlorperazine)
    • ● 抗凝血劑- Warfarin 可邁丁- Coumadin
    • ● 高血壓藥- 脈優- Amlodipine- Norvasc
    • ● 高血壓藥 (道福寧) Dophilin
    • ● 類固醇 藥物 - Steroid Drugs
    • ● 消化性潰瘍藥 - Rabeprazole (Pariet)
    • ● 消化性潰瘍藥- Esomerprazole (Nexium)
    • ● 斷血炎 (Transamin) - 傳明酸
    • ● 除鐵能 - Deferoxamine (Desferal)
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現在位置 : 健康 > 雞蛋與第二型糖尿病發生機率

每天吃壹顆雞蛋會增加第二型糖尿病風險
An Egg a day Raise Risk of Type II Diabetes
2011-11-11
       美國白明罕尼哈佛醫學院迪爵斯醫師發表專文指出每日至少攝取壹顆雞蛋者,也就是每週攝取至少七顆雞蛋者,就男性而言,得到糖尿病的風險比未吃雞蛋者,高出58%就女性而言高出77%。每顆雞蛋含有200毫克之膽固醇,以及1.5公克飽和性脂肪酸 (Saturated fatty acid),這兩種成份會增加糖尿病風險。
      對於男性而言,每週吃壹粒雞蛋,第二型糖尿病風險增加9%
每週吃二至四粒雞蛋,第二型糖尿病風險增加18%
每週吃四至六粒雞蛋,第二型糖尿病風險增加46%
每週吃七粒或七粒雞蛋以上,第二型糖尿病風險增加58%
       對於女性而言,每週吃壹粒雞蛋,第二型糖尿病風險減少3%
每週吃二至四粒雞蛋,第二型糖尿病風險增加19%
每週吃四至六粒雞蛋,第二型糖尿病風險增加18%
每週吃七粒或七粒雞蛋以上,第二型糖尿病風險增加77%
(Diabetic Care Nov . 21 , 2008)
Eggs and Diabetes
High levels of egg consumption (daily) are associated with an increased risk of type 2 diabetes in men and women.
Egg Consumption and Risk of Type 2 Diabetes in Men and Women
Luc Djoussé, MD, DSC1,   J. Michael Gaziano, MD123,  Julie E. Buring, ScD1245 and
 I-Min Lee, MBBS, SCD25
 Author Affiliations
1. Division of Aging, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 
2. Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 
3. Massachusetts Veterans Epidemiology and Research Information Center (MAVERIC), Boston Veterans Affairs Healthcare System, Jamaica Plain, Massachusetts 
4. Dept. of Ambulatory Care and Prevention, Harvard Medical School, Boston, MA
5. Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts 
Corresponding author: Luc Djoussé, [email protected]
Abstract
OBJECTIVE—Whereas limited and inconsistent findings have been reported on the relation between dietary cholesterol or egg consumption and fasting glucose, no previous study has examined the association between egg consumption and type 2 diabetes. This project sought to examine the relation between egg intake and the risk of type 2 diabetes in two large prospective cohorts.
RESEARCH DESIGN AND METHODS—In this prospective study, we used data from two completed randomized trials: 20,703 men from the Physicians' Health Study I (1982–2007) and 36,295 women from the Women's Health Study (1992–2007). Egg consumption was ascertained using questionnaires, and we used the Cox proportional hazard model to estimate relative risks of type 2 diabetes.
RESULTS—During mean follow-up of 20.0 years in men and 11.7 years in women, 1,921 men and 2,112 women developed type 2 diabetes. Compared with no egg consumption, multivariable adjusted hazard ratios for type 2 diabetes were 1.09 (95% CI 0.87–1.37), 1.09 (0.88–1.34), 1.18 (0.95–1.45), 1.46 (1.14–1.86), and 1.58 (1.25–2.01) for consumption of <1, 1, 2–4, 5–6, and ≥7 eggs/week, respectively, in men (P for trend <0.0001). Corresponding multivariable hazard ratios for women were 1.06 (0.92–1.22), 0.97 (0.83–1.12), 1.19 (1.03–1.38), 1.18 (0.88–1.58), and 1.77 (1.28–2.43), respectively (P for trend <0.0001).
