Meta-analysisindependent cross-checkabstract checked I-EGG-112 standard review
Eggs and death risk: small link mainly in American studies
Association of Egg Consumption with Risk of All-Cause and Cardiovascular Disease Mortality: A Systematic Review and Dose-Response Meta-Analysis of Observational Studies.
Overview
Ma W et al.. J Nutr 2022 · PMID 35524693 · DOI 10.1093/jn/nxac105
Each extra egg per day was linked to 6% higher all-cause mortality, but only in some subgroups.
Does the study support the specific claim? Partly · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Pool studies on eggs and mortality.
- How was the study done?
Dose-response meta-analysis.
- How many people, animals or samples were studied?
11.9 million participants.
- What was actually found?
Small association in subgroups.
- How large was the observed effect?
RR 1.06 (1.02-1.10) per egg/day.
- What do the results mean in everyday life?
Very high egg intake may be linked with slightly higher mortality in US populations.
- What are the study's limitations?
Subgroup-driven; observational.
- What does it say about Elawady's specific claim?
Partly supports the direction, not the size or generality.
- Do the results apply to Germany and Europe?
Uncertain.
- What can explicitly not be concluded from this study?
It cannot prove causation.
Scientific in-depth review
1. Full reference
- Authors
- Ma W et al.
- Journal
- J Nutr
- Year
- 2022
- Identifier
- PMID 35524693 DOI 10.1093/jn/nxac105
- Verification
- verified – PubMed efetch 2026-10-26; Crossref works API 2026-10-26
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
not stated in abstract
2. Research question
Is egg consumption associated with all-cause and CVD mortality?
3. Study design and population
- Study design
- Meta-analysis – Systematic review and dose-response meta-analysis of observational studies
- Population
24 articles, 48 reports, 11,890,695 participants
- Country
Multinational
- Period
Search to 3 November 2021
- Sample size
11,890,695
- Inclusion and exclusion criteria
not detailed in abstract
4. Methods and endpoints
- Exposure / intervention
Egg intake per 1 egg/day
- Comparator
Lower intake
- Endpoints
All-cause, CVD, ischaemic heart disease and stroke mortality
- Statistical methods
Random-effects; restricted cubic splines
5. Actual results
- Results
Per 1 egg/day: all-cause mortality RR 1.06 (1.02-1.10), restricted to women, Americans and studies adjusting for hyperlipidaemia; CVD mortality linear association only in participants >60 years, Americans, follow-up >=15 years and studies adjusting for hyperlipidaemia; no association with IHD or stroke mortality.
- Absolute risks
not reported
- Authors' conclusion
Egg consumption was linearly associated with modestly increased all-cause mortality; it may be prudent to avoid high egg consumption.
6. Strengths
- Very large pooled population
- Dose-response modelling
7. Weaknesses
- Subgroup-driven associations (multiplicity)
- Overlaps with Mousavi 2022 (I-EGG-05) and Zhao 2022
8. Risk of bias
- Orienting tool
- AMSTAR 2
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Abstract-level; observational inputs.
9. Assessment of the statistical interpretation
Small relative effect; associations limited to subgroups, which raises multiplicity and confounding concerns.
10. Relevance to the specific claim
Partial support for a modest mortality association, concentrated in US studies.
11. Independent contrary findings
Mousavi 2022 (I-EGG-05): no association highest vs lowest.
12. Transferability to Germany and Europe
Unclear.
13. Overall methodological judgement
Modest, subgroup-limited signal; overlaps with other meta-analyses.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | moderate |
| Directness | direct |
| Reproducibility | partly replicated |
| Consistency with the overall evidence | inconsistent |
| Regional transferability | moderate |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Role of accompanying foods.