ArticleLiterature Review

Egg Consumption and Heart Health: A Review

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Abstract

Cardiovascular disease is the leading cause of death in the United States. Until recently, reducing dietary cholesterol has been a part of the American Heart Association (AHA) and American College of Cardiology (ACC) guidelines on lifestyle management, despite inconclusive evidence to support the recommendation. Considering eggs are a rich source of dietary cholesterol (typically containing 141–234 mg per egg), individuals with increased risk for CVD are advised not to consume eggs. Furthermore, based on the 2012 AHA/ACC guidelines, individuals with lower risk for CVD have previously been advised to avoid consuming eggs due to the high content of dietary cholesterol. Rather than strictly limiting cholesterol intake, the AHA and ACC guidelines now recommend dietary patterns that emphasize fruits, vegetables, whole grains, low-fat dairy products, poultry, fish, and nuts as an approach to favorably alter blood lipid levels. Of note, the 2015–2020 Dietary Guidelines for Americans have removed the recommendation of limiting cholesterol intake to no more than 300 mg per day; however, the guidelines advise that individuals should eat as little dietary cholesterol as possible while consuming a healthy eating pattern. The purpose of this review is to summarize the documented health risks of egg consumption in individuals with low and high risk for CVD and determine whether current recommendations are warranted based on the available literature. We also aim to provide guidance for future studies that will help further elucidate the health modulating effect of eggs.

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... While it is hypothesized that TMAO may contribute to atherosclerosis, this pathway has not been definitively linked to the causal mechanism for atherosclerosis. Furthermore, eggs contain essential nutrients, comprising high-quality protein, vitamins and minerals, and antioxidants, including lutein and zeaxanthin, which help prevent inflammation, oxidation, and atherosclerosis [45]. There are no controlled trials demonstrating an adverse impact of egg consumption on cardiovascular disease risk among individuals at lower or higher risk. ...
... The evidence strongly suggests that in a wide variety of apparently healthy subjects, adding eggs to normal dietary intake does not adversely affect blood lipid profiles, which are risk factors for coronary heart disease across a range of ages and ethnicities [45]. Overall, the available research indicates that consuming eggs does not have detrimental effects on certain markers associated with cardiovascular disease risk in individuals at high risk for CVD, such as overweight and obese adult men [47]. ...
... In the EGG group, which consumed more dietary cholesterol and choline than the subgroup, reduction of tumor necrosis factor-α and serum amyloid A was observed. In general, the available research suggests that eating eggs does not negatively alter some markers of CVD risk in individuals at high risk for CVD, such as overweight and obese adults [45]. Thus, eggs can be part of a healthy, balanced diet when consumed with moderation. ...
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All recent guidelines on cardiovascular prevention have highlighted the role of a healthy diet and lifestyle advocating an holistic approach to reduce the cardiovascular burden among the population. Despite these efforts, registries have reported that only a minority of healthcare professionals provide advice on diet and lifestyle, and, in most cases, counseling is suboptimal for several reasons. Cardiovascular benefits linked to lifestyle and nutrition seem to be underestimated by many patients and doctors. This overview aims to summarize well-established benefits related to lifestyle and nutrition, discuss the current debates in this field in order to improve awareness among the medical community and promote better implementation of non-pharmaceutical measures to prevent the occurrence of atherothrombotic events, by reducing cardiovascular risk factors such as hypertension, diabetes, dyslipidemia, and obesity.
... Nevertheless, this study [18] did not discover any correlation between the consumption of food containing cholesterol and increased levels of cholesterol. Furthermore, a rise in total cholesterol levels may not accurately show the risk of atherosclerosis because the cholesterol profile also includes high-density lipoprotein (HDL), which protects against atherosclerosis [8]. The Framingham study has not shown any connections between blood cholesterol and several health outcomes, including all-cause mortality, coronary artery disease, and myocardial infarction [18]. ...
