Eggs Across The Lifespan

Eggs contain a number of nutrients that are essential throughout the lifespan:

  • High-quality protein contains building blocks needed to support healthy bones and muscles. Research suggests that exercise, along with optimal protein intake, can slow the effects of sarcopenia or chronic age-related muscle loss.
  • Choline is essential for normal liver function and brain health. It is especially important during pregnancy to support normal fetal growth and development, and most pregnant women do not consume adequate amounts of choline. Consuming eggs during pregnancy is one solution to choline consumption issues.
  • Lutein and zeaxanthin are antioxidants that are believed to reduce the risk of developing cataracts and slow the progression of age-related macular degeneration, a disease that develops with age.

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CPE Webinar Opportunity – Building an “Optimal Diet”: Putting Protein into Practice

Stu-Phillips-Headshot

ENC has partnered with Academy of Nutrition and Dietetics’ SCAN (Sports, Cardiovascular, and Wellness Nutrition) Dietary Practice Group to offer a continuing education webinar titled Building an “Optimal Diet”: Putting Protein into Practice, presented by Dr. Stuart Phillips.

Dr. Phillips is a professor at McMaster University and one of the leading investigators in the field of exercise metabolism. His work focuses on the impact of nutrition and exercise on human skeletal muscle protein turnover. During the webinar, he discusses protein needs and timing of intake for maximum muscle growth and maintenance for athletes and the aging population. Additionally, he elaborates on how protein quality plays a major role in muscle anabolism. To close his talk, Dr. Phillips shares suggestions for practical applications of the latest protein research, including recommending natural protein sources with high biological value, such as eggs and milk, to help health professionals to make up-to-date diet recommendations to their clients and patients.

The webinar is approved by the Commission on Dietetic Registration (CDR) for 1 CPEU and is free of charge throughout the month of July. To receive the CPEU, SCAN members and non-members must log into the SCAN website to order and view the webinar.

Observations from Experimental Biology 2014

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Today’s post comes from guest blogger, Apeksha Gulvady, PhD. Apeksha holds an MA and PhD in Nutritional Sciences from the University of Texas in Austin, where her research focused on the role of aging and diet-induced obesity on immune cell function. Apeksha previously worked with PepsiCo R&D, where she supported core nutrition business activities and priorities in both global foods and beverages, and has recently joined Edelman Public Relations to pursue her passion for nutrition communications.

For years, a single nutrient paradigm laid the foundation for the efforts of nutrition science to target nutrient deficiencies. As associations between lifestyle factors and chronic diseases became more evident, the focus of research fittingly transitioned from individual nutrients to foods as carriers of these nutrients, and finally to dietary patterns of food intake that can potentially impact health. Studies on protein advanced similarly and earned their way onto the dais at the 2014 Experimental Biology (EB) conference – the world’s largest life sciences annual meeting, comprised of 24,000+ scientific researchers, federal regulators, consumer groups and industry representatives.

After four exciting days at the conference in San Diego this year, attendees’ brains were brimming with information about the power of protein in the diet, among other key topics. Protein sessions were some of the best attended sessions overall, suggesting that protein research remains of prime interest to the nutrition science community. Protein studies, several of which were supported in part or full by the ENC research grant program, pointed to how adjustment of both quality and quantity of this macronutrient can bring about small but meaningful changes in metabolism and body composition.

In one study presented at EB 2014, egg protein, when consumed for breakfast, was shown to affect postprandial energy metabolism and provide increased satiety in overweight children.1 Protein, therefore, may play a key role in weight management. Another study demonstrated that consumption of one egg per day did not influence blood lipid levels in diabetic patients. Egg protein was thus concluded to not increase risk for cardiovascular disease in the study population.2

Beyond protein, evidence from a meta-analysis of dietary cholesterol and heart health suggested that previously declared correlations between dietary cholesterol consumption and heart disease may be unfounded.3 Researchers also investigated the effects of differential macronutrient distribution in the diet and found that lowering carbohydrate intake had the potential to decrease insulin resistance4 and accelerate fat oxidation.5 Exploring the link between diet, diabetes and cardiovascular disease, an animal study found whole egg protein increased blood vitamin D concentrations and favorably affected physiologic diabetic dysfunctions.6 And in another study of nutrient adequacy, eggs were found to potentially positively impact serum levels of certain carotenoids.7

As presented at the 2014 EB conference, current evidence thus suggests that consuming eggs as a source of high-quality protein may assist in weight loss, improve disease risk factors and promote intakes of certain nutrients. However, whether the aforementioned effects can be sustained over time warrants additional investigation.

