The Association Between Egg and Egg-Derived Cholesterol Consumption, and Their Change Trajectories, with Obesity Among Chinese Adults: Results from the China Health and Nutrition Survey
Authors: Tang Tianhui , Chen Binghua , Hu Jiahao , Fan Hangzhao , Zhang Zilan , Zhai Tianyang , Li Chunxiao , Wang Duolao , Xue Wanli , Pei Leilei , Chen Fangyao , Mi Baibing , Zhao Yaling 
Published: January 2025

Background/Objectives: As a widely consumed, nutritious, and affordable food, eggs and their derivatives’ impacts on obesity remain inconclusive. In this study, we aimed to determine the association between egg and egg-derived cholesterol consumption, and their change trajectories, with obesity among Chinese adults. Methods: Longitudinal data collected by the China Health and Nutrition Survey from 1997 to 2015 were analyzed. The latent growth mixture model was used to identify eggs and egg-derived cholesterol consumption trajectories. Cox proportional hazard models with shared frailty were used to analyze the association between egg and egg-derived cholesterol consumption, and their change trajectories, with obesity. Results: Data from 10,971 and 9483 participants aged ≥18 years old were used for the analyses of general obesity and central obesity, respectively. Compared to participants with an average egg intake of 0.1–50.0 g/d during the follow-up period, adults who never consumed eggs or those with an average egg intake of 50.1–100.0 g/d and >100.0 g/d had a higher risk of general obesity, with hazard ratios (HRs) and 95% confidence intervals (CIs) of 1.31 (1.08, 1.58), 1.30 (1.07, 1.60), and 1.98 (1.17, 3.35), respectively, and had a higher risk of central obesity, with HRs (95% CIs) of 1.17 (1.04, 1.31), 1.31 (1.14, 1.50), and 1.64 (1.15, 2.36), respectively. Participants with a “Baseline Low-Significant Rising Pattern” or a “Baseline High-Rising then Falling Pattern” of egg consumption trajectories during the follow-up period had a higher risk of general obesity, with HRs (95% CIs) of 1.56 (1.25, 1.93) and 1.38 (1.13, 1.69), respectively, and central obesity, with HRs (95% CIs) of 1.47 (1.29, 1.68) and 1.52 (1.34, 1.72), respectively. Compared to the second quartile (Q2) group of the average egg-derived cholesterol intake during the follow-up period, Q1, Q3, and Q4 groups had a higher risk of general obesity, with HRs (95% CIs) of 1.28 (1.06,1.54), 1.21 (1.02, 1.44), and 1.43 (1.19, 1.71), respectively, and a higher risk of central obesity, with HRs (95% CIs) of 1.20 (1.08, 1.33), 1.11 (1.01, 1.23), and 1.32 (1.19, 1.46), respectively. Participants with a “Baseline Low-Significant Rising Pattern” or with a “Baseline High-Rising then Falling Pattern” of egg-derived cholesterol consumption during the follow-up period had a higher risk of general obesity, with HRs (95% CIs) of 1.54 (1.25, 1.92) and 1.37 (1.15, 1.64), respectively, and a higher risk of central obesity, with HRs (95% CIs) of 1.46 (1.28, 1.68) and 1.47 (1.32, 1.64), respectively. Conclusions: Both the insufficient and excessive intake of eggs and egg-derived cholesterol tended to be associated with a higher risk of general and central obesity. Suddenly increasing or consistently high levels of egg and egg-derived cholesterol intake seemed to be associated with a higher risk of obesity. To prevent obesity, people should consume a moderate amount of eggs and egg-derived cholesterol.