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.

Egg Metabolites Lower Type 2 Diabetes Risk: Insights into a Potential Mechanism

Mickey Rubin - Diabetes Post Blog Photo (1)

New egg nutrition research was making the headlines once again recently with the news of a new study that showed consumption of one egg every day is associated with a blood metabolite profile that would indicate a lower risk of type 2 diabetes.

The study1, published in the journal Molecular Nutrition and Food Research, examined 2,682 men aged 42-60 years of age as part of the Kuopio Ischemic Heart Disease (KIHD) Risk Factor Study in Finland. Dietary intakes were assessed with 4-day food records at baseline while type 2 diabetes incidence was assessed at 4, 11, and 20 years. Researchers compared the metabolic profile of individuals with higher egg intake – about one egg per day – to the metabolic profile of those with lower egg intake – about two eggs per week on average. The authors then took this information and looked for any relationships between those who developed type 2 diabetes or those who otherwise remained healthy during a follow-up period of almost 20 years.

The authors found different metabolic profiles between those with higher egg intake compared to those with lower intake. Specifically, individuals with higher egg intake tended to have lower levels of metabolites that are linked with type 2 diabetes, whereas individuals with lower egg intake had higher levels of metabolites that are linked to higher risk of type 2 diabetes.

This new study provides unique insight towards potential mechanisms by which egg intake may lower risk for developing type 2 diabetes over time. It is possible that the metabolic profile of high egg consumers may be a factor in reducing type 2 diabetes risk over time. Whether egg intake promotes metabolites involved in type 2 diabetes risk reduction or reduces metabolites involved in increasing type 2 diabetes risk is not clear from this study and thus more research is needed.

Interestingly, this new study is a follow-up secondary analysis from a study2 originally published in 2015 in the American Journal of Clinical Nutrition, and it is important to look back at what the original study found. The original study included the same cohort of Finish men in the KISHD Risk Factor Study in Finland. After adjustment for potential confounders, those in the highest compared with the lowest egg intake quartile had a 38% lower risk of incident type 2 diabetes. The authors also reported lower levels of C-reactive protein, an indicator of inflammation, and lower fasting glucose with higher egg intake.

When viewed together, the results of these studies from the KIHD cohort suggest a reduced risk for type 2 diabetes with egg consumption, an association that may be due in part to a favorable metabolic profile of high egg consumers.

The American Diabetes Association3 and the American Heart Association4 encourage people with diabetes to consume a healthy dietary pattern that includes nutrient-rich foods.  A large egg provides 13 essential vitamins and minerals, 6 grams of protein (12% DV), as well as 250 mcg of antioxidants lutein and zeaxanthin, and these new data continue to support that eggs are a beneficial part of healthy dietary patterns.

For more information on other recent studies examining eggs and type 2 diabetes, be sure to read this research summary from ENC’s Nutrition Research Update.

 

References:

  1. Noerman S et al. Metabolic Profiling of High Egg Consumption and the Associated Lower Risk of Type 2 Diabetes in Middle-Aged Finnish Men. Mol Nutr Food Res. 2018 Dec 12. [Epub ahead of print]
  2. Virtanen JK, et al. Egg consumption and risk of incident type 2 diabetes in men: the Kuopio Ischaemic Heart Disease Risk Factor Study. Am J Clin Nutr. 2015 May;101(5):1088-96.
  3. American Diabetes Association. Standards of Medical Care in Diabetes – 2017.  Diabetes Care. 2017;40 (supplement 1): S33-43.
  4. Fox CS, Golden SH, Anderson C, et al. Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence: A Scientific Statement From the American Heart Association and the American Diabetes Association. Diabetes Care 2015;38:1777-1803.

Eggs, Diabetes, and the Current Scientific Evidence

Diabetes Blog Photo

The Dietary Guidelines for Americans no longer provide a limit for dietary cholesterol for healthy people,1  however, some questions remain about the cardiovascular impact in people with diabetes or impaired fasting glucose.  This Nutrition Research Update highlights new evidence that supports eggs can be included in a healthy dietary pattern without adverse cardiovascular effects linked to diabetes, and in some cases, can be linked to beneficial outcomes. Continue reading “Eggs, Diabetes, and the Current Scientific Evidence”

What Foods Should People with Diabetes Eat

JW Blog Photo

By Jill Weisenberger, MS, RDN, CDE, CHWC, FAND

Many people with diabetes avoid health-boosting foods because of the food’s perceived effect on blood glucose or because of long-held fears of carbohydrates, fats or cholesterol. As type 2 diabetes is a metabolic disease with effects reaching the liver, heart, brain and more, people with diabetes should be encouraged to avoid the myopic view that diabetes is merely a blood sugar problem. Thus, a diet for type 2 diabetes management must also consider overall health with emphasis on glucose control, reversing insulin resistance and preventing heart disease and stroke.

The following are several foods people with diabetes often have questions about. Continue reading “What Foods Should People with Diabetes Eat”

Whole Eggs and Cholesterol Absorption

BoiledEggsSalad

Dietary cholesterol intake from whole eggs has shown to elicit a highly variable impact on blood cholesterol levels, with approximately two-thirds of the population having a minimal or no response. This has certainly effected a shift in modern day thinking regarding dietary cholesterol. Why wouldn’t dietary intake directly affect body levels? A recent study in Nutrients delved further into the relationship between cholesterol in eggs and plasma cholesterol levels by measuring how cholesterol is absorbed immediately after a meal. Continue reading “Whole Eggs and Cholesterol Absorption”

Eggs, Cholesterol and Cardiometabolic Health

Eggs, Cholesterol and Diabetes (1)

Does cholesterol intake impact cardiometabolic health? Two prospective studies from Boston University School of Medicine show no link between dietary cholesterol and type 2 diabetes. The findings, published in the journal Nutrients, use data from the Framingham Offspring Study to analyze the effects of dietary cholesterol intake over a 20-year period: Continue reading “Eggs, Cholesterol and Cardiometabolic Health”