Home » MBJ FEATURE » Industry expects little sales impact from JAMA study linking egg consumption to cardiovascular disease

Industry expects little sales impact from JAMA study linking egg consumption to cardiovascular disease


Mickey Rubin

Mark Leggett

Cal-Maine Foods, Inc., the largest producer of shell eggs in the U.S., sold approximately 1,037.7 million dozen shell eggs in fiscal 2018, representing about 20 percent of the domestic egg production. But how will sales of eggs from Cal-Maine Foods and other suppliers be affected by a report March 19 in the Journal of American Medicine (JAMA) that higher consumption of dietary cholesterol or eggs was “significantly associated with higher risk of incident cardiovascular disease (CVD) and all-cause mortality in a dose-response manner?”

JAMA also had a strongly worded editorial cautioning about egg consumption: “In this issue of JAMA, Zhong and colleagues report new insights about a controversial topic, the association of egg consumption and dietary cholesterol with cardiovascular CVD incidence and all-cause mortality. Clearly, the topic of this study is important to clinicians, patients, and the public at large because the association of egg consumption and dietary cholesterol with CVD, although debated for decades, has more recently been thought to be less important. Compared with the meta-analyses and reviews previously published, this report is far more comprehensive, with enough data to make a strong statement that eggs and overall dietary cholesterol intake remain important in affecting the risk of CVD and more so the risk of all-cause mortality.”

Mark Leggett, president, Mississippi Poultry Association, said eggs are a healthy and safe food.

“The U.S. Dietary guidelines say that eggs are good for you, and a reasonably priced form of protein,” Leggett said. “Most studies show egg intake does not negatively affect cardiovascular health. Observational studies like this that require people to remember what they eat are suspect because people won’t always recall that accurately.”

The study was described as “a bit of an outlier” by Dr. Mickey Rubin, executive director of the Egg Nutrition Center that is the science and education division of the American Egg Board.

“I’m a scientist so I look at the scientific literature,” Rubin said. “You really need to look at where this study fits in the broader context. Most research from the past couple decades shows that eggs are part of healthy eating patterns. There were many studies done that were the impetus for changing U.S. dietary guidelines to stop saying dietary cholesterol was a nutrient of concern.”

Nutrients of concern are those health authorities believe Americans are getting too much or too little of.

Rubin said the recent study published in JAMA was of studies that were observational in nature.

“One of the things about observational studies is they don’t show cause and effect,” he said. “You don’t know what other cardiovascular risks study participants had. In studies like these, it is very difficult to separate out other factors that might be contributing to heart disease such as nutrition, genetics, and lifestyle factors like exercise and smoking. And the results were not very robust. There was only a small association. So, when you see an outlier study that says one thing when most of the other studies are saying something different, you have to decide: Is this really something we should change our thinking on? It is important to look at many different studies over many different types of populations.”

Rubin said these types of studies are good indicators of relationships, but do not show pure cause and effect.

“There were a lot of things about the study that didn’t make it as strong as it could have been,” Rubin said. “Other studies on eggs and cholesterol have been more robust.”

As part of the American Egg Board’s ongoing consumer tracking studies, when the recent study was published, people were surveyed to see if they had heard about the study and if it affected their perception of the impact of eating eggs. About three-quarters of the people said they are not limiting eggs and are not concerned about the impact of eggs on their health. About 27 percent viewed the news as favorable about eggs, and for 56 percent it had no impact.

About 17 percent reported a negative reaction to the study, but those 17 percent were already more likely to be infrequent egg consumers.

Rubin thinks the public views “the study of the day”, especially when it contradicts previous studies, with skepticism.

“The public is smarter than that,” Rubin said. “They are looking at things in a broader context. They are not going to change their thinking just because of one study.”

Based on the consumer surveys, Rubin said they don’t expect a big impact on egg sales.

“Eggs are a nutrient rich food that fit into a number of healthy diet patterns,” he said. “They go great with things like salads. They provide a nutrient package you can’t get anywhere else. And at a cost of only 15 cents for one large egg, this is also an inexpensive source of protein and important nutrients. It is an enjoyable food that fits in a lot of places. The whole egg is really quite a package.”

Rubin said one previous meta-analysis on the topic of eggs and cholesterol looked at 16 studies with almost 350,000 individuals and showed no relationship between eggs, cholesterol and heart disease risk.

“Larger strong studies didn’t show the same results as this current one,” Rubin said.

Rubin said additional studies have shown small, but statistically significant,  favorable relationships with egg consumption and cardiovascular risk in non-U.S. cohorts, while randomized controlled trials consistently show egg intake does not negatively impact cardiovascular disease risk factors.

“The fact that studies outside the U.S. appear to show favorable relationships with egg intake and cardiovascular risk may speak to the importance of what other foods are consumed with eggs as part of the overall diet pattern, as recent research has demonstrated the importance of separating eggs from other foods to understand their independent impact on health outcomes,” Rubin said.

Dolph Baker, chairman and chief executive officer of Cal-Maine Foods, Inc., said in a press release that egg consumption has been strong throughout fiscal 2019 with near record per capita egg consumption.


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About Becky Gillette