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Egg Controversy

April 25, 2011 Written by JP    [Font too small?]

A reader recently inquired about why I use so many eggs in the recipes I post on this site. After all, eggs contain a considerable amount of cholesterol and saturated fat. Some medical authorities claim that these dietary components are harmful to the cardiovascular system. In fact, if you browse through the scientific literature you’ll find plenty of reason for pause with respect to eating eggs as a regular part of your diet. And if you happen to be “at risk” for heart disease, forget about it! Don’t even look at eggs! But as is often the case, first impressions don’t always tell the entire story.

The November 2010 issue of the Canadian Journal of Cardiology is enough to steer anyone away from eggs or, at least, egg yolks. Egg whites are generally given a pass because they’re high in protein and are cholesterol and fat-free. However, the yolks are the epicenter of what of many nutritionists loathe. According to researchers from the Stroke Prevention & Atherosclerosis Research Centre in Ontario, Canada a very dangerous trend is emerging in the population at large: “It is increasingly believed that consumption of dietary cholesterol and egg yolks is harmless”. Here are a few other choice quotes from this very convincing piece: “Dietary cholesterol, including egg yolks, is harmful to arteries” and “Stopping the consumption of egg yolks after a stroke or myocardial infarction would be like quitting smoking after a diagnosis of lung cancer: a necessary action, but late”. Are you scared yet? (1)

The trouble with the previously cited publication is that just doesn’t jive with the majority of the most current evidence. Take, for instance, a study appearing in the April 2011 edition of the International Journal of Food Science and Nutrition. This well-designed trial examined the impact of eating either a chicken sandwich, an omelette or a potato in addition to a standard breakfast in a group of 31 healthy men and women. All three food options were isocaloric or contained the same number of calories. The aim of the experiment was to determine which add-on food best satisfied subsequent hunger and would, thereby, reduce “energy consumption between meals”. The results? You guessed it. The addition of an omelette lead to a greater satiating effect. This isn’t the first time eggs have been linked to improved satiety. And since obesity and overweight are such major health threats in the world today, it would seem that eating more eggs may be a step in a lighter direction. (2,3,4)

Satisfying hunger is one thing. What about the impact of eating whole eggs on diabetes and heart disease? Four recent studies have specifically looked into this controversial topic. The results may be surprising to some:

Diabetes: The February 2011 issue of the British Journal of Nutrition examined the implications of eating two low-calorie diets, a high-protein/high-cholesetrol diet and a high-protein/low-cholesterol diet, in a a group of 65 type 2 diabetics (T2D). The high-cholesterol dieters were required to eat two eggs per day. All the participants lost weight over a 12 week period – about 13 lbs. More importantly, they all showed reductions in diastolic and systolic blood pressure, fasting blood sugar and insulin, HbA1c (long term blood sugar), “non-HDL cholesterol”, total cholesterol and triglycerides. Also of significance is that only the high-cholesterol dieters exhibited an increase in the beneficial HDL cholesterol.  A previous population study out Harvard Medical School from June 2010 concluded that “there was no association between egg consumption or dietary cholesterol and increased risk of T2D”. (5,6)

Heart Disease: In March 2011, a paper was presented in the European Journal of Clinical Nutrition. It evaluated the proposed association between egg consumption and incidence of cardiovascular disease (CVD) in a group of 14,815 Mediterranean men and women. Food frequency questionnaires were used to estimate the typical weekly egg intake. The study volunteers were followed for an average of about 6 years. During that period of time, a total of 91 new cases of confirmed CVD were documented. When comparing those that consumed the largest amount of eggs versus the lowest, the authors of the study determined that, “No association between egg consumption and the incidence of CVD was found in this Mediterranean cohort”. A separate US-based, population study in the February 2011 issue of Public Health Nutrition came to a similar conclusion. (7,8)

Eating Eggs Regularly May Protect Against Age-Related Macular Degeneration

Source: Am J Clin Nutr November 2009 vol. 90 no. 5 1272-1279 (link)

If you’re still not sold on the possibility that eggs may actually be good for you, you’re not alone. Chicken farmers are well aware of the concerns that many consumers and nutritionists have about their product. This impression has lead to changes in chicken feed which, ultimately, resulted in alterations in the nutritional composition of eggs. A report from earlier this year presented by the US Department of Agriculture found that modern eggs are about 14% lower in cholesterol and 64% higher in Vitamin D than eggs analyzed in 2002. A wide variety of natural additives are currently being investigated as a means of improving the health attributes of eggs. In the future, designer eggs may be enhanced by feeding chickens any number of dietary supplements including: alfalfa extract, garlic, iodine, inulin and selenium. This is also being considered as a means of addressing malnutrition in children and women of childbearing years. (9,10,11,12,13,14,15)

