(P26-36-26) Egg Intake Modifies the Association Between Meat Consumption and Cardiovascular Disease Risk: Results From the Adventist Health Study-2 Linked With Medicare Data

Objectives: To examine how egg intake frequency modifies the association between meat consumption and incident cardiovascular disease (CVD) in a population with wide variation in animal‑sourced food intake.

Methods: We analyzed data from 36,311 adults in the Adventist Health Study‑2, a prospective cohort of U.S. Seventh‑day Adventists, linked with Medicare claims to identify incident CVD. Diet was assessed at baseline using a validated food frequency questionnaire. Egg intake was categorized from never/rarely to ≥5 times/week. Meat intake was modeled at 0, 10, 30, and 100 g/day. Over a mean 15.7 years of follow‑up, 12,723 incident CVD cases were identified. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated for each egg–meat combination, using extensively covariate-adjusted Cox proportional hazards models. Interaction was evaluated on a multiplicative scale.

Results: We observed a statistically significant egg × meat interaction (p=0.025). Higher meat intake was associated with increased CVD risk across all egg intake categories. Among participants who did not consume eggs, CVD risk increased with meat intake from HR 1.05 (95% CI, 1.03–1.07) at 10 g/day to HR 1.68 (95% CI, 1.38–2.05) at 100 g/day. Across all meat levels, individuals who consumed eggs more frequently tended to have lower CVD risk than those who did not consume eggs. At 100 g/day of meat, CVD risk was significantly elevated across all egg intake categories; although trends were less consistent, the contrast between HR 1.68 (no eggs) and HR 1.19 (≥5 eggs/week) suggests that egg intake may still attenuate risk even at high meat consumption. Trend analyses showed a dose‑response increase in CVD risk with higher meat intake (p-trend, < 0.0001-0.008) and consistent inverse trends with more frequent egg intake (p-trend, 0.009-0.01).

Conclusions: In this health‑conscious cohort, meat consumption demonstrated a clear dose‑response relationship with higher CVD risk. Within the cohort’s modest range of egg consumption, more frequent egg intake was associated with lower CVD risk across all meat intake levels, though not enough to offset the substantial elevation associated with high meat consumption. These findings highlight the importance of considering combined dietary exposures when evaluating CVD risk in older adults.

Funding Sources: NIH/NCI and American Egg Board