Egg consumption and CHD and stroke mortality: a prospective study of US adults

Section/ Ite
Topic m Recommendation Reported on page #
#
Title 1 (a) Indicate the Baby Nutritional Status Improvement
and study’s design with Through Mother Empowerment in Baby
abstract a commonly used Care in South Sulawesi Indonesia
term in the title or
the abstract
(b) Provide in the a. purpose : “to identify the effectiveness
abstract an of mother empowerment in caring for
informative and babies of 0-6 months by providing health
balanced summary education with modeling approach.”
of what was done b. the methode and result : “Used quasi-
and what was experimental pre-post control group
found design.” And “the results of this study at
month 1 showed no significant difference
in body weight/shoulder lenght, at 6
months old, there were significant
difference in body weight/lenght, but
there is no significant difference in the
LK/U.”
c. the conclusion : “it is that increasing
mother empowerment through health
education improves infant growth”
d. Keywords : “mother empowerment,
baby nutrition status, health education,
modeling approach.”
Introduction
Backgro 2 Explain the The quality of baby growth at critical
und/ratio scientific times is influenced both by genetic and
nale background and enviorenment factors.
rationale for the
investigation being
reported
Objectiv 3 State specific a. “to identify the effectiveness of
es objectives, maternal empowerment through the
including any pre- provision of health education with a
specified modeling approach to the
hypotheses anthropometric status of babies 0-6
months of age.”
Methods
Study 4 Present key The study design is “quasi experimental
design elements of study pre-post with control group design.”
design early in the
paper
Setting 5 Describe the “ This study was conducted in Maros.
setting, locations, Overall, the maternal sample was 81
and relevant dates, people, consisting of 41 people in the
including periods intervention group and 40 people in the
of recruitment, control group. The methods used in
exposure, follow- health education were demonstration, re-
up, and data demonstration and simulation, while the
collection tools used were leaflets, flipcharts and
pantom. The modeling learning process
had four phases: Attention, retention,
reproduction and motivation. Most of the
phase was the learner internal process in
social learning. The research instruments
used in this study were questionnaire and
observation sheets. The measured
variable was the baby anthropometric
data, consisting of weight, body length
and head circumference. Univariate and
bivariate data analyses were performed to
see the general description of each
variable along with its distribution and
frequency, such as gender and age and
consider the relationship between nutrient
intake and nutritional status.”