... Mutungi et al. observed a significant increase in HDL levels in individuals who consume eggs alongside moderate carbohydrate restriction [23]. There is potential for further investigation into the effects of egg consumption among individuals with normal carbohydrate intake, particularly since low carbohydrate diets have been associated with reduced triglyceride levels in the bloodstream [8]. Potent antioxidants like lutein and zeaxanthin, known to protect against lipid oxidation and prevent atherosclerosis, may account for the apparent absence of evidence suggesting harm from egg yolk consumption. ...
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Eggs, which are often considered a complete food, have recently been scrutinized by the media as a potential cause of cardiovascular disease. However, the media hasn't shown the same enthusiasm for processed foods high in fructose, the consumption of refined cooking oil, seed oils, and carbohydrate-rich meals, the connection between these factors and metabolic diseases, or the potential long-term impacts on population comorbidities, as they have for criticizing egg yolks as a cause for cardiovascular disease in recent times. This review investigates the relationship between eggs and lipid levels, glucose levels, atherosclerosis, and antioxidant properties, as well as comparing them to cholesterol-free egg controls. We conducted the review in response to a recent trend of discarding nutritious and energy-rich egg yolks due to the belief propagated by the media that removing egg yolks from a normal diet is cardioprotective after the media started to blame egg yolks as the cause of the recent surge in heart attacks. However, the media fails to highlight the fact that eggs have been an integral part of the human diet since the domestication of hens. On the other hand, recent additions to the human diet a few decades ago, such as fructose-rich breakfast cereals, coffee beverages with sugar levels comparable to candy bars, protein supplements for diabetics that are notorious for raising blood glucose levels, and the heightened consumption of seed oil, which causes inflammation, have been responsible for the surge in cardiovascular events in recent times. Social media platforms often showcase visually appealing junk food products and sugary beverages as a sign of wealth, promoting unhealthy processed food and ultimately causing a decline in an individual's lifespan and overall health.
... Bizning tanamizdagi xolesterinning taxminan 20-25% tuxum, maaso, sut mahsulotlari va boshqalar kabi hayvonlarning oziq-ovqatlaridan kelib chiqqanligi sababli. bizning diyetadagi xolesterin konsentratsiyasini bilish muhimdir [5]. ...
... Public interest in dietary cholesterol has increased significantly due to the association of cholesterol levels in blood plasma with the risk of heart disease. Since about 20-25% of cholesterol in our body comes from animal products, such as eggs, mass, dairy products, etc. it is important to know the concentration of cholesterol in our diet [5]. ...
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Margarin, margarin va sariyogʻ omixtasi hamda sariyogʻni bojxona maqsadlari uchun identifikasiya qilish uchun kimyoviy tarkiblari xromatomass spektrometriya ususlida tadqiq qilindi. Bunda ularning tarkibidagi xolesterin moddasi asosiy koʻrstkich sifatida belgilab olindi. Tadqiqot natijalariga koʻra margarin tarkibida xolesterin moddasi mavjud emasligi, sariyogʻ margarin omixtasida 0,06 mg/g hamda sariyogʻ tarkibida 2,66 mg/g xolesterin moddasi mavjudligi aniqlandi. Bunga koʻra margarin yoki sariyogʻ va margarin omixtasi mahsulotlari tashqi iqtisodiy faoliyat tovarlar nomenklaturasining 15 guruhida, sariyogʻ esa 04 guruhida tasniflanishi koʻrasatildi.
... Sin embargo, Aljohi et al. (2019), no encontraron alteraciones en los niveles de biomarcadores de enfermedades cardiovasculares con un consumo de 12 huevos/semana en adultos mayores. Clayton et al. (2017), reportaron en su revisión que no hubo afectación en las concentraciones de lípidos en sangre con la ingesta de 2 huevos en el desayuno, 5 veces/semana, durante 14 semanas, en comparación con un desayuno isocalórico sin huevo. Del mismo modo, no se reportan cambios en las concentraciones del colesterol alto o bajo, en hombres de mediana edad ni en mujeres premenopáusicas (20-50 años) con ingestas de 3 huevos/día durante 30 días; así como tampoco, en mujeres posmenopáusicas (≥ 60 años) y adultos de 40 a 65 años con ingestas de 3 y 1 huevo/día, respectivamente. ...