From my perspective, simply saying that eggs aren’t harmful isn’t enough of a reason to endorse or use them. To answer the initial question posed by my reader: I use organic, omega-3 enriched eggs in many grainless recipes because they’re a textural replacement for gluten (a protein that is sometimes allergic) and they’re a fantastic source of nutrient density. Eggs are loaded with antioxidant carotenoids such as lutein and zeaxanthin, bioavailable protein, nutrients including choline and omega-3 fatty acids such as DHA. But please don’t leave with the impression that adding eggs to just any diet is a recipe for good health. If you consume a generally unhealthy menu plan that’s loaded with artificial ingredients and refined carbohydrates, it’s unreasonable to assume that eggs will protect you. This is probably why some studies seem to find an adverse affect attributed to eggs. In the context of a poor diet, eggs may in fact contribute to illness. However, if you combine them with other nutrient dense whole foods, I believe eggs are among the healthiest options around. (16,17,18,19,20)

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!


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Posted in Diabetes, Heart Health, Nutrition

29 Comments & Updates to “Egg Controversy”

  1. bayoubabe Says:

    I recently tried TURKEY EGGS. I googled the nutritional information, and they have THREE TIMES the amount of cholestrol of regular chicken eggs. They were good, but I gave away the rest of the dozen !

    Some interesting facts here about eggs. Keep up the good work 🙂

  2. angie Says:

    Eggs + other whole foods = bliss!

    Keep up the good work, JP!

  3. Mark S Says:

    My hens loved this article and knew of the benefits of eggs long before. 🙂

  4. Richard David Feinman Says:

    My take on the egg studies is at

  5. Kelly Says:

    Great info. on eggs. My family loves eggs (organic, no hormones, no additives) and we wish our Home Owners Assoc. would allow hens in the yard.
    Keep up the great articles JP

  6. lana stamper Says:

    we have 13 hens and have fresh eggs every day. My hens run out in the eve. and love to forage in the woods. If I eat anything for breakfast besides eggs….iam starved all day. They really satisfy my hunger. Your comments and article was very informative. thanks!

  7. Jess Says:

    We have a few chickens that provide us with eggs in the morning, to be honest the amount of protein in them works absolute wonders for building muscle, and after all – building muscle is one of the best ways to reduce fat.

  8. JP Says:

    Thank you, BayouBabe. Eggs from ducks, geese, quail, turkeys, etc. all vary in terms of their nutritional content. Unfortunately, there isn’t much data available on the health implications of eating non-chicken eggs. However, I wouldn’t hesitate eating them personally.

    Be well!


  9. JP Says:

    Thank you, Angie. Will do! 🙂

    Be well!


  10. JP Says:

    Smart hens, Mark. Some might even call them eggheads. 🙂

    Be well!


  11. JP Says:

    Thank you for linking to your column on eggs and scientific research, Dr. Feinman. Very informative and highly recommended.

    Be well!


  12. JP Says:

    Many thanks, Kelly. I hear you. A reality show we sometimes watch on the Food Channel (“Extra Virgin”) features a couple who recently started raising hens in their back yard – somewhere in the Los Angeles area. Nothing better tasting than fresh eggs. So good.

    Be well!


  13. JP Says:

    Thank you for sharing your experience with us, Lana. Always good to hear about real world anecdotes that support the science I come across. Much appreciated!

    Be well!


  14. JP Says:

    Agreed, Jess. Eggs provide a wonderful source of protein.

    Be well!


  15. JP Says:

    Update 05/18/15:


    Nutrients. 2015 May 11;7(5):3449-63.

    One Egg per Day Improves Inflammation when Compared to an Oatmeal-Based Breakfast without Increasing Other Cardiometabolic Risk Factors in Diabetic Patients.

