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.

Recorded Webinars and Other Videos

ENC-Funded Research Presented at the Experimental Biology Meeting in March 2015

Egg Nutrition Center is the science division of The American Egg Board headquartered in Park Ridge, Illinois. This 2-minute highlight video and the eight videos below this one reflect some of the ENC-funded research that was presented at the Experimental Biology meeting in March 2015.

Continue reading “Recorded Webinars and Other Videos”

Omega-3 fatty acids: are we getting enough

Featured article in the Winter 2015 Issue of Nutrition Close-Up; written by James D. House, PhD

The Food and Nutrition Board of the Institute of Medicine published in 2002 official estimates of the human requirements for fatty acids.1 At that time, only two fatty acids, the major constituents of fats and oils, were deemed to be essential for the healthy, adult human population: linoleic acid (18:2n-6), an omega-6 fatty acid; and α-linolenic acid (18:3n-3), an omega-3 fatty acid. These fatty acids are considered essential because they cannot be synthesized by the body, and must therefore be supplied through the diet. Linoleic acid, a polyunsaturated fatty acid, is found in most dietary fats and oils, and is particularly high in corn and soybean oils. α-linolenic acid (ALA) is less prevalent in the diet, with potential sources including flaxseed and flax oil, hemp oil and canola oil, as well as certain animal products, including eggs (Table 1). With respect to requirement estimates, the current Adequate Intake (AI) values for linoleic acid are 12 and 17 g/d for young women and men, respectively. The Adequate Intake values for ALA are 1.1 and 1.6 g/d for young women and men, respectively.  Continue reading “Omega-3 fatty acids: are we getting enough”

Read Papers from The Controversial Role of Macronutrient Composition in Diabetes and Related Disorders

In 2013, ENC sponsored and organized a satellite symposium “The Controversial Role of Dietary Protein in Diabetes and Related Disorders” chaired by Mitch Kanter, PhD, Executive Director, ENC, held in conjunction with the American Society for Nutrition’s 2013 Advances and Controversies in Clinical Nutrition Conference (December 5-7,2013) in Washington, DC.

The program featured presentations which provided an overview of the available evidence on macronutrient composition and specifically, dietary protein, in the prevention and management of diabetes and diabetes-related risk factors. Coordinated by Tia Rains, PhD, Senior Director, Nutrition Research & Communications, ENC, proceedings were recently published in a supplement within Journal of Nutrition titled: The Controversial Role of Macronutrient Composition in Diabetes andRelated Disorders of the Journal of Nutrition.

Click below to access the online reprint of each article:

Kevin C Maki and Alyssa K Phillips. Dietary Substitutions for Refined Carbohydrate That Show Promise for Reducing Risk of Type 2 Diabetes in Men and Women

Amy P Campbell and Tia M Rains. Dietary Protein Is Important in the Practical Management of Prediabetes and Type 2 Diabetes

Theresa A Nicklas, Carol E O’Neil, and Victor L Fulgoni III. Differing Statistical Approaches Affect the Relation between Egg Consumption, Adiposity, and Cardiovascular Risk Factors in Adults

Barbara A Gower and Amy M Goss. A Lower-Carbohydrate,Higher-Fat Diet Reduces Abdominal and Intermuscular Fat and Increases Insulin Sensitivity in Adults at Risk of Type 2 Diabetes

Can People with Heart Disease Start Eating Eggs Again?

Eggs-One-CrackedFor the past several decades, individuals with heart disease or at high risk for the development of heart disease have been advised to consume <200 mg/day of dietary cholesterol, whereas healthy adults are advised to consume <300 mg/day. Such recommendations are based on the assumption that dietary cholesterol produces harmful increases in blood cholesterol, which increases risk for developing atherosclerosis.

However, this simplistic thinking of A (i.e., dietary cholesterol) increases B (i.e., blood cholesterol) which increases C (i.e., heart disease risk) has been challenged in recent years as advances in diet and cardiovascular disease (CVD) research have revealed that the story is not that straight forward .  We now know that there are other risk factors that influence heart disease risk potentially as much as or more so than elevated blood cholesterol (e.g., inflammation, vascular function, etc.). And with regards to blood cholesterol, not all types of “bad” cholesterol (LDL-cholesterol) may be atherogenic.  Finally, dietary patterns may be more important for influencing CVD risk markers than isolated components, like dietary cholesterol.  And dietary cholesterol may not adversely affect CVD risk factors to the same degree as was previously thought.

Consistent with this thinking is a recently published paper by Dr. David Katz from the Yale University School of Medicine.  His laboratory evaluated 32 patients with documented coronary artery disease who consumed one of three daily breakfast treatments for 6 weeks each: 2 eggs/day; ½ cup of Egg Beaters/day; high-carbohydrate meals such as a bagel, waffles, pancakes, and cereal with milk.  Each treatment period was separated by a 4-week washout.

A number of different cardiovascular risk markers were measured before and after each 6-week intervention period.  Compared to the high-carbohydrate condition, 2 eggs/d did not adversely affect flow-mediated dilatation (an indicator of vascular function), blood cholesterol, blood pressure, or body weight. Further, there were no differences between the 2 egg/day and Egg Beaters conditions.  This despite the fact that cholesterol intake was 742 mg/d in the egg group versus ~200 mg/d in the Egg Beaters and high-carbohydrate breakfast conditions.

This is the first clinical intervention study to evaluate the effects of cholesterol/egg intake on multiple cardiovascular risk markers, including endothelial function, in patients with diagnosed CVD.  The investigators state in the paper that, “Excluding eggs from the diets of patients with CVD as per the AHA dietary recommendations could potentially lead to alternate choices high in starch and sugar, potentially associated with increased CVD morbidity and mortality.”

Although this study was small and relatively short in duration, the results certainly challenge the current thinking around cholesterol restrictions for those with CVD.  As is always the case in nutrition science, additional research is needed to better understand the role of dietary cholesterol in disease risk and progression.