... Estas investigaciones y muchas otras han permitido reevaluar las restricciones del consumo de huevo; además, hoy existe un mayor conocimiento sobre las causas de las enfermedades cardiovasculares, las cuales pueden explicar cómo el colesterol en la dieta influye en el colesterol en la sangre (Katz et al., 2014;Clayton et al., 2017). ...
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El huevo es un alimento con una gran cantidad de nutrientes para ser utilizados por nuestro organismo. El objetivo de la revisión es suministrar información general sobre el huevo de gallina y su relación con la salud; además, revisar el estado de los tratamientos térmicos y tecnologías emergentes aplicadas con el fin de generar valor en productos del sector avícola. La revisión se realizó sobre bases de datos de revistas científicas adscritas a Science Direct, Scopus, Scielo y Redalyc, durante un periodo comprendido entre 2013 y 2020. Dado que el huevo se considera un alimento de alto riesgo para la salud y un producto con una variedad de propiedades funcionales, en los últimos años, se ha identificado una tendencia en aplicar tratamientos térmicos que permitan obtener un producto seguro microbiológicamente para los consumidores y con el menor efecto en dichas propiedades para ser utilizado por la industria. En general, el huevo es una materia prima fácilmente procesable a través de diferentes tecnologías, que permiten obtener productos líquidos o sólidos para ser utilizados en nuevos productos procesados. El uso de estas tecnologías permite reducir los costos operativos y mejorar la calidad del producto.
... INTERHEART, a case-control study conducted in 52 countries, identifield the factors and health behaviors that create the risk of acute myocardial infarction, which accounts for more than 90% of the population. These factors include hypertension, dyslipidemia, diabetes, obesity, smoking, alcohol, diet, and sedentary lifestyle (Timmis et al., 2020) Eggs are the main source of dietary cholesterol (200-300 mg/100 g, approximately 180 mg per medium egg), and their consumption in moderation has been recommended to reduce dietary cholesterol intake (Clayton et al., 2017). ...
... Americans accentuate taking cholesterol more than 300 mg per day. Guidelines recommend individuals to reduce dietary cholesterol (Clayton et al., 2017). Eggs are rich in nutrients and the source of essential oils and amino acids and nutrients with the highest cholesterol content. ...
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This study was planned and conducted to investigate the effects of egg consumption on metabolic syndrome components and potential mechanisms of action on humans. Egg, an important source of animal protein, is defined as a functional food containing various bioactive compounds that can affect the proinflammatory and anti‐inflammatory pathways. As a matter of fact, the egg can show immunomodulatory, anti‐inflammatory, antioxidant, anticancer, or antihypertensive effects with its bioactive components. It is claimed that egg consumption may protect individuals against metabolic syndrome by increasing HDL‐C levels and reducing inflammation. The increase in egg consumption creates the perception that it may lead to cardiovascular diseases due to its cholesterol content. However, there is insufficient evidence as to whether dietary cholesterol‐lowers LDL‐C. The possible potential mechanisms of egg impact on human health, MEDLINE, Embase, the Cochrane Central, www.ClinicalTrials.gov, PubMed, Science Direct, Google Scholar, and selected websites including) and databases were examined in this regard. With a view to delving into the rather mysterious relationship between egg cholesterol and blood cholesterol, it is necessary to understand the absorption of cholesterol from the egg and to know the functioning of the intestinal microbiota. Studies conducted to date have generally yielded inconsistent results regarding egg consumption and risks of CVD, diabetes, and metabolic syndrome.
... [67][68][69][70][71][72] However, despite these favorable effects of egg cholesterol, patients at high CV risk, such as those with preexisting CVD or T2DM, would be prudent to refrain from high egg consumption and instead maintain diets that are high in fiber content. 73,74 One egg, depending on its size, contains between 141 and 234 mg of cholesterol, but this amount of cholesterol does not appreciably increase the plasma cholesterol level 75 or the risk for CVD, although other studies have shown that moderate egg consumption was associated with an increased incidence of CVD. The analysis of the data in this review is controversial regarding the association of egg consumption with the incidence of CVD, with some studies showing no association, [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] and others showing a positive association. ...
