Articles

Early introduction of eggs may reduce the risk of food allergy to egg

By: Jen Houchins, PhD

According to a recent systematic review conducted for the USDA and the Department of Health and Human Services Pregnancy and Birth to 24 months project, “…there is evidence to suggest that introducing allergenic foods in the first year of life (>4 months) does not increase risk of food allergy or atopic dermatitis but may prevent peanut and egg allergy. Moderate evidence suggests that introducing egg in the first year of life (>4 months) may reduce the risk of food allergy to egg.”1

In the U.S., approximately 1% of all children, and about 12% of children with food allergies are allergic to eggs.2  Egg allergies are considered to have a high rate of resolution in childhood, with approximately 50% of children with egg allergy reaching tolerance between the ages of 2-9 years.3,4

Of significant interest, it has been observed that approximately 70% of children with egg allergy can tolerate extensively baked egg in foods like muffins or cakes (as opposed to lightly cooked eggs like scrambled or French toast).4-6 Several studies have suggested that introduction of baked egg in the diet of children who can tolerate these foods may help hasten resolution of allergy,4,6 with some data showing frequent ingestion increases the likelihood of tolerance compared to infrequent ingestion.7  

Although these are promising observations, many of these recent studies lack adequate control groups, limiting conclusions of the impact of extensively baked egg on allergy progression or development of tolerance.6   So, while more research is needed to better understand the role of baked eggs to potentially alter the course of egg allergy, “…inclusion of egg and milk in its baked form may also have other benefits.  It is reasonable to expect that liberation of the diet may boost nutrition, improve the child and family’s quality of life and reduce family anxiety, however, no studies have specifically investigated this.”6  Importantly, caregivers of children with egg allergy should consult the child’s physician before introducing extensively baked egg into the child’s diet.

If baked eggs are tolerated, there is the added benefit that eggs provide various amounts of all nutrients listed by the American Academy of Pediatrics as essential for brain growth.8  Eggs additionally provide 252 mcg of lutein + zeaxanthin, carotenoids with emerging evidence linking to brain development and health.9,10  As a nutrient-rich food that is a good or excellent source of eight essential nutrients, including choline, incorporation of eggs into the diet early may not only reduce the risk of food allergy to egg, but also serve as an important food to support brain development. 

For more information on early introduction, please join us for our upcoming webinar hosted in conjunction with the National Peanut Board on June 18th from 10:30 – 11:30 ET. Register here. See our Pregnancy and Birth to 24 Months toolkit for more information.

References:

1. Obbagy, J.E., et al., Complementary feeding and food allergy, atopic dermatitis/eczema, asthma, and allergic rhinitis: a systematic review. Am J Clin Nutr, 2019. 109(Supplement_7): p. 890s-934s.
2. Gupta, R.S., et al., The Public Health Impact of Parent-Reported Childhood Food Allergies in the United States. Pediatrics, 2018.
3. Sicherer, S.H. and H.A. Sampson, Food allergy: A review and update on epidemiology, pathogenesis, diagnosis, prevention, and management. J Allergy Clin Immunol, 2018. 141(1): p. 41-58.
4. Savage, J., S. Sicherer, and R. Wood, The Natural History of Food Allergy. J Allergy Clin Immunol Pract, 2016. 4(2): p. 196-203; quiz 204.
5. Nowak-Wegrzyn, A. and A. Fiocchi, Rare, medium, or well done? The effect of heating and food matrix on food protein allergenicity. Curr Opin Allergy Clin Immunol, 2009. 9(3): p. 234-7.
6. Dang, T.D., R.L. Peters, and K.J. Allen, Debates in allergy medicine: baked egg and milk do not accelerate tolerance to egg and milk. World Allergy Organ J, 2016. 9: p. 2.
7. Peters, R.L., et al., The natural history and clinical predictors of egg allergy in the first 2 years of life: a prospective, population-based cohort study. J Allergy Clin Immunol, 2014. 133(2): p. 485-91.
8. Schwarzenberg, S.J. and M.K. Georgieff, Advocacy for Improving Nutrition in the First 1000 Days to Support Childhood Development and Adult Health. Pediatrics, 2018. 141(2).
9. U.S. Department of Agriculture and Agricultural Research Service. FoodData Central. 2019; Available from: https://fdc.nal.usda.gov/index.html.
10. Johnson, E.J., Role of lutein and zeaxanthin in visual and cognitive function throughout the lifespan. Nutr Rev, 2014. 72(9): p. 605-12.