CONCLUSIONS—These data suggest that high levels of egg consumption (daily) are associated with an increased risk of type 2 diabetes in men and women. Confirmation of these findings in other populations is warranted.
       Type 2 diabetes is highly prevalent and is associated with high health care costs and societal burden (1). Therefore, it is important to identify modifiable risk factors that may help reduce the risk of type 2 diabetes. Eggs are not only major sources of dietary cholesterol (∼200 mg/egg) but also contain other important nutrients such as minerals, vitamins, proteins, carotenoids, and saturated (∼1.5 g/egg), polyunsaturated (∼0.7 g/egg), and monounsaturated (∼1.9 g/egg) fatty acids (2,3). Whereas several of these nutrients have been associated with an increased risk of type 2 diabetes (i.e., saturated fat and cholesterol [4,5]), other nutrients may confer a lower risk of type 2 diabetes (i.e., polyunsaturated fat [4]).
       Whereas egg consumption was not associated with coronary heart disease (CHD) or stroke overall, Hu et al. (6) reported a twofold increased risk of CHD for egg consumption of more than one per week among men with type 2 diabetes in the Health Professionals’ Follow-up Study and a 49% increased risk of CHD among women in the Nurses’ Health Study, compared with intake of less than one per week. Furthermore, we have reported similar findings in U.S. male physicians with type 2 diabetes but not in those without type 2 diabetes (7), suggesting that frequent egg consumption may have negative health effects among individuals with type 2 diabetes. However, it is not known whether egg consumption increases the risk of type 2 diabetes itself. In animal experiments, a diet rich in fat has been shown to induce hyperglycemia and hyperinsulinemia (8). In addition, a diet enriched with egg yolk was associated with elevated plasma glucose compared with a control diet in rats (9). Data from the Zutphen Study (10) have indicated a positive association between egg consumption or dietary cholesterol and fasting glucose. However, in a randomized trial of 28 overweight or obese patients on a carbohydrate-restricted diet, consumption of three eggs per day had no effects on fasting glucose compared with abstention from eggs (11). Current data on the effects of dietary cholesterol on serum cholesterol have been inconsistent, ranging from positive associations (2,12) to lack of effect (12–14) and may be partly due to a large variability in individual response to dietary cholesterol (14,15).
       To our knowledge, no previous study has examined the association between egg consumption and the incidence of type 2 diabetes in a large prospective cohort of men and women. Because eggs can serve as a good source for vitamins, proteins, and other nutrients in the U.S., it is important to determine the net degree of benefit and harm of egg consumption on the risk of type 2 diabetes. The current study examines the association between egg consumption and incident type 2 diabetes among men and women who participated in two large completed randomized control trials.
RESEARCH DESIGN AND METHODS--
       We used data from the Physicians’ Health Study (PHS) I and the Women's Health Study (WHS), two completed randomized, double-blind, placebo-controlled trials designed to study the effects of aspirin and β-carotene (PHS) or low-dose aspirin and vitamin E (WHS) in the prevention of cardiovascular disease and cancer. Detailed description of the PHS I and WHS has been published previously (16–18). Briefly, a total of 22,071 U.S. male physicians aged ≥40 years at entry (1982) were randomized using a 2×2 factorial design to aspirin (325 mg every other day), β-carotene (50 mg every other day), or their corresponding placebos. Similarly, 39,876 female health professionals aged ≥45 years at entry (1992–1995) were randomized to low-dose aspirin (100 mg on alternate days), vitamin E (600 IU on alternate days), or their corresponding placebos. Each participant gave written informed consent, and the institutional review board at Brigham and Women's Hospital approved both study protocols. For the present analyses, we excluded 1,368 men because of prevalent type 2 diabetes (n = 641), missing data on egg consumption (n = 365), or missing data on potential confounders: smoking, alcohol intake, BMI, exercise, hypertension, and fruits and vegetables (n = 362). Among women, we excluded 3,581 because of prevalent type 2 diabetes (n = 1,171), missing data on egg consumption (n = 852), or missing data on potential confounders: BMI, exercise, smoking, energy intake, fruits and vegetables, nutrients, alcohol consumption, and hypertension (n = 1,558). Thus, a final sample of 20,703 men and 36,295 women was used in the current analyses.