... 90 Patients with preexisting CVD or T2DM should avoid high egg consumption and reduce the total cholesterol intake to less than 300 mg/d. 73,74 With respect to the association of egg consumption and dairy products by lacto-ovo vegetarians, there appears to be no harmful effect of this combination, because these subjects have low plasma lipids, low total cholesterol/HDL and LDL/HDL ratios, and a low incidence of CVD. 91 With respect to the data of reviews and meta-analyses of cohort and epidemiologic studies compared to randomized, controlled studies, there are some pluses and minuses with their analysis, as stated by Cheng. ...
Article
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There is a great debate regarding the association of cholesterol intake from egg consumption and the incidence of cardiovascular disease (CVD). Most studies show that moderate egg consumption is not associated with a significant increase in CVD, stroke, heart failure, and type 2 diabetes mellitus (T2DM), whereas others dispute this fact and state that there is an association with increased egg consumption, especially if they are consumed with saturated fats. In addition, the recent relaxation of cholesterol intake to > 300 mg/day by the American College of Cardiology/American Heart Association Nutritional Guidelines has fueled this debate. In order to get a current perspective on the significance of moderate egg consumption with the primary incidence of CVD, a focused Medline search of the English language literature was conducted between 2010 and March 2020 using the terms, cholesterol intake, egg consumption, coronary artery disease, CVD, T2DM. Nineteen pertinent papers were retrieved, and these, together with collateral literature, will be discussed in this review article. The analysis of data from the papers retrieved indicated that several studies showed moderate egg consumption (1 egg/day) is not associated with adverse cardiovascular effects in subjects free of CVD or T2DM, whereas other studies showed a positive association, especially in patients with preexisting CVD or T2DM. Therefore, at present, there is no unanimous agreement on this subject, and the controversy will continue until new confirmatory evidence becomes available.
... Eggs are an affordable and low-calorie source of many nutrients, including unsaturated fatty acids, choline, essential amino acids, iron, folate, and other B vitamins (1). Eggs are also among the foods with the highest cholesterol content, with ∼200 mg cholesterol/egg (1). ...
... Eggs are an affordable and low-calorie source of many nutrients, including unsaturated fatty acids, choline, essential amino acids, iron, folate, and other B vitamins (1). Eggs are also among the foods with the highest cholesterol content, with ∼200 mg cholesterol/egg (1). Given the potential impact of dietary cholesterol on serum cholesterol concentrations (2), it has long been recommended to consume no more than 300 mg/d of dietary cholesterol (3). ...
Article
Background: Whether egg consumption is associated with the risk of type 2 diabetes (T2D) remains unsettled. Objectives: We evaluated the association between egg consumption and T2D risk in 3 large US prospective cohorts, and performed a systematic review and meta-analysis of prospective cohort studies. Methods: We followed 82,750 women from the Nurses' Health Study (NHS; 1980-2012), 89,636 women from the NHS II (1991-2017), and 41,412 men from the Health Professionals Follow-up Study (HPFS; 1986-2016) who were free of T2D, cardiovascular disease, and cancer at baseline. Egg consumption was assessed every 2-4 y using a validated FFQ. We used Cox proportional hazard models to estimate HRs and 95% CIs. Results: During a total of 5,529,959 person-years of follow-up, we documented 20,514 incident cases of T2D in the NHS, NHS II, and HPFS. In the pooled multivariable model adjusted for updated BMI, lifestyle, and dietary confounders, a 1-egg/d increase was associated with a 14% (95% CI: 7%, 20%) higher T2D risk. In random-effects meta-analysis of 16 prospective cohort studies (589,559 participants; 41,248 incident T2D cases), for each 1 egg/d, the pooled RR of T2D was 1.07 (95% CI: 0.99, 1.15; I2 = 69.8%). There were, however, significant differences by geographic region (P for interaction = 0.01). Each 1 egg/d was associated with higher T2D risk among US studies (RR: 1.18; 95% CI: 1.10, 1.27; I2 = 51.3%), but not among European (RR: 0.99; 95% CI: 0.85, 1.15; I2 = 73.5%) or Asian (RR: 0.82; 95% CI: 0.62, 1.09; I2 = 59.1%) studies. Conclusions: Results from the updated meta-analysis show no overall association between moderate egg consumption and risk of T2D. Whether the heterogeneity of the associations among US, European, and Asian cohorts reflects differences in egg consumption habits warrants further investigation.This systematic review was registered at www.crd.york.ac.uk/prospero as CRD42019127860.