5 Ways to Find Balance

By Stacey Mattinson, MS, RDN, LD

The Egg Nutrition Center partnered with Stacey Mattinson, MS, RDN, LD to write this blog post.

During times of uncertainty, encouraging patients and clients to focus on aspects of their health they can control is even more important. When life throws curveballs and routines fall out of whack, self-care becomes even more essential. Here are five ways we can encourage balance during hectic times:

1. Fuel your Body (and Brain!) with Combination Meals and Snacks. Often people find themselves grazing or snacking frequently because their food choices aren’t bulky enough to promote satiety. Multi-food group combos pairing protein-rich foods, like eggs, with sources of fiber and healthful fats trigger satiety signals and provide maximum nutrients and absorption.

Great examples include:

Each of these examples provides nutrient-rich sources of protein, carbohydrate and fat, coupled with colorful plants, making a perfect macro- and micronutrient matrimony. With only 1 in 10 adults eating enough fruits and vegetables1 , eggs are a particularly great vehicle in a plant-forward diet. In fact, naturally nutrient-rich eggs can help with the absorption of nutrients found in plant foods like vitamin E and carotenoids. Plus, pairing plant foods with high-quality protein foods, like eggs, can help meet protein needs to help support healthy muscles and strong bones.

2. Prioritize Family Meals. Whether this means physically in your own home or virtually, mealtime is the perfect time to check in with family. Research indicates family meals are associated with greater consumption of fruits, vegetables, fiber, calcium-rich foods and vitamins.2 Kids also see improved grades, less participation in risky behaviors and less likelihood of developing eating disorders with more family meals eaten per week.3 Whether you choose breakfast, lunch or dinner, the benefits amplify with more meals eaten together each week. Try kid-friendly recipes like the Caprese Egg Muffins, Whole Wheat Chocolate Chip Pancake Poppers, or Egg Pita Snackers.

3. Eat Intuitively. Humans are born with innate hunger and fullness cues. Although these can be overridden over time when they are ignored, they can be uncovered by practicing mindfulness around eating experiences. Evaluating hunger before, during and after eating occasions helps sharpen personal awareness and unearth habits of eating in response to stress, boredom or emotions. Alternative coping mechanisms like walking, meditation, practicing a hobby or catching up with a friend are healthy responses to external triggers unrelated to hunger.

4. Sweep Out the Negative. Give permission to not be perfect. Successful long-term healthy habits are bred from someone’s ability to quickly dive back into positive behaviors rather than ruminate on unhealthy pitfalls. The week is not botched from a cookie, a missed workout or indulging in your favorite takeout. No one has tainted the next hour or the next day. Encourage clients to hop back on the healthy train and likewise consider removing negative social media influences that might make them feel poorly about themselves.

5. Add in One New Positive Habit. If nothing else, ask your clients, “What’s one thing you could change today that would help you live a healthier life?” This question invites clients to weigh their values, empowering manageable, realistic changes.

When clients are looking for advice on how to optimize health during uncertain times, remember to look at the big picture and point them toward long-term, sustainable lifestyle changes in ways that are meaningful to them!

References:

  1. Lee-Kwan SH, Moore LV, Blanck HM, Harris DM, Galuska D. Disparities in State-Specific Adult Fruit and Vegetable Consumption — United States, 2015. MMWR Morb Mortal Wkly Rep 2017;66:1241–1247. DOI: http://dx.doi.org/10.15585/mmwr.mm6645a1.
  2. Adv Nutr. Come and Get It! A Discussion of Family Mealtime Literature and Factors Affecting Obesity Risk. 2014 May; 5(3): 235–247. Published online 2014 May 6. doi: 10.3945/an.113.005116
  3. Can Fam Physician. Systematic review of the effects of family meal frequency on psychosocial outcomes in youth. 2015 Feb; 61(2): e96–e106.