    There is concern that egg intake may increase blood glucose in patients with type 2 diabetes mellitus (T2DM). However, we have previously shown that eggs reduce inflammation in patients at risk for T2DM, including obese subjects and those with metabolic syndrome. Thus, we hypothesized that egg intake would not alter plasma glucose in T2DM patients when compared to oatmeal intake. Our primary endpoints for this clinical intervention were plasma glucose and the inflammatory markers tumor necrosis factor (TNF)-α and interleukin 6 (IL-6). As secondary endpoints, we evaluated additional parameters of glucose metabolism, dyslipidemias, oxidative stress and inflammation. Twenty-nine subjects, 35-65 years with glycosylated hemoglobin (HbA1c) values <9% were recruited and randomly allocated to consume isocaloric breakfasts containing either one egg/day or 40 g of oatmeal with 472 mL of lactose-free milk/day for five weeks. Following a three-week washout period, subjects were assigned to the alternate breakfast. At the end of each period, we measured all primary and secondary endpoints. Subjects completed four-day dietary recalls and one exercise questionnaire for each breakfast period. There were no significant differences in plasma glucose, our primary endpoint, plasma lipids, lipoprotein size or subfraction concentrations, insulin, HbA1c, apolipoprotein B, oxidized LDL or C-reactive protein. However, after adjusting for gender, age and body mass index, aspartate amino-transferase (AST) (p < 0.05) and tumor necrosis factor (TNF)-α (p < 0.01), one of our primary endpoints were significantly reduced during the egg period. These results suggest that compared to an oatmeal-based breakfast, eggs do not have any detrimental effects on lipoprotein or glucose metabolism in T2DM. In contrast, eggs reduce AST and TNF-α in this population characterized by chronic low-grade inflammation. Be well! JP

  16. JP Says:

    Updated 05/16/16:


    Nutrition Journal 201615:54

    A dietary cholesterol challenge study to assess Chlorella supplementation in maintaining healthy lipid levels in adults: a double-blinded, randomized, placebo-controlled study

    Background: Previous animal studies suggested that Chlorella, a unicellular green alga, has a preventive role in maintaining serum cholesterol levels against excess dietary cholesterol intake. This study aimed to conduct a pioneering investigation to clarify this issue in healthy subjects by adopting a dietary cholesterol challenge, which has not been used previously in similar studies of Chlorella in hypercholesterolemia.

    Methods: In this double blind, randomized, placebo-controlled study, 34 participants ingested 510 mg of dietary cholesterol from three eggs concomitantly with a usual dose of Chlorella (5 g/d) or a matched placebo for 4 weeks.

    Results: The dietary cholesterol challenge induced consistently higher concentrations of serum total cholesterol (TC, P <  0.001), LDL-C (P = 0.004), and HDL-C (P = 0.010) compared with baseline values, suggesting that the challenge was reliable. Thus, we observed a preventive action of Chlorella in maintaining serum TC versus placebo levels (3.5 % versus 9.8 %, respectively; P = 0.037) and LDL-C versus placebo levels (1.7 % versus 14.3 %, respectively; P = 0.012) against excessive dietary cholesterol intake and in augmenting HDL-C versus placebo levels (8.3 % versus 3.8 %, respectively). Furthermore, serum α-carotene showed the best separation between the placebo and Chlorella groups (R2X and R2Y > 0.5; Q2 > 0.4).

    Conclusion: The results suggest that a fully replicated dietary cholesterol challenge may be useful in assessing the effectiveness of dietary supplements in maintaining the serum lipid profiles of adults whose habitual diets are high in cholesterol.

    Be well!


  17. JP Says:

    Updated 05/30/16:


    Am J Clin Nutr. 2016 Mar;103(3):895-901.

    Associations of egg and cholesterol intakes with carotid intima-media thickness and risk of incident coronary artery disease according to apolipoprotein E phenotype in men: the Kuopio Ischaemic Heart Disease Risk Factor Study.

    BACKGROUND: In general populations, the effects of dietary cholesterol on blood cholesterol concentrations are modest. However, the relation is stronger in those with an ɛ4 allele in the apolipoprotein E gene (APOE). There is little information on the association between cholesterol intake and the risk of coronary artery disease (CAD) among those with the ApoE4 phenotype.

    OBJECTIVE: We investigated the associations of intakes of cholesterol and eggs, a major source of dietary cholesterol, with carotid intima-media thickness and the risk of incident CAD in middle-aged and older men from eastern Finland.

    DESIGN: The study included 1032 men aged 42-60 y in 1984-1989 at the baseline examinations of the prospective, population-based Kuopio Ischaemic Heart Disease Risk Factor Study. Data on common carotid artery intima-media thickness (CCA-IMT) were available for 846 men. Dietary intakes were assessed with 4-d food records. Associations with incident CAD and baseline CCA-IMT were analyzed by using Cox regression and ANCOVA, respectively.

    RESULTS: The ApoE4 phenotype was found in 32.5% of the men. During the average follow-up of 20.8 y, 230 CAD events occurred. Egg or cholesterol intakes were not associated with the risk of CAD. Each 1 additional egg (55 g)/d was associated with a multivariable-adjusted HR of 1.17 (95% CI: 0.85, 1.61) in the ApoE4 noncarriers and an HR of 0.93 (95% CI: 0.50, 1.72) in the ApoE4 carriers (P-interaction = 0.34). Each 100-mg/d higher cholesterol intake was associated with an HR of 1.04 (95% CI: 0.89, 1.22) in the ApoE4 noncarriers and an HR of 0.95 (95% CI: 0.73, 1.25) in the ApoE4 carriers (P-interaction = 0.81). Egg or cholesterol intakes were also not associated with increased CCA-IMT.