Egg consumption
       Among men, information on egg consumption was self-reported at baseline using a simple abbreviated semiquantitative food-frequency questionnaire. Participants were asked to report how often, on average, they had eaten one egg during the past year. Possible response categories included “rarely/never,” “1–3/month,” “1/week,” “2–4/week,” “5–6/week,” “daily,” and “2+/day.” This information was obtained at baseline and at 24, 48, 72, 96, and 120 months after randomization. Among women, information on egg consumption was self-reported using a 131-item validated food-frequency questionnaire (19) at baseline. Women were asked to report their average consumption of eggs over the past year. Possible response categories were “Never or <1/month,” “1–3/month,” “1/week,” “2–4/week,” “5–6/week,” “1/day,” “2–3/day,” “4–5/day,” and “6+/day.” Because very few subjects consumed one or more eggs per day (7.8% for men and 1.0% for women), we combined categories of one per day and beyond for stable estimates. The validity of food-frequency questionnaires in similar populations has been published elsewhere (19,20). The correlation of egg consumption with dietary cholesterol was 0.61 (P < 0.0001) and with saturated fat among women was 0.26 (P < 0.0001).
Ascertainment of incident type 2 diabetes
       Type 2 diabetes was ascertained by self-report on annual follow-up questionnaires in both men and women. Follow-up and ascertainment of type 2 diabetes cases were completed in March 2007. Because all men were physicians, self-report was deemed sufficient. Among the female health professionals, self-reports of type 2 diabetes were validated using American Diabetes Association criteria, for which additional information was obtained using telephone interviews, supplemental questionnaires, or review of medical records from treating physicians (21,22). Overall, the positive predictive value for type 2 diabetes validation was 91% (21).
Other variables
       Demographic data were collected at baseline. In addition, information on prevalence of hypertension, hypercholesterolemia, family history of diabetes (WHS only), smoking, exercise, and alcohol consumption was obtained at baseline. Whereas limited data on foods were available in men, detailed dietary information was collected in the WHS, allowing estimation of energy intake and nutrients.
Statistical analyses
       We classified each subject according to the following categories of egg consumption per week: 0, <1, 1, 2–4, 5–6, and ≥7. We computed person-time of follow-up from baseline until the first occurrence of 1) type 2 diabetes, 2) death, or 3) censoring date, the date of receipt of the last follow-up questionnaire (March 2007). Within each egg-consumption group, we calculated the incidence rate of type 2 diabetes by dividing the number of cases by the corresponding person-time. We used Cox proportional hazard models to compute multivariable adjusted hazard ratios (HRs) with corresponding 95% CIs using subjects in the lowest category of egg consumption as the reference group. The initial model adjusted for age, whereas the multivariable model controlled for age (continuous), BMI (<25, 25–29, ≥30 kg/m2), smoking (never, former, and current smokers), alcohol consumption (0, 1–3 drinks/month, 1–6 drinks/week, ≥1 drinks/day), physical activity (vigorous exercise 0, <1, 1–3, ≥4 times per week in men and quintiles of kilocalories per week expended in leisure-time physical activity in women), and history of hypercholesterolemia and hypertension. Because detailed information on diet and family history was available for women, the multivariable model in women also adjusted for family history of diabetes, energy intake (quintiles), intake of fruits and vegetables (quintiles), red meat consumption (<0.5, 0.5–0.9, and ≥1 serving/day), and intake of polyunsaturated fats (quintiles), saturated fats (quintiles), and trans fats (quintiles). To examine whether the relation between egg and diabetes was mediated by dietary cholesterol, we evaluated the risk of diabetes associated with dietary cholesterol and also included dietary cholesterol in the multivariable model in women. A similar approach was used for saturated fat. A P value for linear trend was obtained by fitting a continuous variable that assigned the median egg consumption in each egg category in a Cox regression model.