New Harvard Study: Eggs Not Associated with Cardiovascular Risk

According to New Harvard Study: An Egg a Day Not Associated with Cardiovascular Disease Risk

By: Mickey Rubin, PhD

Mounting evidence continues to support the role of eggs in a heart-healthy diet. A new Harvard study updates findings first published over 20 years ago, and reinforces that eating eggs is not associated with cardiovascular disease.

The latest study is a follow-up to a landmark investigation first published in 1999. The original study, led by Hu and colleagues from the Harvard School of Public Health, reported no relationship between egg intake and coronary heart disease or stroke in women from the Nurses’ Health Study (NHS) cohort and men from the Health Professionals Follow-Up Study (HPFS) cohort. At that time the researchers concluded that an egg a day did not impact heart disease or stroke risk.

The current study is an updated analysis of the study published in 1999 and includes up to 24 additional years of follow-up and extends the analysis to the younger cohort of Nurses’ Health Study II. Thus, this latest analysis included 83,349 women from NHS; 90,214 women from NHS II; and 42,055 men from HPFS. Additionally, to compare these new findings to the extensive literature base on the topic of egg intake and cardiovascular risk, the researchers performed a systematic review and meta-analysis of 27 other published studies from the U.S., Europe, and Asia.

Results from the updated analysis from NHS, NHS II, HPFS, as well as the updated meta-analysis of global cohorts are consistent:

  • Egg consumption of one egg per day on average is not associated with cardiovascular disease risk overall
    • Results were similar for coronary heart disease and stroke
  • Egg consumption seems to be associated with a slightly lower cardiovascular disease risk among Asian cohorts

An important strength of this study is the use of repeated dietary assessments over the course of several decades in contrast to some observational cohorts which utilize only a single dietary measure at enrollment. According to the authors, it is desirable to have repeated dietary assessments over time to account for variation of dietary intake and other factors that contribute to atherosclerosis.

This latest study makes a significant contribution to the scientific literature on egg intake and cardiovascular health. These results are also consistent with the 2015 Dietary Guidelines recommendation that cholesterol is no longer a nutrient of concern for Americans and guidelines published in a science advisory from the American Heart Association in 2019.

Eggs are a good or excellent source of eight essential nutrients including choline and lutein, nutrients important for brain and memory development along with long-term health. Eggs can be an important part of all healthy eating plans.

Snacks and Small Bites to Help You Eat Right

By Kim Hoban, RDN, CDN, CPT

The Egg Nutrition Center partnered with Kim Hoban, RDN, CDN, CPT to write this blog post.

While there is no one way to eat “right,” small changes and small meals or snacks can have a big impact on health and wellness. Incorporating snacks and small bites into the day can be a simple way to help boost energy levels, regulate blood sugar and ensure adequate nutrition. If you’re busy and often on-the-go, prefer grazing over sit down meals or are trying to replenish appropriately after a workout, snacks can be a helpful tool in reaching your nutrition goals.

This month, we are joining the Academy of Nutrition and Dietetics in celebrating National Nutrition Month. In a nod to this year’s theme to “Eat Right, Bite by Bite”, we’ve rounded up some well-balanced snacks and small bites to fuel you all day long.

So what should snacks and small bites include? Strict rules around food are no fun, but when planning out snacks or mini meals, a good rule of thumb is to pair protein foods with carbohydrates and/or fat. Think fruit with nut butter, crackers and cheese or veggies with hard boiled eggs, like in these veggie egg pops! In fact, hard boiled eggs are such a simple, convenient and nutritious snack option, due to the one-two punch of protein and fat. Just one large egg offers six grams of high-quality protein and all nine essential amino acids. Hard boiled eggs are also great dipped in hummus or guacamole, drizzled with your favorite pesto or simply seasoned with salt and pepper.

Don’t forget to include snacks when planning your week or meal prepping ahead of time too! Egg muffins can be made in advance as an easy on-the-go option. Try these Caprese Egg Muffins or Quinoa Egg Muffins as a way to get some extra protein and veggies between meals or post workout. These Egg Pita Snackers make a great mini meal any time of day. If you’re looking for something sweeter, whip up a batch of these Cherry Cheesecake Baked Breakfast Bars to have on hand for breakfast, mid-afternoon snack or even dessert.

No matter what your meal and snack pattern looks like, you too can eat right, bite by bite this National Nutrition Month!