Abstract
Background/Objectives: Eggs are an excellent nutritional source. However, historical associations of dietary cholesterol with serum cholesterol and cardiovascular disease, along with restrictive dietary guidelines may have been barriers to egg consumption. This study examines trends over time, patterns, and predictors of egg consumption in individuals followed for 48 years, and current barriers to usage. Methods: Participants were 6326 men and women enrolled in the Rancho Bernardo Study in 1972-1974 when asked about the number of eggs consumed/week. Subsequent egg intake was collected with food frequency questionnaires during clinic visits in 1988-1991 (n = 1627) and 1992-1996 (n = 1385), and with the original question on a 2021 mailed survey (n = 710), when barriers to intake were also queried. Results: The mean (±SD) number of eggs consumed was 3.6 ± 3.0 in 1972-1974, 1.8 ± 2.1 in 1988-1991, 1.8 ± 2.2 in 1992-1996, and 3.4 ± 3.5 in 2021. Comparisons within 5-year categories of enrollment age (<20, 20-24, 25-29, 30-34, 35-39, >40) showed no differences in egg intake between 1972 and 1974, and when older in 2021. Men consumed more eggs than women at all timepoints (p's < 0.0001). High cholesterol and taking cholesterol-lowering medication were associated with lower egg consumption in 1972-1974 (p's < 0.0001), but were not associated in 2021. Over 22% reported limiting egg intake in 2021; the majority cited cholesterol content of eggs or having high cholesterol as barriers. Conclusions: Egg consumption was responsive to dietary guidelines, decreasing over time then increasing by 2021 to levels similar to those of the early 1970s. Despite the abandonment of these guidelines, they continue to have a negative impact for a segment of society, suggesting the need for additional education on the health benefits of eggs.