    CONCLUSION: Egg or cholesterol intakes were not associated with increased CAD risk, even in ApoE4 carriers (i.e., in highly susceptible individuals).

    Be well!


  18. JP Says:

    Updated 05/30/16:


    Eat Behav. 2016 Jan;20:14-20.

    Comparison of the satiating properties of egg- versus cereal grain-based breakfasts for appetite and energy intake control in children.

    BACKGROUND: Few studies exist that have systematically examined the role of protein, and egg protein in particular, in appetite and energy intake regulation in children.

    OBJECTIVE: The aim of this study was to compare the effects of three different types of breakfast on appetite and energy intake at subsequent meals in children.

    DESIGN: Forty children, ages 8-10, were served a compulsory breakfast (egg, cereal, or oatmeal) and lunch, consumed ad libitum, once a week for three weeks. Children’s appetite ratings were assessed repeatedly throughout the morning. On each test day, caregivers completed food records, which captured children’s intake for the remainder of the day.

    RESULTS: There was a significant main effect of breakfast condition on energy intake at lunch (P=0.02) indicating that children consumed ~70 fewer calories at lunch following the egg breakfast (696 ± 53 kcal) compared to the cereal (767 ± 53 kcal) and oatmeal (765 ± 53 kcal) breakfasts. Calories consumed for the remainder of the day and daily energy intake did not differ across conditions (P>0.30). There also were no significant differences in children’s appetite ratings between conditions (P>0.43).

    CONCLUSIONS: Consuming an egg-based breakfast significantly reduced short-term, but not longer-term, energy intake in children in the absence of differences in appetite ratings.

    Be well!


  19. JP Says:

    Updated 05/30/16:


    Nutrients. 2015 Oct 2;7(10):8402-12.

    Egg Intake and Dietary Quality among Overweight and Obese Mexican-American Postpartum Women.

    Despite their low cost and high nutrient density, the contribution of eggs to nutrient intake and dietary quality among Mexican-American postpartum women has not been evaluated. Nutrient intake and dietary quality, as assessed by the Healthy Eating Index 2010 (HEI-2010), were measured in habitually sedentary overweight/obese (body mass index (BMI) = 29.7 ± 3.5 kg/m²) Mexican-American postpartum women (28 ± 6 years) and compared between egg consumers (n = 82; any egg intake reported in at least one of three 24-h dietary recalls) and non-consumers (n = 57). Egg consumers had greater intake of energy (+808 kJ (193 kcal) or 14%; p = 0.033), protein (+9 g or 17%; p = 0.031), total fat (+9 g or 19%; p = 0.039), monounsaturated fat (+4 g or 24%; p = 0.020), and several micronutrients than non-consumers. Regarding HEI-2010 scores, egg consumers had a greater total protein foods score than non-consumers (4.7 ± 0.7 vs. 4.3 ± 1.0; p = 0.004), and trends for greater total fruit (2.4 ± 1.8 vs. 1.9 ± 1.7; p = 0.070) and the total composite HEI-2010 score (56.4 ± 12.6 vs. 52.3 ± 14.4; p = 0.082). Findings suggest that egg intake could contribute to greater nutrient intake and improved dietary quality among postpartum Mexican-American women. Because of greater energy intake among egg consumers, recommendations for overweight/obese individuals should include avoiding excessive energy intake and incorporating eggs to a nutrient-dense, fiber-rich dietary pattern.

    Be well!


  20. JP Says:

    Updated 06/17/16:


    Int J Food Sci Nutr. 2016 Jun 16:1-9.

    The effects of the combination of egg and fiber on appetite, glycemic response and food intake in normal weight adults – a randomized, controlled, crossover trial.

