Nutritious Dietary Patterns

Dietary patterns (also called eating patterns) are the combinations and quantities of food and beverages consumed over time. Consistent evidence indicates that, in general, a plant-based dietary pattern is more health-promoting than the current average U.S. diet. However, a “plant-based” eating patterns doesn’t mean only plants; pairing high-quality protein foods, like eggs, with plants is essential for the synthesis and maintenance of muscle tissue, and for achieving optimal vitamin and mineral intakes.

The 2015-2020 Dietary Guidelines for Americans recommend three healthy eating patterns, all of which include eggs. But what are the sample eating patterns, and what are the key differences between them?

To learn more about healthy eating patterns, including those recommended in the 2015-2020 Dietary Guidelines, and how eggs fit within those patterns, explore the following PowerPoint, and feel free to share it with friends!

Healthy Eating Patterns: How do Eggs Fit?

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Stay Informed, Stay Certified: Continuing Education Available from the Egg Nutrition Center

In an effort to keep health professionals updated on the latest in credible nutrition research, the Egg Nutrition Center (ENC) provides easy access to valuable continuing education opportunities. In fact, ENC is currently showcasing the two outstanding webinars highlighted below:

Dietary Patterns for Cardiometabolic Health: Unscrambling the Guidance
David Katz, MD

Bringing together two hot topics in today’s food and nutrition environment, this webinar takes a step back to assess the impact of food patterns on cardiometabolic health as well as the prevention of diseases and chronic conditions that health professionals commonly see in their patients. Dr. David Katz, a board-certified specialist in preventative medicine and public health, clinical instructor of medicine at the Yale School of Medicine, and founding director of Yale University’s Prevention Research Center, takes viewers through the latest research on the health effects of the diet’s macronutrient content as well as the trends in consumption in the recent past. Dr. Katz clearly translates science into practical dietary guidance that health professionals can use with clients and patients.

This webinar is approved by the Commission on Dietetic Registration (CDR) for 1 CPEU.


Building a Better Breakfast with High-Quality Protein and Produce
Neva Cochran, MS, RDN, LD
While health professionals are well aware of the importance of breakfast, research continues to build on the benefits of fueling in the morning, which include boosts in nutrient adequacy of the diet, satiety and improvement in various markers of health. In this webinar, award-winning registered dietitian nutritionist Neva Cochran discusses the latest research on the health outcomes associated with eating breakfast. She also provides simple suggestions to help patients and clients create a daily nutrient-rich breakfast that combines high-quality protein with fruits and vegetables.

This webinar is approved by the Commission on Dietetic Registration (CDR) for 1 CPEU.

For more information and useful resources on these and other topics, check out ENC’s Patient/Client Education Materials.

Have an Egg-cellent Meatless Monday

Are you or your clients participating in Meatless Monday? It can be tricky for some individuals to redesign their plate and get a balanced, protein-rich meal. However, eggs pair well with many different foods, making it easy to create simple, affordable meals for any time of day.


Idea # 1 Family Fun: Meatless Monday can be a great time to have breakfast at dinner,  especially if a  family might need help “getting in the groove” of trying meatless meals. Some nutritious examples include:

  • Whole wheat pancakes or waffles topped with fruit and a glass of skim milk on the side
  • Omelet or burrito station with different veggies and cheese – get the kids involved to make meal preparation fun for all!

Idea # 2 Busy Monday:  The great news is that many egg dishes can be made the night before and cooked the next day, saving time and energy.

  • Here are a few recipes (several meatless) that you can easily make ahead.
  • Make Monday dinner and have more to eat the rest of the week-casseroles reheat well, as do these Muffin Fritattas. You could even make these Sunday and have them reheated on Monday!
  • Keep hard-boiled eggs on hand for a quick snack or addition to a salad.

Need More Ideas:

Check out @IncredibleEggs on Twitter and Facebook-for a variety of great recipes , including this Mushroom and Spinach Frittata and Quinoa Egg Bake with Thyme and Garlic. I personally made this one for dinner (took a larger piece than the breakfast portion and added some fruit on the side). Delish!


Egg Nutrition Center teamed up with our friends at the Produce for Better Health Foundation (PBH)/Fruits and Veggies More Matters to create this recipe for  Herbed Spinach Quiche Portabella Caps (pictured above). By pairing eggs with other nutrient-rich foods, it’s easy to build a well-balanced and colorful plate.

Do you have any favorite vegetarian egg dishes you recommend for your clients?

Eggs and Diabetes: Increased Risk or Guilt by Association?


The Background

The 2010 Dietary Guidelines for Americans (1) recommended limiting dietary cholesterol and specifically egg consumption for individuals with type 2 diabetes (T2D). The recommendation was based on epidemiology studies reporting positive statistical association of increased cardiovascular disease (CVD) risk for individuals with T2D who consumed 7 or more eggs each week. While the Dietary Guideline Committee cited the concern about egg consumption for T2D, they acknowledged that the relationship was a statistical association with no proof of cause or mechanism and emphasized the need for more research.

