The effect of a high-egg diet on cardiovascular risk factors in people with type 2 diabetes: the Diabetes and Egg (DIABEGG) study—a 3-mo randomized controlled trial

Fuller, Nicholas R.; Caterson, Ian D.; Sainsbury, Amanda; Denyer, Gareth; Fong, Mackenzie; Gerofi, James; Baqleh, Katherine; Williams, Kathryn; Lau, Namson S; Markovic, Tania

doi:10.3945/ajcn.114.096925

Cited by 101 publications

(76 citation statements)

References 26 publications

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“…However, in subgroup analysis, high egg consumption has been associated with increased risk of IHD or overall CVD in diabetic patients (8)(9)(10). For example, in a meta-analysis by Shin et al 3 Assessed with the use of linear regression (continuous variables) or chi-square test (categorical variables). 4 Energy-adjusted (to 2000 kcal/d) with the use of the residual method (13).…”

Section: Discussionmentioning

confidence: 98%

“…2 The funders had no role in the design, implementation, analysis, or interpretation of the data, or in the decision to submit the paper for publication. 3 Supplemental Figure 1 is available from the "Supplemental data" link in the online posting of the article and from the same link in the online table of contents at http://ajcn.nutrition.org.…”

Section: Study Populationmentioning

confidence: 99%

“…However, findings from trials of the effects of high egg consumption on lipid profile concentrations have not been consistent. For example, a recent trial involving 140 overweight or obese individuals with prediabetes or type 2 diabetes observed no adverse effect from a diet high in eggs (2 eggs/d for 6 d/wk) on lipid profiles (3). Thus, better understanding of whether egg consumption is associated with risk of cardiovascular disease (CVD) 4 is of high public health relevance.…”

Section: Introductionmentioning

confidence: 97%

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Egg consumption and risk of heart failure, myocardial infarction, and stroke: results from 2 prospective cohorts

Larsson

Åkesson

Wolk

2015

The American Journal of Clinical Nutrition

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Section: Discussionmentioning

confidence: 98%

Section: Study Populationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

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Egg consumption and risk of heart failure, myocardial infarction, and stroke: results from 2 prospective cohorts

Larsson

Åkesson

Wolk

2015

The American Journal of Clinical Nutrition

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“…An extremely high intake of eggderived cholesterol (800 mg/d, 3-4 eggs/d) was shown to increase serum LDL-cholesterol in patients with type-1 diabetes, but not in type-2 diabetes (42) , a finding that has never been substantiated for lower, more physiological intakes of eggs in these different patient groups. A lack of effect of eggs on serum LDL-cholesterol in type-2 diabetes was reported in response to a high protein, energy-restricted diet that resulted in significant reductions in body weight, total serum cholesterol, non-HDL cholesterol and indices of glycaemic control after 12 weeks (43) , and also in the DIADEGG study, the largest egg intervention study to date in type-2 diabetes (44) . This study tested the effects of high egg diet (2 eggs/d for 6 d for 12 weeks) against a low egg diet (<2 egg/week), and showed no significant effects on body weight or biomarkers of CVD, including serum LDL-cholesterol.…”

Section: Impact Of Egg Feeding On Serum Ldl-cholesterol In Diabetesmentioning

confidence: 99%

Eggs: good or bad?

Griffin

2016

Proc. Nutr. Soc.

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Eggs have one of the lowest energy to nutrient density ratios of any food, and contain a quality of protein that is superior to beef steak and similar to dairy. From a nutritional perspective, this must qualify eggs as 'good'. The greater burden of proof has been to establish that eggs are not 'bad', by increasing awareness of the difference between dietary and blood cholesterol, and accumulating sufficient evidence to exonerate eggs from their associations with CVD and diabetes. After 60 years of research, a general consensus has now been reached that dietary cholesterol, chiefly from eggs, exerts a relatively small effect on serum LDL-cholesterol and CVD risk, in comparison with other diet and lifestyle factors. While dietary guidelines have been revised worldwide to reflect this view, associations between egg intake and the incidence of diabetes, and increased CVD risk in diabetes, prevail. These associations may be explained, in part, by residual confounding produced by other dietary components. The strength of evidence that links egg intake to increased CVD risk in diabetes is also complicated by variation in the response of serum LDL-cholesterol to eggs and dietary cholesterol in types 1 and 2 diabetes. On balance, the answer to the question as to whether eggs are 'bad', is probably 'no', but we do need to gain a better understanding of the effects of dietary cholesterol and its association with CVD risk in diabetes. Eggs: Dietary: Cholesterol: CVD: DiabetesAn egg is equipped to support life, with a profile of essential micronutrients that is unparalleled by any other food. Eggs are relatively low in energy (326·35 kJ (78 kcal)/medium egg) and saturated fat (1·7 g/medium egg) in comparison with other animal products, and can boast the highest quality of dietary protein, with certain dairy foods (1) . Eggs also represent the principal source of dietary cholesterol, which has been a major barrier to egg consumption, primarily because of the outdated, but popular misconception that egg cholesterol converts directly into serum cholesterol, and thus increased risk of CVD. While dietary and serum cholesterol are the same chemical entity, the concentration of serum cholesterol (LDL-cholesterol) falls under the physiological control of whole-body cholesterol homeostasis. This process can be influenced by numerous dietary factors, including dietary cholesterol and fatty acids, but depends ultimately on the essential requirement of cells for cholesterol, and reciprocal interplay between the biosynthesis of cholesterol in tissues, and absorption of cholesterol and bile acids in the gut.A growing body of evidence from prospective cohort studies (2)(3)(4) , systematic reviews and meta-analyses (5)(6)(7)(8) have culminated in a consensus that eggs, and dietary cholesterol derived from eggs, exert a relatively small and clinically insignificant effect on serum LDL-cholesterol in comparison with other lifestyle factors. In one study, modifiable lifestyle factors accounted for <40 % of CHD mortality, to which eating one eg...

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“…Although some studies indicate that more egg consumption in patients with diabetes results in more CAD events (11,14,15), this relation has been questioned (16). Moreover, in a randomized controlled 3-mo trial of 2 eggs/d for 6 d/wk in patients with type 2 diabetes there was no adverse effect on lipid profile when the diet included a higher content of MUFAs and PUFAs (17). Of interest, however, are the results from the recent IMProved Reduction of Outcomes: Vytorin Efficacy International Trial, which showed in patients with diabetes a particularly pronounced beneficial effect of ezetimibe (a drug that inhibits intestinal absorption of cholesterol) 1 simvastatin compared with simvastatin alone on CVD events (18).…”

Section: Is Diabetes Different?mentioning

confidence: 93%