    This study evaluated appetite and glycemic effects of egg-based breakfasts, containing high and moderate protein (30 g protein and 20 g protein +7 g fiber, respectively) compared to a low-protein cereal breakfast (10 g protein) examined in healthy adults (N = 48; age 24 ± 1 yr; BMI 23 ± 1 kg/m2; mean ± SE). Meals provided 390 kcal/serving and equal fat content. Food intake was measured at an ad libitum lunch meal and blood glucose response was measured. Visual analog scales (VAS) were used to assess hunger, satisfaction, fullness, and prospective food intake. The egg-based breakfast meal with high protein produced greater overall satiety (p < 0.0001), and both high protein and moderate protein with fiber egg-based breakfasts reduced postprandial glycemic response (p < 0.005) and food intake (p < 0.05) at subsequent meal (by 135 kcal and 69 kcal; effect sizes 0.44 and 0.23, respectively) compared to a cereal-based breakfast with low protein and fiber. Be well! JP

  21. JP Says:

    Updated 10/10/16:


    J Am Coll Nutr. 2016 Oct 6:1-13.

    Meta-analysis of Egg Consumption and Risk of Coronary Heart Disease and Stroke.

    The possible relationship between dietary cholesterol and cardiac outcomes has been scrutinized for decades. However, recent reviews of the literature have suggested that dietary cholesterol is not a nutrient of concern. Thus, we conducted a meta-analysis of egg intake (a significant contributor to dietary cholesterol) and risk of coronary heart disease (CHD) and stroke. A comprehensive literature search was conducted through August 2015 to identify prospective cohort studies that reported risk estimates for egg consumption in association with CHD or stroke. Random-effects meta-analysis was used to generate summary relative risk estimates (SRREs) for high vs low intake and stratified intake dose-response analyses. Heterogeneity was examined in subgroups where sensitivity and meta regression analyses were conducted based on increasing egg intake. A 12% decreased risk (SRRE = 0.88, 95% confidence interval [CI], 0.81-0.97) of stroke was observed in the meta-analysis of 7 studies of egg intake (high vs low; generally 1/d vs <2/wk), with little heterogeneity (p-H = 0.37, I2 = 7.50). A nonstatistically significant SRRE of 0.97 (95% CI, 0.88-1.07, p-H = 0.67, I2 = 0.00) was observed in the meta-analysis of 7 studies of egg consumption and CHD. No clear dose-response trends were apparent in the stratified intake meta-analyses or the meta regression analyses. Based on the results of this meta-analysis, consumption of up to one egg daily may contribute to a decreased risk of total stroke, and daily egg intake does not appear to be associated with risk of CHD. Key Teaching Points: • The role of egg consumption in the risk of stroke and coronary heart disease has come under scrutiny over many years. • A comprehensive meta-analysis of prospective cohort studies that reported risk estimates for egg consumption in association with CHD or stroke was performed on the peer-reviewed epidemiologic literature through August 2015. • Overall, summary associations indicate that intake of up to 1 egg daily may be associated with reduced risk of total stroke. • Overall, summary associations show no clear association between egg intake and increased or decreased risk of CHD. • Eggs are a relatively low-cost and nutrient-dense whole food that provides a valuable source of protein, essential fatty acids, antioxidants, choline, vitamins, and minerals.

    Be well!


  22. JP Says:

    Updated 12/10/16:


    J Nutr Sci Vitaminol (Tokyo). 2016;62(5):361-365.

    The Effect of the Consumption of Egg on Serum Lipids and Antioxidant Status in Healthy Subjects.

    The egg is a nutrient-dense food and contains a number of antioxidants. The consumption of eggs has been considered to improve the balance of diets, although its impact on serum cholesterol levels has been a matter of concern in many countries. Here, we conducted a pilot study to investigate whether daily additional consumption of an egg might affect serum lipid profiles and also antioxidant status in healthy subjects. Fourteen male subjects were provided with breakfasts including a boiled egg for 4 wk. At the end of intervention, serum concentrations of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) were unchanged, despite the significant increase in the intake of dietary cholesterol. In contrast, a significant increase in high-density lipoprotein cholesterol (HDL-C) and a reduction of the LDL-C/HDL-C ratio were observed. Interestingly, the malondialdehyde modified-LDL (MDA-LDL)/LDL-C ratio and the oxidizability of LDL were significantly reduced. Serum total antioxidant capacity value after the intervention period was higher than at baseline. These data indicate that consuming one egg per day for 4 wk as breakfast in addition to a normal diet does not affect serum lipids, and suggests that it may improve serum antioxidant status in healthy males.

    Be well!


  23. JP Says:

    Updated 01/18/17:


    J Nutr. 2017 Jan 11.

    Intake of up to 3 Eggs per Day Is Associated with Changes in HDL Function and Increased Plasma Antioxidants in Healthy, Young Adults.

    BACKGROUND: HDL function may be more important than HDL concentration in determining risk for cardiovascular disease. In addition, HDL is a carrier of carotenoids and antioxidant enzymes, which protect HDL and LDL particles against oxidation.