... Lecithin, a blood vessel scavenger, plays an important role in lipid metabolism. It can neutralize excessive cholesterol intake and restore the blood cholesterol level to normal [39]. In this study, in the first stage, the lecithin content of the experimental group was increased significantly. ...
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The effects of Acremonium terricola culture (ATC) on production performance, serum biochemical parameters, egg quality and amino acid contents in the yolk of eggs of Beijing You-chicken were conducted in the current study. A total of 216 Beijing You-chickens (330 days old) were randomly divided into 2 groups. The control group (CON) was fed a corn-soybean-based diet, and the experimental group was fed a basal diet supplemented with 0.20% ATC. The pretest period was 7 d, and the experiment period was 8 weeks. The production performance, serum biochemical parameters, egg quality, and the concentrations of amino acids in the yolk of eggs were measured at the 4 weeks (FW, the first stage) and the 8 weeks (EW, the second stage) of the experiment, respectively. Compared with the CON group, there were no significant differences (P > 0.05) in the production performance of the experimental group at the end of four- and eight-week periods of study. The concentration of serum LH, FSH and E2 increased significantly for the ATC group, at both time periods when compared to CON group, while the triglyceride (TG) content was only increased significantly (P < 0.05) in the first stage. The average egg weight, albumen height, and Haugh unit representing egg quality of Beijing You-chickens in the experimental group were increased significantly (P < 0.05) compared with the CON group at both time periods, while the egg shape index and yolk weight were only increased significantly (P < 0.05) in the second stage. The protein content in the yolk was increased significantly at both time periods (P < 0.05). Levels of lecithin and Vitamin A in yolks of the ATC supplemented group increased significantly (P < 0.05) compared to the CON group, at both FW and EW, respectively. The contents of aspartic acid, threonine, methionine, leucine, and arginine were increased significantly in the first stage. In addition, the contents of threonine, glutamine, and valine were increased significantly in the second stage (P < 0.05). Our results suggest that dietary supplementation with 0.20% ATC improves serum biochemical parameters and egg quality in Beijing You-chickens. Future studies should focus on optimizing ATC dosage and exploring its underlying mechanisms for enhanced poultry production.
... Los ejemplos actuales de alimentos enriquecidos con ω3 están constituidos principalmente por los lácteos, bebidas de soja, jugos, carnes frías, flan, pasta de maní, aceitunas, galletitas, huevos y formulas infantiles, cuyo desarrollo e incorporación en el mercado representa un gran desafío 12 .Dentro de los alimentos enriquecidos con ω3, los huevos de gallina son los que se encuentran con mayor disponibilidad, por ser uno de los alimentos nutricionalmente más completos para un adecuado crecimiento y desarrollo. El huevo enriquecido con ácidos grasos ω3 se logra a través de la alimentación que se les proporciona a las gallinas; dicha alimentación presenta altos niveles de aceite de pescado, semillas de lino o chía y en consecuencia, estos ácidos grasos se incorporan a la yema del huevo; de esta manera esta clase de producto presenta un mayor contenido en ω3 que un huevo común; ésto constituye una buena estrategia para generar valor agregado al huevo que beneficia tanto a los consumidores como a los avicultores[13][14][15][16][17][18] .Considerando todo lo expuesto y en virtud de la trascendencia en los últimos años de la importancia de la cantidad, tipo y equilibrio de los lípidos en la dieta en relación con el avance de enfermedades cardiovasculares y obesidad, el objetivo de este trabajo es estudiar el efecto de la administración, al destete y durante 10 días, de dietas completas en nutrientes según AIN 93 y suplementadas con huevo enriquecido en ácidos grasos ω3 y con huevo común, sobre el perfil lipídico en suero de ratas en período de crecimiento. Efecto del consumo de huevo con alto contenido en ω3 y huevo común sobre el perfil lipídico de ratas en crecimiento.ByPC 2019;83(3):21-26. ...
