Articles

How to Incorporate Eggs into the Mediterranean Diet

By Natalie Rizzo, MS, RD

The Egg Nutrition Center partnered with Natalie Rizzo, MS, RD to write this blog post.

Although it has the word “diet” in the name, the Mediterranean Diet is a flexible style of eating that isn’t centered around weight loss. There aren’t any strict rules or calorie counting on the Mediterranean Diet, either. Rather, it encourages eating like people do in the Mediterranean region — a nutritious eating pattern full of whole foods.

Named as the #1 Best Overall Diet by US News & Report, the Mediterranean Diet is a healthy style of eating that promotes portion control, whole foods and an active lifestyle. Eating the Mediterranean way includes plenty of colorful fruits and vegetables, beans and legumes, whole grains, fish, poultry, eggs, olive oil and fresh herbs. Even a glass of red wine in moderation is encouraged. However, this eating pattern also involves limiting intake of refined grains, red meat, processed or packaged foods and foods that are high in added sugar. 

In addition, lifestyle factors are an important aspect of the Mediterranean Diet. Avoiding tobacco and exercising regularly are healthy habits no matter what, but the Mediterranean Diet also encourages cooking your own meals, choosing seasonal ingredients and enjoying mealtime with family and friends.

The benefits of the Mediterranean Diet

As one of the top diets in the world, there is an abundance of research surrounding the Mediterranean Diet and how it affects certain health conditions. Below are some of the most promising fields of study. 

Heart health

The Med Diet is rich in nutrients that are associated with good heart health, like fiber, antioxidants, vitamins, minerals and healthy fats. With that, the Mediterranean Diet has been shown to help protect against cardiovascular disease. As a matter of fact, a large observational study of over 30,000 women found that those who followed the Med Diet for a 10-year period had lower risk of heart attacks, strokes, and heart failure. 

With the revision of the Dietary Guidelines in 2015 to remove cholesterol as a nutrient of concern, eggs have been considered a part of a heart healthy diet. On top of that, the American Heart Association (AHA) Nutrition Committee published a science advisory on Dietary Cholesterol and Cardiovascular Risk in 2019. The advisory stated that following a heart-healthy eating pattern, such as the Mediterranean Diet, is more important than adhering to a specific cholesterol number.  

The advisory also noted that healthy individuals can include one whole egg per day in their heart healthy eating patterns. Older adults can include up to two eggs per day, and vegetarians who do not consume cholesterol from animal foods may include more eggs in their diet, in moderation.

Type 2 Diabetes

According to a 2015 review, the Mediterranean diet is associated with better glycemic control in those with Type 2 Diabetes. Researchers attribute these positive results to the high intake of polyphenols (beneficial plant compounds) from fruits, vegetables, whole grains, and nuts. Pairing eggs with plant-based heart-healthy foods also helps with the absorption of important nutrients, like Vitamin E and carotenoids. In addition, eating an egg-based breakfast, rich in protein (about 26 grams of egg protein), has been shown to promote glycemic control in people with type 2 diabetes and pre-diabetes, as compared to a high-carbohydrate breakfast.

Brain function

Another reason to incorporate Mediterranean approved eggs into your diet is that nutrients in eggs have been shown to have brain benefits. Researchers at the University of Illinois published two studies looking at the relationship between lutein status, as measured using a non-invasive eye test called Macular Pigment Optical Density (MPOD), and cognition in children. They found that MPOD concentration was positively associated with academic performance. Eggs also contain choline, a nutrient that is vital for the development of brain and spinal cord development in utero. Plus, dietary choline has been shown in some studies to be linked with reduced risk of cognitive decline with age. 

Eggs in the Mediterranean Diet

The Mediterranean Diet is not only nutritious, but it’s also very accessible. By incorporating plenty of whole foods in your diet, you’re already on your way to eating the Med way. Eggs are not only a staple of the Mediterranean Diet, but they also play a role in weight management, muscle strength, healthy pregnancy, brain function, eye health and more. Here are some meal examples that combine the power of the Med Diet with the benefits of eggs. 

Addition, Not Subtraction to Best Support Clients

By: Angela Gomez, RDN

Key messages

  • Focusing on what can be added rather than reduced or eliminated, when it comes to behavior change, may help build a growth mind-set and build self-efficacy in the clients we work with.
  • Supporting clients on their health journey by adding to the behaviors they are already engaged in is a more collaborative and positive approach that may increase success and reduce harm.

When discussing behavior change, emphasizing addition (rather than harping on subtraction), can create a mind shift in the individuals and families we work with. Focusing on the addition of health behaviors gives people more options and helps create an experimental environment, rather than a “pass-fail” environment. If we help develop this skill in parents or guardians, then they, in turn, can influence their family in a similar way. This is where the “think addition, not subtraction” phrase comes into play.