But there is no data for period of

recruitments and follow up data.
Participa 6 (a) Cross-sectional Did not found
nts study—Give the
eligibility criteria,
and the sources and
methods of
selection of
participants
(b) Case-control The criteria for the present study, “are
study—For using lactation management
matched studies, (breastfeeding) modules given at the end
give matching of the third trimester of pregnancy. Health
criteria and the education II, using the growth and
number of controls
development stimulation module 1
per case
(babies 0-3 months), was given in the
first week post-partum and health
education III, using growth stimulation
module 2 (babies 3-6 months) was given
when the babies are aged (3 months)”
Variable 7 Clearly define all For this asnwer in study population of
s outcomes, methods in third paragraph and in
exposures, statistical analyses in first paragraph.
predictors,
potential
confounders, and
effect modifiers.
Give diagnostic
criteria, if
applicable
Data 8* For each variable For the egg consumption using the
sources/ of interest, give question is ‘How many times over the
measure sources of data and past month have you consumed eggs
ment details of methods including scrambled, fried, omelettes,
of assessment hard-boiled and egg salad’For the
(measurement). Statistical analyses, Egg consumption
Describe was calculated by dividing the number of
comparability of reported eating occasions (EO) per month
assessment by 30 d toget an estimate of the typical
methods if there is number of EO per day.
more than one
group
Bias 9 Describe any -
efforts to address
potential sources of
bias
Study 10 Explain how the -
size study size was
arrived at
Quantita 11 Explain how -
tive quantitative
variables variables were
handled in the
analyses. If
applicable, describe
which groupings
were chosen and
why
Statistica 12 (a) Describe all -
l statistical methods,
methods including those
used to control for
confounding
(b) Describe any -
methods used to
examine subgroups
and interactions
(c) Explain how -
missing data were
addressed
(d) Cohort study— -
If applicable,
explain how loss to
follow-up was
addressed
Case-control study
—If applicable,
explain how
matching of cases
and controls was
addressed
Cross-sectional
study—If
applicable, describe
analytical methods
taking account of
sampling strategy
(e) Describe any -
sensitivity analyses
Results
Participa 13 (a) Report numbers in our study population stratified by egg
nts * of individuals at consumption category is presented in
each stage of study
 —eg numbers Table 1. ‘High’ egg consumers ($7
potentially eligible, EO/week) were more likely to have
examined for diabetes, have fewer years of
eligibility, education,be current smokers and less
confirmed eligible, likely to be white (non-Hispanic). In the
included in the
stroke analysis in men, there was a
study, completing
follow-up, and significant reduction in the risk of
analysed mortality among the highest egg
consumers comparedwith the lowest after
adjustment for baseline marital status,
education level, smoking status
(current/past v. never), baseline BMI,
WHR, hypertension and type 2 diabetes
mellitus (HR50?31, 95% CI 0?12, 0?78)
and dietary variables (HR50?27, 95% CI
0?10, 0?73).
(b) Give reasons The participant did not observe an inverse
for non- association between ‘high’ egg
participation at consumption and stroke
each stage mortality among women.
(c) Consider use of
a flow diagram
Descripti 14 (a) Give Characteristics for participant ofthis study
ve data * characteristics of are a men, adjustment for age and energy,
study participants additional adjustment for baseline marital
(eg demographic, status, education level and smoking
clinical, social) and status,.
information on
exposures and
potential
confounders
(b) Indicate number In this study not able to stratify the
of participants with present analysis by gender because of the
missing data for small sample size and limited covariate
each variable of adjustment to age, energy intake and
interest gender.
(c) Cohort study— -
Summarise follow-
up time (eg,
average and total
amount)
Outcome 15 Cohort study— -
data * Report numbers of
outcome events or
 summary measures
over time
Case-control study -
—Report numbers
in each exposure
category, or
summary measures
of exposure
Cross-sectional The adjusted HR comparing the highest
study—Report egg consumers to the lowest were 0?97
numbers of (95% CI 0?40, 2?39) for CHD mortality
outcome events or and 0?32 (95% CI 0?07, 1?42) for stroke
summary measures mortality.
Main 16 (a) Give unadjusted The answer is in last paragraph of result.
results estimates and, if “When we restricted the analysis to men
applicable, and women with self-reported type 2
confounder- diabetes, we did not observe a significant
adjusted estimates association between egg consumption and
and their precision
CHD or stroke mortality (Table 4). We
(eg, 95%
confidence were not able to stratify the present
interval). Make analysis by gender because of the small
clear which sample size and limited covariate
confounders were adjustment to age,energy intake and
adjusted for and gender. The adjusted HR comparingthe
why they were highest egg consumers to the lowest were
included 0?97 (95% CI 0?40, 2?39) for CHD
mortality and 0?32 (95% CI 0?07, 1?42)
for stroke mortality.”
(b) Report category
boundaries when
continuous
variables were
categorized
(c) If relevant,
consider translating
estimates of
relative risk into
absolute risk for a
meaningful time
period
Other 17 Report other -
analyses analyses done—eg
analyses of
subgroups and
 interactions, and
sensitivity analyses
Discussion
Key 18 Summarise key In this study is founded that self-reported
results results with egg consumption frequency was not
reference to study associated with increased mortality from
objectives CHD or stroke in men or women after
adjustment for established risk factors. In
addition, and it did not observe increased
CHD or stroke mortality among diabetics
with ‘high’ egg consumption (v. ‘low’) in
subgroup analyses
Limitati 19 Discuss limitations The discuss limitations of the study in
ons of the study, taking paragraph sixof discussion “An inherent
into account limitation in the data set and our analysis
sources of potential is the use of 24 h recall to assess dietary
bias or imprecision. and nutrient intake associated with a
Discuss both chronic outcome. Egg consumption was
direction and based on ‘usual’ consumption patterns
magnitude of any reported through a 30 d FFQ, while the
potential bias other dietary variables were based on
what the individual reported consuming
on a particular day.”
The major limitation of the 24 h recall
method is related to the variation from
day to day, making it impossible to
identify a representative day(43) the
result in the study different with other
research, the examples A review of
epidemiological studies by Kritchevsky
and Kritchevsky(21) concluded that there
was no significant positive association
between consuming one or more eggs per
day and CHD events, after adjustment for
dietary confounders in addition to other
known risk factors and Using data from
the Physicians’ Health Study I (1981), a
randomized, double-
blind,placebocontrolled clinical trial
designed to study the use of lowdose
aspirin and b-carotene for the prevention
of CVD and cancer, Djousse´ and
Gaziano(19) evaluated the association
 between egg consumption and risk of
incident stroke, myocardial infarction
(MI) and death. That study found no
evidence of a significant positive
association between egg consumption and
incident MI or strokes.
Interpret 20 Give a cautious This study “did not observe increased
ation overall CHD or stroke
interpretation of mortality among people with diabetes;
results considering however, the study
objectives, power to detect an association was
limitations,
limited by the relatively
multiplicity of
analyses, results smaller number of observed cases and the
from similar relatively short
studies, and other duration of follow-up.”
relevant evidence “An inherent limitation in the data set and
our analysis is the use of 24 h recall to
assess dietary and nutrient intake
associated with a chronic outcome. Egg
consumption was based on ‘usual’
consumption patterns reported through a
30 d FFQ, while the other dietary
variables were based on what the
individual reported consuming on a
particular day.”
Generali 21 Discuss the The general of this discussion in six
sability generalisability paragraph of discussion “We observed a
(external validity) statistically significant reduction in stroke
of the study results mortality among men reporting ‘high’ egg
consumption. A similar inverse
association was observed by Sauvaget et
al.(24) with the evaluation of the
relationship between consumption of
animal products, including eggs, and
stroke using data from the Life Span
Study that followed survivors of the
Hiroshima/Nagasaki bombings. They
found a significant reduction in risk
among men and women reporting almost
daily egg consumption (RR50?70, 95%
CI 0?51, 0?95) after adjusting for sex,
birth cohort, city, radiation dose, BMI,
smoking, alcohol, education, diabetes and
hypertension(35).......”
Other information
Funding 22 Give the source of The present study was funded by the Egg
funding and the Nutrition Center (C.G.S., L.M.B. and
role of the funders N.L.T.) and National Institutes of Health
for the present 268 CG Scrafford et al. Training Grant
study and, if T32HD046405 (C.G.S).
applicable, for the
original study on
which the present
article is based