Article
Introducción: los ácidos grasos ω3 (AGω3) son considerados protectores de la salud cardiovascular.Objetivo: se estudió el efecto que provocan dietas suplementadas con huevo enriquecido en AGω3 sobre el perfil lipídico sérico de ratas. Materiales y métodos: ratas Wistar , al destete, recibieron durante 10 días: a)- dieta de caseína conteniendo como fuente lipídica aceite de soja 15 Kcal /100 Kcal dieta (grupo control C), b)- dieta a) suplementada con 22% de huevo liofilizado enriquecido en ω3 (grupo Hω3) y c)- dieta a) suplementada con 22% de huevo común liofilizado (grupo H). Las dietas aportaron el resto de los nutrientes según AIN-93. Al finalizar, en suero se determinaron triglicéridos (TG), colesterol total (CT) y colesterol-HDL (HDL) y se calculó colesterol-LDL (LDL). En ambas variedades de huevo, se determinó la composición centesimal y el perfil de ácidos grasos. Resultados: perfil lipídico sérico (mg%, X± DE): CT C: 65,73 ± 13,74 Hω3: 95,27 ± 7,26* H: 89,82 ± 12,08*; TG C: 62,71 ± 18,79 Hω3: 49,13 ± 15,63 H: 45,63 ± 14,39; HDL: C: 21,24 ± 4,61 Hω3: 27,51 ± 2,47 H: 24,61 ± 2,87; LDL: C: 33,52 ± 11,66 Hω3: 57,94 ± 7,50 H: 56,08 ± 10,12 (*p<0,01). Ambas variedades de huevo son parecidas en su composición; el suplementado presenta un 35% más de AGω3. En Hω3 y H, el CT y LDL son mayores que en C (p<0,01). Conclusiones: a pesar de la suplementación, los resultados sugieren la importancia de la matriz alimentaria a la hora de diseñar un alimento.
... In previous analyses in this same cohort, we also found that egg consumption was associated with lower longterm risks of incident high blood pressure and diabetes [15]. Collectively, our results are consistent with the conclusion that egg consumption is not adversely associated with blood lipids or other cardiometabolic risk factors in adults [25]. ...
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Background For many years, United States’ dietary policy recommended limiting egg intake to no more than 3/wk in the belief that restricting dietary cholesterol would lower plasma cholesterol levels and thereby reduce the risk of cardiovascular disease. The evidence supporting these recommendations is controversial. Objectives To examine the impact of eggs, a major contributor to dietary cholesterol intake, on lipid levels and to determine whether these egg effects are modified by other healthy dietary factors in adults. Methods Males and females aged 30–64 y with available 3-d diet record data, without cardiovascular disease and not taking lipid- or glucose-lowering medications in the prospective Framingham Offspring cohort were included (n = 1852). Analysis of covariance models were used to compare mean follow-up lipid levels adjusting for age, sex, BMI, and dietary factors. Cox proportional hazard’s models were used to estimate risk for elevated lipid levels. Results Consuming ≥5 eggs/wk was not adversely associated with lipid outcomes. Among men, consuming ≥5 (compared with <0.5) eggs/wk was associated with an 8.6 mg/dL lower total cholesterol level and a 5.9 mg/dL lower LDL cholesterol level, as well as lower triglycerides. Overall, higher egg intake combined with higher dietary fiber (compared with lower intakes of both) was associated with the lowest total cholesterol, LDL cholesterol, and LDL cholesterol–to–HDL cholesterol ratio. Finally, diets with higher (compared with lower) egg intakes in combination with higher total fish or fiber intakes, respectively, were associated with lower risks of developing elevated (>160 mg/dL) LDL cholesterol levels (hazard ratio: 0.61; 95% confidence interval: 0.44, 0.84; and HR: 0.70; 95% confidence interval: 0.49, 0.98, respectively). Conclusions Higher egg intakes were beneficially associated with serum lipids among healthy adults, particularly those who consumed more fish and dietary fiber.