       In secondary analyses, we examined possible effect modification by prevalent hypercholesterolemia (yes/no) and amount of energy from carbohydrate (low vs. high), using median energy from carbohydrate as cut point in women only, where data were available. We tested for statistical interaction by including the main effects and the product terms between egg consumption and hypercholesterolemia in a hierarchical Cox regression model (PROC TPHREG in SAS). We also conducted sensitivity analyses by excluding subjects with less than 2 years of follow-up. We repeated the main analysis using updated egg consumption at 24, 48, 72, 96, and 120 months in a time-dependent Cox model in men only, where repeated measures on egg consumption were available. Lastly, we used generalized linear models and polytomous logistic regression to impute missing values for continuous and categorical variables, respectively. All analyses were completed using SAS (version 9; SAS Institute, Cary, NC). Significance level was set at 0.05.


RESULTS--
       The mean ± SD age at randomization was 53.5 ± 9.4 years (range 39.7–85.9) in the PHS I and 54.5 ± 7.0 years (38.7–89.9) in the WHS. Among egg consumers, the median egg consumption was approximately one egg per week in men and women. Table 1 presents baseline characteristics of the study participants. Frequent consumption of eggs was associated with higher BMI, higher proportion of current smoking, higher prevalence of hypertension, and lower prevalence of hypercholesterolemia. In addition, frequent consumption of eggs was associated with older age and more alcohol consumption in men and higher energy intake, as well as intakes of saturated and trans fatty acids, and dietary cholesterol in women.
       A total of 1,921 new cases of type 2 diabetes were documented in men during a mean follow-up of 20.0 years. Among women, 2,112 new cases of type 2 diabetes occurred during a mean follow-up of 11.7 years. From the lowest to the highest category of egg consumption, crude incidence rates of diabetes were 35.8, 41.3, 42.7, 46.8, 62.4, and 67.0 cases per 10,000 person-years in the PHS I. A similar increase in rates of type 2 diabetes with egg consumption was observed in women, with corresponding crude incidence rates of 39.6, 45.8, 43.3, 64.8, 76.8, and 112.7 cases per 10,000 person-years, respectively. Whereas consumption of up to one egg per week was generally not associated with an increased risk of type 2 diabetes in either sex in multivariate analyses, more frequent consumption of eggs was associated with an increased risk of type 2 diabetes (Table 2). Compared with subjects who did not report egg consumption, intake of seven or more eggs per week was associated with a 58% increased risk of type 2 diabetes in men and a 77% increased risk of type 2 diabetes in women after adjustment for potential confounders (Table 2). Updating egg consumption using time-dependent Cox regression (PHS I) yielded a stronger relation between egg consumption and incident type 2 diabetes in men with HRs of 1.0 (reference), 1.10 (95% CI 0.99–1.23), 1.31 (1.16–1.47), 1.40 (1.10–1.77), 1.77 (1.39–2.26), and 1.99 (1.23–3.23), from the lowest to the highest category of egg consumption, respectively, using a multivariable model as above (this was not done for women due to lack of updated information on egg consumption). Lastly, exclusion of subjects with follow-up time <2 years in either cohort did not alter the results (P for trend <0.0001 in men and 0.0001 in women).