References:

  1. Binns A, Gray M, Seo H-S, Zhang B, Luckett C, Smith K, Baum JI. Consumption of an egg-based breakfast reduces hunger and increases postprandial energy metabolism in normal weight (NW) and overweight (OW) school-aged children. FASEB J. 2014;28(1S):381.4.
  2. Ballesteros MN, Valenzuela F, Robles A, Artalejo E, Valdez H, Fernandez ML. One egg a day does not increase the risk for cardiovascular disease in diabetic patients. FASEB J. 2014;28(1S):381.5
  3. Berger SE, Raman G, Vishwanathan R, Jacques P, Johnson EJ. Dietary cholesterol and heart health: a systematic review and meta-analysis. FASEB J. 2014;28(1S):267.6.
  4. Watkins BA, Pappan KL, Kim J, Freidenreich D, Kunces L, Volk B, Saenz C, Volek J. Carbohydrate feeding and impact on global metabolomics in relation to insulin sensitivity in men with metabolic syndrome. FASEB J. 2014;28(1S):248.8.
  5. Kunces LJ, Volk B, Freidenreich D, Saenz C, Fernandez ML, Maresh C, Kraemer W, Phinney S, Volek J. Effect of a very low carbohydrate diet followed by incremental increases in carbohydrate on respiratory exchange ratio. FASEB J. 2014;28(1S):LB444.
  6. Van Wyk K, Schalinske K. Whole egg protein markedly increases blood vitamin D concentrations in male Sprague-Dawley rats. FASEB J. 2014;28(1S):1041.9.
  7. Aljohi H, Dopler-Nelson M, Wilson TA. Consumption of 12 eggs per week for 1 year increases serum zeaxanthin concentrations but not other major carotenoids, tocopherols, and retinol in humans. FASEB J. 2014;28(1S):645.25.

Choline Intakes and Recommendations in the U.S. May Be Suboptimal


Dr.-Taylor-C.-WallaceToday’s post comes from Taylor C. Wallace, PhD, CFS, FACN. Dr. Wallace is an accomplished food and nutrition expert, residing in the Washington, DC area.  He has published numerous peer-reviewed articles in addition to three academic textbooks.  Dr. Wallace has a doctorate degree in Food Science & Nutrition from The Ohio State University and frequently serves as a media spokesperson on hot topic nutrition, food safety and food technology issues.  Visit Dr. Taylor Wallace’s blog at www.drtaylorwallace.com.

Choline is a nutrient similar to B-vitamins, often lumped in with them, but not officially a B-vitamin.  It helps our livers avoid accumulating fat, aids in neurotransmission and is a structural component of our cell membranes.

Have you ever considered how much choline is in your diet?  The fact is that most consumers and even health professionals are “in the dark” when it comes to knowledge on this vital nutrient.  Choline has several important functions in the body; it is essential for proper liver and brain function across the lifespan.  Deficiency typically results in liver and muscle damage in adults.  Women with lower intakes of choline have a much higher chance of having a baby with a neural tube defect, since choline is highly involved in fetal growth and brain development.  Achieving adequate choline intake during pregnancy and lactation is even more important since the mother’s reserves may be easily depleted (i.e. low intake by mom equals low intake by baby).1

The U.S. Institute of Medicine (IOM) last reviewed and established Dietary Reference Intakes for choline over 15 years ago (see table).2  The Adequate Intake (AI) is a calculated “target value” to achieve for optimal health.  The Tolerable Upper Intake Level (UL) is the value a healthy individual should not exceed.  When these values were established by IOM in 1998, it was assumed that less than 5% of the population needed more than the established AI, due to genetic differences among individuals.  Since then, it has been reported that as much as 50% of the population may require a higher level of choline.3

Table 1: Dietary Reference Intakes for Choline as defined by IOM in 1998.

