Cardiometabolic Health

Cardiometabolic health is a relatively new term that encompasses cardiovascular and metabolic diseases, including type 2 diabetes and metabolic syndrome. Collectively, such conditions are the leading cause of preventable death worldwide. They all share similar risk factors (e.g., overweight/obesity, elevated blood pressure) which can be modified by diet and lifestyle choices. The available evidence indicates that eggs, when consumed as part of an overall healthy diet pattern, do not affect risk factors for cardiometabolic disease. Recent recommendations from the American Heart Association, American College of Cardiology and American Diabetes Association do not limit egg or cholesterol intake, a change from earlier guidance from these organizations. In fact, several global health organizations, including Health Canada, the Canadian Heart and Stroke Foundation, the Australian Heart Foundation and the Irish Heart Foundation, promote eggs as part of a heart-healthy diet.

Given the public health significance of understanding cardiometabolic diseases, research on risk reduction remains an active area of pursuit. For example:

  • A randomized controlled study in people with metabolic syndrome showed that those consuming three whole eggs per day as part of a reduced carbohydrate diet experienced favorable changes in HDL-cholesterol, insulin sensitivity, and other aspects of the lipoprotein lipid profile
  • A randomized controlled weight loss trial in people with diagnosed type 2 diabetes showed improved lipid and glucose markers following consumption of 2 eggs per day for 12 weeks.
  • An egg-based breakfast, rich in protein (35% energy; 26.1 g egg protein), promoted glycemic control in people with type 2 diabetes and pre-diabetes relative to a high-carbohydrate breakfast.

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Taking Sodium with a Grain of Salt

~Marcia

Has sodium been getting a bad rap?  A new study would have you believe so. As a dietitian who has worked with hundreds of people who have diabetes and/or heart disease, I’ve probably talked myself blue about the importance of cutting back on sodium.  The reality is that it’s hard to eat less. Wouldn’t it be great if we could start shaking salt on our foods again or reach for a handful of potato chips without feeling twinges of guilt?

To be fair, sodium isn’t all that bad.  After all, it’s needed to help regulate fluid balance in the body.  And our kidneys do a great job of controlling how much sodium we keep in our bodies, excreting any in the urine.  But in the even that your kidneys aren’t working so well (maybe due to diabetes, for example), sodium tends to stick around, making it harder for your heart to pump and raising blood pressure.

salt

The 2010 Dietary Guidelines for Americans tell us that we’re supposed to reduce our sodium intake to less than 2300 milligrams (mg) per day – that’s about a teaspoon of salt. Most of us consume at least 3400 mg per day.  If you happen to be over the age of 51, and or African American or have high blood pressure, diabetes or chronic kidney disease (which is about half of the American population) your goal is no more than 1500 mg per day.  Most of our sodium comes from processed foods such as cold cuts, hot dogs, canned soup, cheese and pizza.  Even some cereals, salad dressings and desserts are surprisingly high in sodium.

A study published in the May 4 issue of the Journal of the American Medical Association begs to differ with the whole notion that too much sodium can cause problems. The authors of this study followed almost 3,700 European men and women for eight years, measuring urine sodium excretion, blood pressure and cardiac events, such as heart attack, heart failure and stroke. The results? The people who excreted the lowest amount of sodium in their urine were 56% more likely to die from heart disease compared to those excreting higher amounts of sodium.  (Keep in mind that the more sodium you consume, the more you lose in your urine). And the amount of sodium excreted seemed to have little effect on blood pressure.

These findings go against the grain of what dietitians, physicians and other health professionals have been telling us for years: too much sodium may raise blood pressure, which in turn, may increase your risk of having a heart attack or stroke.  But, as with many studies, there were some weaknesses with the study, including a small sample size and the fact that other factors weren’t considered, such as physical activity and calorie intake.

What does this mean for you?  It’s hard to ignore the many other, well-designed studies linking a high sodium intake with high blood pressure.  And since one in three Americans has high blood pressure, it makes sense, at least at this time, to cut back on sodium, along with reaching a healthy weight and fitting in more physical activity. So, as tempting as it may be to reach for the salt, my advice is to keep the salt shaker in the cupboard and grab the pepper mill instead!

Experimental Biology – Washington, D.C.

I just returned from the Experimental Biology meetings, which were held in Washington D.C. Experimental Biology is one of the largest biology/nutrition research meeting of its kind in the world. It’s an excellent way to stay abreast of current research, a good deal of which will ultimately lead to tomorrow’s health and nutrition recommendations.

At this year’s meeting the Egg Nutrition Center sponsored a symposium on dietary cholesterol. The key issue we delved into at the session was the true health implications of dietary cholesterol, and whether or not the cholesterol that we eat is as harmful as many health care professionals have been suggesting for the past 50 years or so. I was pleased to chair the session. Our four presenters were Dr. Penny Kris-Etherton from Penn State University; Dr. David Katz from Yale University, Dr. Maria Luz-Fernandez from the University of Connecticut; and Dr. Kasey Vickers, a post doctoral research fellow from the National Heart, Lung, and Blood Institute (NHLBI) at the NIH. All four are well published, acknowledged experts in the areas of disease prevention, nutrition, cholesterol metabolism and health.