    OBJECTIVE: The goal of this study was to determine the impact of consuming 0-3 eggs/d on LDL and HDL particle size, HDL function, and plasma antioxidants in a young, healthy population.

    METHODS: Thirty-eight healthy men and women [age 18-30 y, body mass index (in kg/m2) 18.5-29.9] participated in this 14-wk crossover intervention. Subjects underwent a 2-wk washout (0 eggs/d) followed by sequentially increasing intake of 1, 2, and 3 eggs/d for 4 wk each. After each period, fasting blood was collected for analysis of lipoprotein subfractions, plasma apolipoprotein (apo) concentration, lutein and zeaxanthin concentration, and activities of lecithin-cholesterol acyltransferase, cholesteryl ester transfer protein, and paraoxonase-1.

    RESULTS: Compared with intake of 0 eggs/d, consuming 1-3 eggs/d resulted in increased large-LDL (21-37%) and large-HDL (6-13%) particle concentrations, plasma apoAI (9-15%), and lecithin-cholesterol acyltransferase activity (5-15%) (P < 0.05 for all biomarkers). Intake of 2-3 eggs/d also promoted an 11% increase in apoAII (P < 0.05) and a 20-31% increase in plasma lutein and zeaxanthin (P < 0.05), whereas intake of 3 eggs/d resulted in a 9-16% increase in serum paraoxonase-1 activity compared with intake of 1-2 eggs/d (P < 0.05). Egg intake did not affect cholesteryl ester transfer protein activity. CONCLUSIONS: Intake of 1 egg/d was sufficient to increase HDL function and large-LDL particle concentration; however, intake of 2-3 eggs/d supported greater improvements in HDL function as well as increased plasma carotenoids. Overall, intake of ≤3 eggs/d favored a less atherogenic LDL particle profile, improved HDL function, and increased plasma antioxidants in young, healthy adults. Be well! JP

  24. JP Says:

    Updated 04/04/17:


    Can J Diabetes. 2017 Mar 27. pii: S1499-2671(16)30562-7.

    Impact of Egg Consumption on Cardiovascular Risk Factors in Individuals with Type 2 Diabetes and at Risk for Developing Diabetes:

    A Systematic Review of Randomized Nutritional Intervention Studies.
    Observational studies have reported inconclusive results regarding the relationship between egg consumption (and dietary cholesterol) and the risk for cardiovascular diseases (CVDs) in individuals with type 2 diabetes, which has led to inconsistent recommendations to patients. We reviewed the evidence of egg consumption on major CVD risk factors in individuals with or at risk for type 2 diabetes (prediabetes, insulin resistance or metabolic syndrome). We performed a systematic search in the databases PubMed, MEDLINE, EMBASE and Web of Science in January 2016. Inclusion criteria included randomized controlled trials in which the amount of egg consumed was manipulated and compared to a control group that received no-egg or low-egg diets (<2 eggs/week). We found 10 articles (6 original trials) that met our inclusion criteria. The majority of studies found that egg consumption did not affect major CVD risk factors. Consumption of 6 to 12 eggs per week had no impact on plasma concentrations of total cholesterol, low-density lipoprotein-cholesterol, triglycerides, fasting glucose, insulin or C-reactive protein in all studies that reported these outcomes in comparison with control groups. An increase in high-density lipoprotein-cholesterol with egg consumption was observed in 4 of 6 studies. Results from randomized controlled trials suggest that consumption of 6 to 12 eggs per week, in the context of a diet that is consistent with guidelines on cardiovascular health promotion, has no adverse effect on major CVD risk factors in individuals at risk for developing diabetes or with type 2 diabetes. However, heterogeneities in study design, population included and interventions prevent firm conclusions from being drawn.

    Be well!


  25. JP Says:

    Updated 12/08/17:


    Am J Clin Nutr. 2017 Dec;106(6):1482-1489.

    Eggs early in complementary feeding increase choline pathway biomarkers and DHA: a randomized controlled trial in Ecuador.

    Background: Choline status has been associated with stunting among young children. Findings from this study showed that an egg intervention improved linear growth by a length-for-age z score of 0.63.

    Objective: We aimed to test the efficacy of eggs introduced early in complementary feeding on plasma concentrations of biomarkers in choline pathways, vitamins B-12 and A, and essential fatty acids.