       Dietary cholesterol was positively associated with the risk of diabetes (multivariable adjusted HR 1.00 [reference], 0.94 [95% CI 0.80–1.11], 1.03 [0.88–1.21], 1.07 [0.91–1.25], and 1.28 [1.10–1.50], from the lowest to the highest quintile of dietary cholesterol, respectively (P for trend <0.0001). Additional adjustment for dietary cholesterol in women attenuated the point estimates in the multivariable model with corresponding HRs of 1.00 (reference), 1.05 (0.91–1.21), 0.94 (0.80–1.10), 1.07 (0.90–1.27), 1.00 (0.73–1.37), and 1.49 (1.06–2.09), respectively (P for trend = 0.10). However, saturated fat was not associated with type 2 diabetes (multivariable adjusted HR 1.0, 1.03 [0.87–1.21], 1.00 [0.84–1.19], 1.00 [0.84–1.20], and 1.10 [0.92–1.33], from the lowest to highest quintile of energy-adjusted saturated fat, respectively). Additional control for saturated fat did not alter the results (e.g., HR of 1.78 [1.30–2.45] without and 1.77 [1.28–2.43] with additional control for saturated fat, comparing the highest with the lowest egg consumption categories). Imputing missing data did not change the findings (online appendix Table A1, available at http://dx.doi.org/10.2337/dc08-1271).
       In a secondary analysis stratified by prevalent hypercholesterolemia at baseline (Table 3), similar patterns were observed in subjects of either sex with and without hypercholesterolemia (P for interaction 0.37 for men and 0.13 for women). Similar relations were observed between egg consumption and type 2 diabetes when data were stratified by low energy from carbohydrate (P for linear trend = 0.0004 for low energy from carbohydrate and 0.12 for high energy from carbohydrate) in women only (data were not available to estimate carbohydrate intake in men), and these findings were not altered when restricted to overweight or obese subjects (online appendix Table A2).
CONCLUSIONS--
       In this large prospective study, we have demonstrated that daily consumption of at least one egg is associated with an increased risk of type 2 diabetes in both men and women, independently of traditional risk factors for type 2 diabetes. Furthermore, the observed association between egg consumption and incident type 2 diabetes was not modified by prevalent hypercholesterolemia in either sex.
       To the best of our knowledge, this is the first study to examine prospectively the association between egg consumption and incident type 2 diabetes in a large population of men and women. Before the current study, limited and inconsistent data (mainly from animal models) have been reported in the literature on the effects of eggs or dietary cholesterol on glucose metabolism. In an animal experiment, a diet rich in fat was shown to induce hyperglycemia and hyperinsulinemia (8). Furthermore, Adamopoulos et al. (9) demonstrated that a diet enriched with egg yolk resulted in elevated plasma glucose compared with a control diet in male Wistar albino rats. Data from the Zutphen Study (10) showed a positive association between egg consumption or dietary cholesterol and fasting glucose. These animal studies and data from the Zutphen Study are consistent with our findings. In contrast, in a randomized trial of 28 overweight or obese subjects on a carbohydrate-restricted diet, consumption of three eggs per day had no effects on fasting glucose compared with no egg consumption (11). Because the positive associations described above were observed in studies without restricted consumption of carbohydrates, it is possible that the hyperglycemic effect of frequent egg consumption might only occur with a diet rich in carbohydrates. However, our secondary data analysis provided no evidence for such a hypothesis in that we observed similar increased risk of type 2 diabetes with consumption of one or more eggs per day in women with low or high energy intake from carbohydrate. Further restriction to women with BMI ≥25 kg/m2, to mimic the above trial of 28 overweight or obese subjects on restricted carbohydrate diet (11), did not alter these findings. Under the premise that our observed findings were driven by dietary cholesterol contained in eggs, one possible explanation for the inconsistency in reported data on the association between egg consumption and glucose metabolism could be the large variability of individual response to dietary cholesterol (14,15,23). Whereas dietary cholesterol has been shown to increase plasma cholesterol in hyperresponders (2,12,24), no effect was documented among hyporesponders (12–14). Second, the lack of an effect of egg consumption on fasting glucose among obese or overweight subjects in the only human randomized trial (11) may imply differential physiological effects of eggs in lean versus overweight or obese subjects. However, the lack of repeated data on fasting glucose in men and women in the present study prevented us from further exploring the relation between adiposity, egg consumption, and fasting glucose.
