Background: Increasingly the potential harm from high cholesterol intake, and specifically from egg yolks,is considered insignificant. We therefore assessed total plaque area (TPA) in patients attending Canadianvascular prevention clinics to determine if the atherosclerosis burden, as a marker of arterial damage,was related to egg intake. To provide perspective on the magnitude of the effect, we also analysed theeffect of smoking (pack-years).Methods: Consecutive patients attending vascular prevention clinics at University Hospital had baselinemeasurement of TPA by duplex ultrasound, and filled out questionnaires regarding their lifestyle andmedications, including pack-years of smoking, and the number of egg yolks consumed per week timesthe number of years consumed (egg-yolk years).Results: Data were available in 1262 patients; mean (SD) age was 61.5 (14.8) years; 47% were women.Carotid plaque area increased linearly with age after age 40, but increased exponentially with pack-yearsof smoking and with egg-yolk years. Plaque area in patients consuming <2 eggs per week (n ¼ 388) was125 129 mm2, versus 132 142 mm2 in those consuming 3 or more eggs per week (n ¼ 603);(p < 0.0001 after adjustment for age). In multiple regression, egg-yolk years remained significant afteradjusting for coronary risk factors.Interpretation: Our findings suggest that regular consumption of egg yolk should be avoided by personsat risk of cardiovascular disease. This hypothesis should be tested in a prospective study with moredetailed information about diet, and other possible confounders such as exercise and waistcircumference.
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