    Design: A randomized controlled trial, the Lulun (“egg” in Kichwa) Project, was conducted in a rural indigenous population of Ecuador. Infants aged 6-9 mo were randomly assigned to treatment (1 egg/d for 6 mo; n = 80) and control (no intervention; n = 83) groups. Socioeconomic data, anthropometric measures, and blood samples were collected at baseline and endline. Household visits were made weekly for morbidity surveillance. We tested vitamin B-12 plasma concentrations by using chemiluminescent competitive immunoassay and plasma concentrations of choline, betaine, dimethylglycine, retinol, essential fatty acids, methionine, dimethylamine (DMA), trimethylamine, and trimethylamine-N-oxide (TMAO) with the use of liquid chromatography-tandem mass spectrometry.

    Results: Socioeconomic factors and biomarker concentrations were comparable at baseline. Of infants, 11.4% were vitamin B-12 deficient and 31.7% marginally deficient at baseline. In adjusted generalized linear regression modeling, the egg intervention increased plasma concentrations compared with control by the following effect sizes: choline, 0.35 (95% CI: 0.12, 0.57); betaine, 0.29 (95% CI: 0.01, 0.58); methionine, 0.31 (95% CI: 0.03, 0.60); docosahexaenoic acid, 0.43 (95% CI: 0.13, 0.73); DMA, 0.37 (95% CI: 0.37, 0.69); and TMAO, 0.33 (95% CI: 0.08, 0.58). No significant group differences were found for vitamin B-12, retinol, linoleic acid (LA), α-linolenic acid (ALA), or ratios of betaine to choline and LA to ALA.

    Conclusion: The findings supported our hypothesis that early introduction of eggs significantly improved choline and other markers in its methyl group metabolism pathway.

    Be well!


  26. JP Says:

    Updated 1/17/18:


    British Journal of Nutrition, 1-12.

    Replacing carbohydrate during a glucose challenge with the egg white portion or whole eggs protects against postprandial impairments in vascular endothelial function in prediabetic men by limiting increases in glycaemia and lipid peroxidation

    Eggs attenuate postprandial hyperglycaemia (PPH), which transiently impairs vascular endothelial function (VEF). We hypothesised that co-ingestion of a glucose challenge with egg-based meals would protect against glucose-induced impairments in VEF by attenuating PPH and oxidative stress. A randomised, cross-over study was conducted in prediabetic men (n 20) who ingested isoenegertic meals (1674 kJ (400 kcal)) containing 100 g glucose (GLU), or 75 g glucose with 1·5 whole eggs (EGG), seven egg whites (WHITE) or two egg yolks (YOLK). At 30 min intervals for 3 h, brachial artery flow-mediated dilation (FMD), plasma glucose, insulin, cholecystokinin (CCK), lipids (total, LDL- and HDL-cholesterol; TAG), F2-isoprostanes normalised to arachidonic acid (F2-IsoPs/AA), and methylglyoxal were assessed. In GLU, FMD decreased at 30–60 min and returned to baseline levels by 90 min. GLU-mediated decreases in FMD were attenuated at 30–60 min in EGG and WHITE. Compared with GLU, FMDAUC was higher in EGG and WHITE only. Relative to baseline, glucose increased at 30–120 min in GLU and YOLK but only at 30–90 min in EGG and WHITE. GlucoseAUC and insulinAUC were also lower in EGG and WHITE only. However, CCKAUC was higher in EGG and WHITE compared with GLU. Compared with GLU, F2-IsoPs/AAAUC was lower in EGG and WHITE but unaffected by YOLK. Postprandial lipids and methylglyoxal did not differ between treatments. Thus, replacing a portion of a glucose challenge with whole eggs or egg whites, but not yolks, limits postprandial impairments in VEF by attenuating increases in glycaemia and lipid peroxidation.

    Be well!


  27. JP Says:

    Updated 08/04/18:


    Food Funct. 2018 Aug 3.

    Egg consumption may improve factors associated with glycemic control and insulin sensitivity in adults with pre- and type II diabetes.

    Without appropriate interventions, prediabetes is typically followed by type II diabetes. Eggs are a rich source of important nutrients including protein, vitamins, minerals, carotenoids and lecithin. In this 12-week, parallel, randomized controlled trial, 42 overweight or obese individuals between the ages of 40 and 75 years with pre- and type II-diabetes were included. Participants were randomly assigned to receive either one large egg per day or an equivalent amount of egg substitute for 12 weeks. Blood samples were obtained to analyze lipid profile and biomarkers associated with glycemic control at all time points. Regular egg consumption resulted in improvements of fasting blood glucose, which was significantly (P = 0.05) reduced by 4.4% at the final visit in the egg group. Participants in the egg group had significantly (P = 0.01) lower levels of homeostatic model assessment of insulin resistance (HOMA-IR) at all visits. In the egg group, ATP-binding cassette protein family A1 (ABCA1) was significantly higher at the 6-week visit (0.78 ± 0.21 vs. 0.28 ± 0.05 mg dL-1, P < 0.001) and tended to be higher at the final visit (0.62 ± 0.11 vs. 0.55 ± 0.18 mg dL-1, P = 0.1). The mean apolipoprotein A1 (apo A1) level was also significantly higher at the final visit in the egg group compared to the control (147.43 ± 5.34 vs. 142.81 ± 5.09 mg dL-1, P = 0.01). There were no significant changes in total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels. Daily consumption of one large egg may reduce the risk of diabetes without having any adverse effects on lipid profiles in individuals with pre- and type II diabetes. Be well! JP