Population AI1 UL2
     
Infants
0-6 months6-12 months
125 mg/d (18 mg/kg)
150 mg/d
Not possible to establish
 
Children
1-3 years
4-8 years
9-13 years
200 mg/d
250 mg/d
375 mg/d
1000 mg/d
1000 mg/d
2000 mg/d
 
Males
14- 18 years
≥19 years
550 mg/d
550 mg/d
3000 mg/d
3500 mg/d
 
Females
14-18 years
≥19 years
400 mg/d
425 mg/d
3000 mg/d
3500 mg/d
 
Pregnancy
All ages
450 mg/d Age-appropriate UL
 
Lactation
All ages
550 mg/d Age-appropriate UL
 

1 AI = Adequate Intake
2 UL = Tolerable Upper Intake Level

According to my recent research, over 91% of the population does not meet the current recommended intake (i.e. the AI) for choline, even when the use of multivitamins are considered.4  This is because most mainstream multivitamins do not contain choline (SHOCKING given the widespread insufficiency across the population and the link to neural tube defects in infants).  Choline is found in a number of food products, but it is most common in animal-derived products.  Eggs, beef and pork are among the best sources of dietary choline.  One egg provides about 125 mg of choline5 or about 1/3 of the daily recommendation.  Also note that choline is present in the egg yolk and not egg whites! Whole eggs, therefore, can be a great option for health professionals to suggest to their clients to help them achieve desirable choline intakes.

 

References:

1. Yan J, Jiang X, West AA, Perry CA, Malysheva OV, Brenna JT, Stabler SP, Allen RH, Gregory JF 3rd, Caudill MA. Pregnancy alters choline dynamics: results of a randomized trial using stable isotope methodology in pregnant and nonpregnant women. Am J Clin Nutr. 2013; 98:1459-67.
2. Institute of Medicine. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin and Choline. Washington, DC: National Academy Press, 1998.
3. Kohlmeier M, da Costa KA, Fischer LM, Zeisel SH. Genetic variation of folate-mediated one-carbon transfer pathway predicts susceptibility to choline deficiency in humans. Proc Natl Acad Sci USA. 2005; 102:16025-16030.
4. Wallace TC, McBurney M, Fulgoni VL III. Multivitamin/mineral supplement contribution to micronutrient intakes in the United States, 2007-2010. J Am Coll Nutr. 2014; 33(2):94-102.
5. U.S. Department of Agriculture, Agriculture Research Service.  USDA National Nutrient Database for Standard Reference.  Available at: http://ndb.nal.usda.gov/.  Accessed on April 25, 2014.

Concentrating on Choline During National Birth Defects Prevention Month

Eighteen babies in the US die every day as a result of a birth defect. Unfortunately, birth defects are much more common than many might think, affecting 1 in 33 babies every year and causing 1 in 5 infant deaths. They have been the cause of over 139,000 hospital stays over the course of a year, resulting in $2.5 billion in hospital costs (1).

Mothers play an essential role in ensuring the healthy growth of their babies, and nutrition during pregnancy and lactation is particularly critical. During development, fetuses and infants have high needs for a range of nutrients, among which choline is notable for its role in reducing the risk for birth defects. In addition, choline is an essential nutrient required for life’s most basic functions, such as normal cell activity, liver function and transporting nutrients throughout the body. The nutrient is so important that the Food and Nutrition Board of the Institute of Medicine has set daily choline recommendations for all life stages (2):

Population Adequate Intake (AI) of Choline
Birth to 6 months 125 milligrams (mg)/day
7 – 12 months 150 mg/day
1 – 3 years 200 mg/day
4 – 8 years 250 mg/day
9 – 13 years 375 mg/day
14 – 18 years 400 mg/day (Females); 550 mg/day (Males)
Adults:(19 and older) 425 mg/day (Females); 550 mg/day (Males)
Pregnant women 450 mg/day
Breastfeeding women 550 mg/day

Pregnant and breastfeeding women merit some of the highest recommendations for daily choline intake. In January, National Birth Defects Prevention Month, this is particularly meaningful. In a previous blog post by Dr. Tia Rains, PhD, highlighted recent research that found during pregnancy, and particularly during the third trimester, large amounts of choline may be needed to support fetal development.  Researchers therefore concluded that while they are higher than those of other life stages, the current choline recommendations for pregnant and breastfeeding women might be below what is truly optimal for the health of mothers and their infants.

This study, suggesting a potential need to increase choline recommendations, adds to an already impressive body of evidence supporting the importance of dietary choline for pregnant and breastfeeding women. Research has shown that choline may help prevent neural tube defects, among the most grave of birth defects. Choline has been shown to play an important role in fetal and infant brain development, affecting the areas of the brain responsible for memory and life-long learning ability, and compared with women who get sufficient choline in their diets, women with diets low in choline have a four times greater risk of having babies with neural tube defects such as spina bifida (3).