Among other key points, Dr. Fernandez brought up the fact that the original dietary recommendation for daily cholesterol intake (<300 mg/d) was based largely on extrapolations from animal studies and human epidemiologic data, and that few studies have actually demonstrated significantly adverse health effects when cholesterol is consumed in that range. Dr. Katz made similar assertions, and he indicated that his research has shown that higher than average daily cholesterol intake does not have negative effects on the vasculature or on other markers of cardiovascular disease, even in patients with existing coronary artery disease.

Our ultimate goal is to generate a manuscript based on the presentations that we submit for publication to a medical journal sometime in the near future.

The symposium generated a lot of spirited discussion and questions from the researchers in the audience. All-in-all, it was an informative and enjoyable session that I was happy to have had the opportunity to participate in

 

 

Incredible Launch of Lower Cholesterol and Vitamin D News

Just returned from a great couple of days in New York City, where AEB/ENC hosted a luncheon event for editors of many of the major health magazines located in NY, as well as a promotional event at Grand Central Station in Manhattan. The primary reason for hosting these activities was to announce the new USDA results indicating that eggs have 14% less cholesterol than previously reported. But, as often happens at these sorts of gatherings, we discussed a number of other topical issues as well with the editors and with consumers at the Grand Central Station event.

The Editors Luncheon consisted of presentations by Dr. David Katz from Yale Griffin Hospital and me. Dr. Katz discussed issues pertaining to diet, cholesterol intake and cardiovascular health. His presentation helped to dispel many of the myths surrounding dietary cholesterol intake and CHD. My presentation focused more on protein needs, and some of the newer literature linking protein intake to satiety and food intake. I also discussed our emerging understanding of macronutrient intake in general, and how former recommendations for carbohydrate intake vs. protein and fat needs were being challenged a bit by newer data indicating a greater need for protein throughout the day, and particularly at the breakfast meal.

At the Grand Central Station event, commuters on their way to and from work stopped by to eat a free egg meal, to participate in a program in which egg farmers donated eggs to the needy, and to meet with egg farmers and nutrition specialists from The Egg Nutrition Center. A lot of insightful questions were posed by the attendees about chicken feed, humane treatment of animals, and dietary needs in relation to health conditions.

All-in-all, a rewarding and fun couple of days. A great way to share new news about diet and health.

– Mitch

New USDA Analysis: Egg are 14% Lower in Cholesterol

There are many who think our food supply is unhealthy and getting more so. But, according to new United States Department of Agriculture (USDA) nutrition data, www.ars.usda.gov/nutrientdata many of our naturally produced foods are actually healthier than during our parent’s childhood. Beef and pork cuts are leaner, lower fat choices of milk and cheese are widely available and now the egg, already low in saturated fat, has been found to be lower in dietary cholesterol and qualifies as a good source of vitamin D. The USDA recently reviewed the nutrient composition of standard large eggs, and results show the average amount of cholesterol in one large egg is 185 mg, 14 percent lower than previously recorded.   The analysis also revealed that large eggs now contain 41 IU of Vitamin D, an increase of 64 percent.

This is wonderful news, since for a long time public health organizations have been continuing to advise people to restrict their dietary cholesterol based on old, less sophisticated research techniques than those used by scientists today. Unlike most countries around the globe who have looked at the science and decided that the evidence is lacking to continue to confuse people with guidance which restricts dietary cholesterol , the US continues to include a 300mg dietary cholesterol restriction in its dietary guidelines. The good news is that it is so much easier to include the many beneficial nutrients that an egg supplies in your diet daily without having to consider your dietary cholesterol intake. Unless of course, you often consume foods containing a great deal of solid fats and added sugar which unlike eggs and seafood that are naturally low in unhealthful fats and added sugars, can complicate your heart disease risk.  One look at the nutrition facts panel, and it’s easy to see why eating an egg daily is a healthy practice that our grandparents understood and valued.

-Marcia

Breakfast is important; tips for making it nutritious


breakfast egg bagel

An article posted the other day in the Washington Post, Consumer Reports Insights: Breakfast is important; tips for making it nutritious, discusses the importance of the breakfast meal. With respect to eggs, the author states, “…having (eggs) at breakfast helps dieters lose weight … possibly because they’re so filling that they reduce the chance of overeating later. People with normal levels of LDL (bad) cholesterol who limit their intake of saturated fat can safely eat up to seven eggs a week; those with high LDL should limit themselves to four, or use egg whites or an egg substitute.” Recent research conducted at the University of Connecticut and Louisiana State University, among other places, supports the author’s contentions.

In addition, newer data from the University of Illinois indicates not only the importance of eating breakfast, but also the importance of consuming adequate protein during the breakfast meal to support muscle growth and repair. The typical American eating pattern consists of marginal protein intake at breakfast and lunch, with the largest amount of protein consumed doing the dinner meal. Researchers suggest that protein intake should be spread more evenly throughout the day, with similar quantities (some say as much as 30g per meal) consumed at breakfast, lunch, and dinner. Eggs are a great way to ensure optimal protein intake during the breakfast meal.