       Overall, the observed increased risk of type 2 diabetes with daily consumption of eggs in the current study raises the possibility of undesirable health effects with high rates of egg consumption and may help explain previously reported increased risk of CHD that was restricted to individuals with type 2 diabetes in the Health Professional Follow-up Study (6), the Nurses’ Health Study (6), and in our earlier publication from the PHS I showing an increased risk of mortality (and suggesting increased risk of CHD and stroke) with frequent egg consumption by subjects with prevalent type 2 diabetes (7). It is possible that frequent egg consumption may potentiate the risk of cardiovascular disease by inducing impaired glucose metabolism and insulin resistance. Future investigations into underlying physiological mechanisms are warranted.
       Besides dietary cholesterol, eggs contain other important nutrients that have been shown to increase (i.e., saturated fat and cholesterol [4,5,25]) or decrease (i.e., polyunsaturated fat [4]) the risk of type 2 diabetes. It is possible that the individual contribution from each of these components as derived not just from eggs but also from other foods may play a role in determining the net effect of egg consumption. Unfortunately, as noted above, we did not have repeated data on fasting glucose, fasting insulin, and other biomarkers of glucose metabolism in either cohort to comprehensively examine possible physiological mechanisms by which egg consumption might influence the risk of type 2 diabetes in our cohort. However, in women, where we had data on dietary cholesterol, there was attenuation of the association after additional adjustment for dietary cholesterol. This suggests that the observed relation between egg intake and diabetes may be partially explained by the cholesterol content of eggs. In contrast, saturated fat was not associated with type 2 diabetes, and adjustment for this did not attenuate the results.
       Additional limitations of the present study include the observational nature of the study design in which residual confounding or unmeasured confounding could partly or completely explain our results. In addition, because egg consumption was self-reported, we cannot exclude reporting bias in the present study. However, because information on egg consumption was collected before the occurrence of type 2 diabetes, such reporting bias is more likely to be nondifferential and thus bias the results toward the null. We did not collect information on whether participants consumed egg yolk (rich in cholesterol) to further examine the contribution of dietary cholesterol from eggs on type 2 diabetes risk in this study. In addition, we had limited dietary data for men to further assess the interplay of eggs and other foods, energy, and nutrients with the risk of type 2 diabetes. The generalizability of our finding is limited as both PHS I and WHS consist of homogeneous groups (male physicians and female health professionals, respectively) with the possibility that their behaviors may differ from those of the general population. Furthermore, over 90% of the study participants were Caucasian. Given the self-report nature of type 2 diabetes, we cannot exclude misclassification of the outcome in these data, especially in the WHS where not all participants were physicians, as was the case in the PHS. However, in the WHS, we had a 91% positive predictive value in a validation study of self-reported type 2 diabetes using American Diabetes Association criteria, for which data were attained by telephone interview, supplemental questionnaire, or review of medical records from treating physicians (21). Moreover, egg consumption was collected before the diagnosis of diabetes; thus, it is likely that any misclassification of diabetes would be nondifferential and bias the results toward the null. Nevertheless, the large sample size, the long duration of follow-up, the repeated and standardized methods for data collection in both cohorts, and the robustness of the findings in sensitivity analyses are major strengths of this study.
       In conclusion, our data are consistent with possible detrimental effects of daily consumption of eggs on the risk of type 2 diabetes in both men and women. Because the median egg consumption in this population (one egg per week for men and women) fell within a range not associated with an increased risk of type 2 diabetes, dietary advice to reduce egg consumption may target individuals who consume one or more eggs per day if these findings are confirmed in other studies. Given the societal burden of type 2 diabetes, confirmation of these findings in other populations and exploration of possible underlying biological mechanisms are warranted.
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