Fortunately, modest nutritional adjustment can help minimize this risk. The best way to meet your needs is to eat foods with choline, and eggs have one of the highest amounts of choline of any food. One large egg – including the yolk – contains about 147 milligrams of choline. Two large eggs contain more than half of the recommended intake for pregnant women and can help them meet their needs Most prenatal and regular multivitamins provide far less than the Adequate Intake for choline, so including eggs as part of a healthy eating pattern is a simple and effective solution. If your clients are looking for easy ways to increase their choline intake, offer appealing egg recipes like this Creamy Pasta & Egg Skillet for the whole family to enjoy.

Creamy-Pasta-and-Egg-Skillet-150x150

What nutritional tips do you provide to your pregnant and breastfeeding clients? Does your practice recognize National Birth Defects Month? Please share your thoughts in the comments section below.

References:

1)      National birth defects prevention month. National Birth Defects Prevention Network Web site. Updated 2014. Accessed Jan 21, 2014.http://www.nbdpn.org/national_birth_defects_prevent.php

2)      Institute of Medicine and National Academy of Sciences USA. Dietary Reference Intakes for Folate, Thiamin, Riboflavin, Niacin, Vitamin B12, Panthothenic Acid, Biotin, and Choline. National Academy Press; Washington, DC: 1998.

3)      Shaw GM, et al. Periconceptional dietary intake of choline and betaine and neural tube defects in offspring. Am J Epidemiol 2004; 160:102-9.

Are the Current Choline Recommendations for Pregnant Women Suboptimal?

Choline is an essential nutrient, particularly during pregnancy, due to its important role in brain development. It is a precursor of phosphatidylcholine (PC), a component of all cell membranes, as well as several other key metabolites critical to supporting increased cell division, tissue expansion, and lipoprotein synthesis during fetal development. In addition to dietary intake, choline can be synthesized within the body, however not at levels sufficient to meet increased demands during pregnancy and lactation.

The current Dietary Reference Intake (DRI), established in 1998, is 450 mg/day for pregnant women, although it is noted in the DRI documentation that “data were not sufficient” for deriving a true requirement and that “the estimate is uncertain,” and may be revised when more data become available.1 Several studies have been conducted since then, the most recent of which was published in The American Journal of Clinical Nutrition which suggests that the current DRI may be suboptimal during pregnancy.2

Researchers from Cornell University studied healthy third-trimester pregnant and non-pregnant women who were randomly assigned to receive either 480 or 930 mg choline/day for 12 weeks. Choline was obtained both from the diet (primarily from eggs) and a supplement. During the last 6 weeks of the study, a special stable isotope form of choline was provided, which allowed the investigators to track choline metabolism in the participants as well as in the fetus by studying placenta tissue and cord blood following delivery.

Results showed that there was a substantial demand for choline during pregnancy, as predicted. However, in those women consuming 930 mg choline/day, biomarkers of placental function and levels of the stress hormone cortisol in cord blood were improved compared to those consuming 480 mg choline/day. Further, several functions of choline were maximized in women consuming the higher versus the lower dosage, leading the scientists to conclude that “current recommendations may be suboptimal” during pregnancy.

Dietary choline is one of several nutritional factors associated with the occurrence of neural tube defects during pregnancy. Although folate intake from foods and supplements is well known to reduce the risk of a pregnancy being affected by neural tube defects, choline and methionine may also be important independent of folate intake. One study found that women consuming low levels of dietary choline have four times the risk of giving birth to a child with a neural tube defect.3

Although the majority of choline consumed in the aforementioned study was derived from supplements, dietary sources can also contribute to total choline intake, as well as provide other essential nutrients important during pregnancy. While dietary choline is found in a wide variety of foods, many foods do not have high quantities of the nutrient. Eggs have one of the highest amounts of choline of any food, providing 147 mg/large egg.

Whether findings from this study and others will lead to a re-visitation of the choline DRI for pregnant women remains to be determined.
____________________
1. IOM (Institute of Medicine). 1998. Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington, DC: The National Academies Press.

2. Yan J, Jiang X, West AA, Perry CA, Malysheva OV, Brenna JT, Stabler SP, Allen RH, Gregory JF 3rd, Caudill MA. Pregnancy alters choline dynamics: results of a randomized trial using stable isotope methodology in pregnant and nonpregnant women. Am J Clin Nutr. 2013;98:1459-67.

3. Shaw GM, Carmichael SL, Yang W, Selvin S, Schaffer DM. Periconceptional dietary intake of choline and betaine and neural tube defects in offspring. Am J Epidemiol. 2004;160:102-9.