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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Bite Into Breakfast and You May Also Take a Bite Out of Diabetes

Today’s blog post is written by Allison Fischer, Dietetic Intern at Loyola University.

Enjoy!

By now you have most certainly heard that breakfast is the most important meal of the day. There are many benefits to eating breakfast – positive impacts on learning and memory, increased likelihood of meeting daily nutrient intake recommendations, lower BMI, and avoiding weight gain. Another study area is relationship between breakfast consumption and decreased risk of Type 2 Diabetes (TD2).

A recent study published in the American Journal of Clinical Nutrition examined the relationship between eating patterns and T2D risk in men. Almost 30,000 health professionals were followed twenty years and provided information regarding their medical histories, lifestyles and health related behaviors. Their diets were assessed according to reported foods eaten and dietary patterns based on when and how often they ate daily. Diet quality was reflected as a prudent diet (increased fruit, vegetable, fish, poultry, and whole grain consumption) or a Western diet (increased red and processed meats, French fries, high-fat dairy, refined grains, sweets, and dessert consumption). This information was then synthesized to evaluate health habits and diabetes risks.

Out of all the men in the study, 83% consumed breakfast. These men generally had healthier lifestyle factors – slightly lower BMIs, smoked less, exercised more, better diet quality, consumed less alcohol and more cereal fiber, and drank less coffee. After adjusting for age, there was a 50% greater risk for T2D in men who did not eat breakfast versus the men who did. This was significant even after adjusting for other dietary and T2D risk factors. Even after adjusting for BMI (well known to correlate with T2D risk), skipping breakfast resulted in a 21% greater risk. The most significant increased risk came from skipping breakfast and having a Western dietary pattern, than for each factor separately.

While there is still work to be done to better understand the link between breakfast and diabetes, here is just one more reason to encourage getting the day off to a healthful start. Be sure to fill your plate with healthy foods, including a quality protein, fruits or vegetables, low or no fat dairy and complex carbohydrates. Fuel yourself for a healthy day and a healthy future!

The Egg is Incredible

What makes them incredible? Eggs are one of nature’s most nourishing creations and an Egg A Day is OK for everyone! Eggs are an affordable, convenient source of high quality protein with varying amounts of the 13 essential vitamins and minerals. To top it off they are only 70 calories, so it is considered a nutrient dense food meaning a high amount of nutrition compared to their calorie content. In addition, scientists often use egg protein as the standard against which they judge all other proteins. Based on the essential amino acids it provides, egg protein is second only to mother’s milk for human nutrition. All this great nutrition for only 15 cents an egg!

Where are the nutrients in an egg-the white or an egg yolk? Here are some highlights: 60 % of the protein is found in the white and 40 % of the protein is in the yolk. However, many of the other key vitamins and minerals are found primarily in the yolk-choline, vitamin D, selenium, riboflavin, phosphorus, B12 and more. Cholesterol is also found in the yolk, but more than 40 years of research has shown that healthy adults can eat eggs without significantly affecting their risk for heart disease.

Happy Friday and check out the Facebook post from Incredible Edible Egg for a review of the lower cholesterol information as well as a recipe for mini breakfast pizzas.

Mythbusters: The Truth About Eggs

Wouldn’t it be fun to do the TV show Mythbusters but focused on Nutrition??

A recent “Eat this Not That” posting from Men’s Health looked at the Egg/Cholesterol myth. Kudos to them for busting the myth (you cannot eat eggs because of the cholesterol). As we say “An Egg a Day is OK!!” There are a multitude of studies showing this same message, but unfortunately consumers and even health professionals are still hesitant to eat eggs. So here’s to hoping these mythbusting messages continue to spread!

Here is an example of a study showing this message:

A study published in Medical Science Monitor including 9,500 people demonstrates that eating one or two eggs a day does not increase the risk of heart disease or stroke among healthy adults. The study notes that eating eggs may actually be associated with a decrease in blood pressure. Qureshi A, et al. “Regular egg consumption does not increase the risk of stroke or cardiovascular diseases. Medical Science Monitor. 2007; 13(1):CR1-8.”

Another parallel message to think about is the additional benefits an egg can offer. In the article they also mention weight management. Satiety/weight management is an area that is being actively researched. Other benefits from the varying 13 essential vitamins and minerals include muscle strength, healthy pregnancy, brain function and more.

Check out the information on “An Egg A Day” to share with patients and fellow health professionals. Also, we will be launching a new cholesterol specific section on our website in the future, so check back.

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