I have used this phrase in my work with private clients, youth sports teams, collegiate athletes, and clients with eating disorders. In my sessions, I’ll often redirect the “subtraction talk” and ask open-ended questions to elicit some “addition talk”. I am not as concerned with emphasizing the behavior a client wants to avoid; I am interested in the behavior they want to change – given what they have available to them now (i.e., time, food accessibility, etc.). There is hope and positivity in the idea of adding small behavior modifications, whereas only focusing on avoiding habitual behaviors can feel defeating.

Need more convincing on why we should emphasize addition over subtraction? Here are three reasons to consider implementing this mindset in your own practice:

1. Subtraction represents rules and restrictions, while addition calls attention to abundance and provides options. Restriction emphasizes the “don’t” without providing options for the “do”. There are simply more possibilities with addition. Supporting clients as they build a growth mindset fosters agency, self-efficacy, and honesty in their journey towards owning their positive health behaviors. In more vulnerable populations, such as clients with eating disorders, encouraging subtractions (or restrictions) will not aid in their recovery process.

Instead of: “Stop eating ‘junk food’ or no more ‘junk food’.”
Try: “What foods would you like to add? How do you feel about brainstorming some snack ideas together that incorporate the foods you’d like to add?”
Benefit: You are discussing foods the client is already interested in adding, instead of directing the client toward restrictions (and creating stress in the process).

2. Focusing on addition fosters a relationship of collaboration between the provider and the client. Many of our clients want to please their healthcare providers and don’t want to “fail”. We can encourage the people we work with to get out of this “pass or fail” mindset by emphasizing addition and treating goals like experiments. We can accept that clients are experts of their own bodies, experiences, and lives. We have the education and experience in our field, and more importantly, our clients have the experience of being in their own bodies and living their day-to-day life. Working collaboratively sets the client up for success as we guide and support them on their health journey.

Instead of: “You should eat breakfast every morning.”
Try: “What days work for you to eat something in the morning, even if it is not a full meal – like having some hard-boiled eggs? What are some foods that sound appealing to eat in the morning?”
Benefit: You open the door to possibilities that appeal to the client, and the client tells you what days they may be able to try and eat something for breakfast. Therefore, the focus is not eating breakfast seven days a week; instead it is creating manageable change by encouraging something in the morning when it works for the client.

3. Focusing on subtraction turns individualized care into generalized care. All of our clients do not have the same access or the same ability to work towards your idea of a desirable health behavior. If you are speaking to a family who has limited resources, it may be harmful to recommend specific subtractions (such as “don’t eat canned foods because they are too high in sodium”). If you are telling individuals to remove a food that strongly connects to their family or culture, it is unlikely they will comply. We need to work with the client to tailor the behavior modification to meet them where they are.

The health of the whole being is the most important. Relying on subtractions will restrict, and may ultimately hinder not only your relationship with the client, but also their personal progress. No one wants more rules to follow or more things to avoid. Shifting to addition will encourage our clients to focus on building positive, sustainable behaviors that work within their current lives, work for their families, and allow progress to occur at their own pace.

Angela Gomez, RDN is based out of both Peoria and Phoenix, Arizona and is a School Nutrition Dietitian, an Eating Disorder Dietitian, and a volunteer Dietitian for a collegiate soccer team.

Let’s Get Cracking: Earth Month Recipes Using Pantry Staples

Kim Hoban, RDN, CDN, CPT

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

Each year around Earth Day, we try to focus on ways we can conserve resources, such as reducing food waste. Now as we experience a global pandemic, we are looking to conserve for additional reasons, like reducing the frequency of trips to the grocery store. 

If you’re using this time to spring clean the pantry, save money or reduce food waste, it’s possible to create delicious, well-rounded meals with pantry staples like oats, rice, canned beans, tomato sauce, nut butter and more. Eggs are a perfect pairing with many of these staple foods, adding high-quality protein, vitamin D and key nutrients like choline, lutein and zeaxanthin.

Baking and cooking can be a fun family activity that can help teach kids math and science, but also important life lessons like patience and problem-solving. Baking can also be a great stress reliever, so get out the flour, sugar, and eggs to bake up sweet treats like Cinnamon Banana Bread. Found a can of pumpkin in the pantry? It might not be fall anymore, but this pumpkin bread is delicious any time of year!

When it comes to fueling yourself and your family throughout the day, start at breakfast by turning to pantry staples like oats and nut butters. This Almond Butter Oatmeal with Egg is a great option, as are more traditional family favorites like French toast and pancakes. Make a single serving pancake by mixing just one banana, one egg and two tablespoons of nut butter, then cooking on a griddle like any other pancake.

When it comes to more savory meals using pantry staples, think about canned foods like diced or crushed tomatoes, tuna, beans and dry goods like rice or quinoa. Use what you have on hand to make Shakshuka or Eggs in Purgatory. Put together an easy lunch using canned tuna, mixing in hard-boiled eggs or beans for more protein. Another easy option is a stir fry or fried rice using eggs and whatever vegetables you have in the cabinet, fridge or freezer.

With many people staying home and spring finally upon us, there’s no better time to start a home garden or a compost bin. Using dried crushed egg shells to add to the compost enriches your garden soil while also reducing kitchen waste. If you have some veggies that are on the verge but not quite ready for compost, utilize these infinitely swappable meal formulas to help reduce food waste.