Shortly after the Dietary Guidelines were presented, Drs. Mozaffarian and Ludwig at Harvard wrote a commentary arguing that the focus of the Dietary Guidelines on single nutrients or single foods was inadequate and misleading for evaluation of modern diverse diets. They argued Dietary Guidelines must consider the context of foods within food patterns and lifestyles to define health risks (2).

Recent Published Studies

A recent paper from Spain evaluating the Mediterranean diet emphasizes this point (3). These investigators specifically evaluated the relationship of egg consumption to diabetes risk in a cohort of adults following a Mediterranean diet pattern. They found no relationship of egg consumption (or cholesterol intake) with T2D risk suggesting that eggs were not a risk factor when consumed within a healthy dietary lifestyle.

Still, contrary to this report, a meta-analysis published in the British Medical Journal (4) evaluated 16 prospective cohort studies that specifically examined relationships of egg consumption with incidence of T2D and CVD and found a positive Risk Ratio (RR) of 1.54 for egg consumption with CVD within the population of T2D.

If you’re not used to thinking about RR, a RR of 1.0 means there is no association, and for comparison, a 50-year old smoking a pack per day has a RR of over 20 for lung cancer. So the true risk of heart disease in a 50-year old male with normal blood lipids and normal blood pressure is about 2% and a RR of 1.54 would increase the risk to 3%.

Perhaps more important than the potential small risk in T2D, these investigators found no association of egg intake with risk of CVD or stroke in non-diabetic adults with the RR less than 1.0 suggesting that greater egg intake reduced risk of both CVD and stroke. Further, they found a RR of 0.75 for egg consumption and stroke in adults with T2D.

Concerns about egg consumption by individuals with T2D remains a question that requires better research to determine if the risk is a true relationship to eggs or if it is a guilt by association with other aspects of overall diet quality. This would include dietary intakes such as total fat, types of fat, dietary fiber, green vegetables or fruit.

Bottom Line

What should not be lost within the debate about diabetes is that study after study shows there is no association
of egg consumption with CVD risk in non-diabetic adults and that egg consumption reduces risk for stroke in both diabetic and non-diabetic adults.


1. U.S. Department of Health and Human Services. Dietary Guidelines for Americans. http:/  Part D, Section 3.

2. Mozaffarian D, Ludwig DS. Dietary Guidelines in the 21st Century a Time for Food. JAMA 304:681, 2010.

3. Zazpe I, Beunza JJ, et al. Egg consumption and risk of type 2 diabetes in a Mediterranean cohort: the SUN project. Nutr Hosp 28:105, 2013.

4. Rong Y, Chen L, et al. Egg consumption and risk of coronary heart disease and stroke: dose-response meta-analysis of prospective cohort studies. BMJ 2013 (doi: 10.1136/bmj.e8539).

Food Patterns

The science of epidemiology is both a gold mine and a disaster for nutrition science. A quick look through the American Journal of Clinical Nutrition or simply scanning the news headlines and you find numerous new discoveries in nutrition health based on epidemiology studies. This research has uncovered many importance questions and led to multiple new lines of research. Unfortunately, epidemiology is too often misused and over-extrapolated to imply cause and effects based on simple statistical associations.

The problem with these studies is the health outcomes are related to dietary intakes of single nutrients or single foods and largely ignores the overall food patterns or lifestyles of the individuals at risk. The weakest part of the data are the food surveys that are supposedly validated, which simply means if you did the same survey 10 times you’d get the same answer 9 times, but it ignores the fact that the answer may be wrong.

A recent paper in Journal of Nutrition (JN 142:1652, 2012) highlights the problem. The investigators surveyed a large group of overweight individuals consuming higher protein diets for weight management and found a statistical association of higher intakes of “red meat and processed meats” with risk of colon cancer. However, after evaluating the overall food intake in greater detail, the investigators found that the higher risk of colon cancer occurred more specifically in individuals who were obese (ie. excess calories) and consumed limited dietary fiber, excess sugar, minimal fruit (ie. low vitamin C), high amounts of lettuce, spinach and beets (ie. high dietary nitrates), and high amounts of processed meats (ie. sausage and hotdogs). In the full context, it’s not surprising these individuals have increased health risks.

A second study in the Journal of Nutrition (JN 142:2112, 2012) sheds additional light on the importance of evaluating individual foods or nutrients in the context of the entire food pattern. These investigators evaluated the USDA NHANES dietary data related to cardiovascular risk factors (CVRF). They also used the food pattern model of the USDA Healthy Eating Index (HEI) which evaluates dietary outcomes against 10 food categories. They found that there was a strong inverse relationship of diet quality and CVRF. The better the overall diet quality the lower the health risks. So in an era when everyone wants to claim a new discovery about a magic or evil nutrient, we’re still finding that variety and moderation remain the most important goals for good nutrition.