  28. JP Says:

    Updated 10/14/18:


    J Am Coll Nutr. 2018 Oct 3:1-6.

    Egg Intake Has No Adverse Association With Blood Lipids Or Glucose In Adolescent Girls.

    OBJECTIVE: Longitudinal data on cardiometabolic effects of egg intake during adolescence are lacking. The current analyses aim to evaluate the impact of usual adolescent egg consumption on lipid levels, fasting glucose, and insulin resistance during late adolescence (age 17-20 years).

    METHODS: Data from 1392 girls, aged 9 to 10 at baseline and followed for 10 years, in the National Heart, Lung, and Blood Institute’s National Growth and Health Study were used to examine the association between usual egg intake alone and in combination with other healthy lifestyle factors and late adolescent lipid levels, fasting glucose, and insulin resistance, measured as homeostasis model assessment of insulin resistance (HOMA-IR). Diet was assessed using 3-day food records during eight examination cycles. Girls were classified according to usual weekly egg intake, ages 9-17 years: <1 egg/wk (n = 361), 1 to <3 eggs/wk (n = 703), and ≥3 eggs/wk (n = 328). Analysis of covariance modeling was used to control for confounding by other behavioral and biological risk factors.

    RESULTS: Girls with low, moderate, and high egg intakes had adjusted low-density lipoprotein cholesterol levels of 99.7, 98.8, and 95.5 mg/dL, respectively (p = 0.0778). In combination with higher intakes of fiber, dairy, or fruits and vegetables, these beneficial effects were stronger and statistically significant. There was no evidence that ≥3 eggs/wk had an adverse effect on lipids, glucose, or HOMA-IR. More active girls who consumed ≥3 eggs/wk had the lowest levels of insulin resistance.

    CONCLUSION: These results suggest that eggs may be included as part of a healthy adolescent diet without adverse effects on glucose, lipid levels, or insulin resistance.

    Be well!


  29. JP Says:

    Updated 03/16/19:


    Clinical Nutrition – Accessed Ahead of Print on 03/16/19

    Consumption of eggs and the 15-year incidence of age-related macular degeneration

    Background and Aims: A naturally rich source of lutein and zeaxanthin are eggs. There is scarce epidemiological data on the temporal association between total egg consumption and age-related macular degeneration (AMD) incidence. We aimed to establish the prospective and independent association between consumption of eggs with the incidence of AMD over a 15-year follow-up.

    Methods: In this population-based cohort study of 3,654 participants aged 49+ years examined at baseline, 2034 participants had complete information on baseline egg consumption and AMD signs over 15 years. AMD was determined from retinal photographs. Egg consumption was assessed using a semi-quantitative food-frequency questionnaire. Total egg intake was calculated through summing up intakes in all forms e.g. boiled, poached, fried, scrambled and/or omelette. We summarized total egg consumption into the following categories: ≤1 egg/week; 2-4 eggs/week; 5-6 eggs/week; and ≥1 egg/day.

    Results: At baseline, participants who consumed 2-4 eggs/week compared to those who consumed ≤1 egg/week (reference group) had reduced risk of incident late-stage AMD after 15 years: multivariable-adjusted odds ratio, OR, 0.51 (95% confidence intervals, CI, 0.28-0.92). Participants who consumed 2-4 eggs/week versus ≤1 egg/week at baseline had 62% reduced risk of developing neovascular AMD. Among those whose AMD onset was at or before the 10-year follow-up, consumption of 2-4 and 5-6 eggs/week was associated with 54% and 65% reduced risk of incident late AMD, respectively. When analyzed as a dichotomized variable, participants who consumed >1 egg/week versus ≤1 egg/week at baseline, had 46% reduced risk of developing late-stage AMD 15 years later: multivariable-adjusted OR 0.54 (95% CI 0.3-0.90). Non-significant associations were observed between egg consumption and incident early AMD.

    Conclusions: Our findings suggest that moderate consumption of eggs significantly reduces the risk of developing incident late-stage AMD over 15 years.

    Be well!


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