If you have more eggs on hand than you’ll be able to use in the coming weeks, don’t hesitate to freeze them. Follow these tips on freezing eggs to save fresh eggs for up to a year.

With so much out of our control as we await a “new normal”, it’s important to focus on all we can do, like getting creative in the kitchen, enjoying time with family and doing our part to celebrate and honor the planet.

Parental Feeding Practices and Child Nutrition

By: Jennifer Anderson, MSPH, RDN, LD 

Key messages

  • Nutrition in the first several years of life sets lifetime food preferences and eating practices
  • Teaching parents how to implement appropriate feeding practices at home enables an environment where children learn to prefer unprocessed, nutrient-dense foods, such as eggs.
  • Parents need to be educated about serving nutrient-dense foods, and responsive feeding and positive parenting techniques.

Nutrition in the first several years of life sets lifetime food preferences and eating practices.1 Proper nutrition in the toddler years is also critical for rapid development.2 In fact, because toddlers have small stomachs, they need a diet of nutrient-dense foods that are minimally processed, such as eggs.

Many parents, however, are faced with picky eating behaviors. Most parents do not have adequate training in parental feeding and child nutrition, and this often leads them to practices that may promote poor nutrition and obesity.3

Many parents do not understand that “picky eating” is a normal behavior observed in most children. As a result, they begin to use unhelpful strategies to overcome this “problem.” They employ tactics such as restriction, bribing, and pressuring to get their children to eat nutritious foods.4 Unfortunately, these tactics are associated with poor long-term nutrition and health outcomes.

Here’s a scenario. A mother learns that eggs are one of the densest food sources of choline, and choline is necessary for proper brain development. She feels strongly that she wants her child to eat eggs. She serves eggs to her two-year-old daughter. Her daughter rejects them. The mom is upset. She begins to pressure her daughter to eat them. She forces her daughter to take a bite and mealtime becomes unpleasant. Other times, she bribes her daughter to eat the eggs, using dessert as a bribe. Unfortunately, these feeding practices can lead to an increased risk of obesity and a decreased preference for eggs in the long run.

This is a common scenario,4 showing parents need both nutrition information and feeding practice information. Nutrition professionals have the opportunity to instruct parents on evidence-based feeding practices. This will help parents teach their children to learn to like healthy choices without causing a damaged relationship with food.

Evidence-based parental feeding practices4 include the following.5

Exposure to nutrient-dense foods. While parents often think that a child does not like a food after only serving it once or twice, it may take many exposures for the child to accept it. It is essential to instruct parents to serve nutrient-dense foods, like eggs, repeatedly, and in different forms. Along with serving them frequently, parents can be given techniques for helping children choose to taste foods.

Responsive feeding. This type of feeding is a structure6 in which parents decide where food is served, what food is served, and when food is served, while children, decide what they want to eat from what is provided, and how much to eat. Parents use hunger and satiety cues from the child to help the child preserve their ability to self-regulate food intake.

Positive parenting. This type of parenting encompasses warmth toward the child and encourages autonomy and self-efficacy in the child. Parents provide behavioral limits and also sensitivity to cues from the child. It also includes role modeling. Parents can be encouraged to model eating a nutrient-dense diet and provide structure around food and feeding.

Given the ubiquitous presence of highly processed low-nutrient food in the food supply, parents need both nutrition and practice information. They need instruction to feed their children nutrient-dense foods that fill important nutrient needs, such as eggs. They also need information about positive feeding practices to help their children learn to eat nutrient-dense foods in the short-term and long-term.

Jennifer Anderson is a registered dietitian, mom of 2, and educates hundreds of thousands of parents @kids.eat.in.color on Instagram. She is the owner of Jennifer Anderson Nutrition, LLC, a public health company focused on chronic disease prevention and maternal mental health.

References

  1. Anzman-Frasca S., et al. Promoting healthy food preferences from the start: a narrative review of food preference learning from the prenatal period through early childhood. Obes Rev. 2018;19:576-604.
  2. Mameli C., et al. Nutrition in the First 1000 Days: The Origin of Childhood Obesity. Int J Environ Res Public Health. 2016;13.
  3. Kiefner-Burmeister A., et al. Implementation of parental feeding practices: does parenting style matter? Public Health Nutr. 2016;19:2410-4.
  4. Daniels L. A. Feeding Practices and Parenting: A Pathway to Child Health and Family Happiness. Ann Nutr Metab 2019;74(suppl 2):29–42.
  5. Daniels L. Complementary feeding in an obesogenic environment: Behavioral and dietary quality outcomes and interventions. In: Black RE, et. al. Complementary feeding: Building the foundations for a healthy lifestyle. Nestlé Nutr Inst Workshop Ser. Volume 87. Basel: Nestec Ltd., Vevey/Karger AG; 2017. pp. 167–81.
  6. Black MM, et. al. Responsive feeding is embedded in a theoretical framework of responsive parenting. J Nutr. 2011;141:490-4.

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.