... On the other hand, egg is a very nutrient dense fooditem, as one medium-sized egg contains only about 75 kcal. Egg is a source of high-quality protein, all essential vitamins except vitamin C, minerals, and several bioactive compounds, and contains mainly unsaturated fat (4,5). For example, one egg accounts for about 62% of the daily recommended intake of vitamin B 12 , 30% of selenium, 16% of iodine, and 12% of vitamin D (fineli.fi). ...
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Cardiovascular diseases (CVD), type 2 diabetes (T2D), and cancer are a significant public health burden in the Nordic and Baltic countries. High intake of eggs, mainly due to its high cholesterol content, has been suggested to have adverse health effects. The purpose of this scoping review is to describe the evidence related to the impact of egg intake on health. A literature search identified 38 systematic reviews and meta-analyses on egg consumption in relation to health outcomes published between 2011 and 30 April 2022. Overall, current evidence from systematic reviews of randomized clinical trials indicates that higher egg intake may increase serum total cholesterol concentration and the ratio of low-density lipoprotein to high-density lipoprotein cholesterol, but with substantial heterogeneity in the response. However, recent evidence from observational studies does not provide strong support for a detrimental role of moderate egg consumption (up to one egg/day) on the risk of CVD, especially in the European studies. The overall evidence from observational studies indicates that egg consumption is not associated with increased risk of mortality or T2D in European study populations. There is also little support for a role of egg consumption in cancer development, although a weak association with higher risk of certain cancers has been found in some studies, mainly case–control studies. Again, no associations with cancer risk have been observed in European studies. Systematic reviews and meta-analyses of egg consumption in relation to other health-related outcomes are scarce. There are also limited data available on the associations between the consumption of more than one egg/day and risk of diseases. Based on the available evidence, one egg/day is unlikely to adversely affect overall disease risk.
... Eggs are one of the most important dietary sources of cholesterol, present in the egg yolk at 180-225 mg per egg [19]. Many societies and organizations recommend limiting egg consumption to avoid raising circulating cholesterol levels [20]. The American Heart Association recommends reducing egg intake unless other sources of dietary cholesterol are limited [21]. ...
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Background: Steatotic liver disease (SLD) is defined as a fat accumulation in more than 5% of hepatocytes; it can progress to non-alcoholic steatohepatitis (NASH), associated with an increased state of inflammation. The aim of this study was to explore the protective effects of eating eggs and any association with SLD and hypertension (HTN). Methods: The study cohort included 908 participants assessed in the fourth recall of the MICOL study, grouped into four groups, based on NALFD and/or HTN. Results: The prevalence of HTN and SLD among participants was 31.61%. Overall, the results indicated a statistical significance of egg consumption, showing a protective role against the two disease conditions, in both the raw and adjusted models (RRR = 0.34, p = 0.009, 0.15 to 0.76 95% C.I.). Conclusions: Many differences were found among the groups, and the protective role of eating eggs was amply demonstrated. We can conclude that it is unwise to demonize the intake of this food and its nutritional properties, in contrast with previous reports in the literature.
... Due to the high cholesterol content of eggs and their possible impact on cardio-metabolic outcomes, there has generally been debate about their effects on human health [15]. A high dietary cholesterol intake was linked to higher blood cholesterol, according to a meta-analysis of 55 studies [16]. ...
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Background Cardiovascular diseases (CVDs) are one of the main causes of death worldwide. Data on the effect of eggs consumption on the risk of CVDs are still unreliable. Therefore, this study aimed to investigate the association between CVDs and the consumption of eggs. Methods In this case-control study, the required data were extracted from the Prospective Epidemiologic Research Studies in Iran (PERSIAN) cohort in Sabzevar, Iran. A total of 4241 adults participated including 1535 patients with CVDs as the case group and 2706 healthy people as controls. Egg consumption was assessed using a valid food frequency questionnaire (FFQ). Results A significant association was observed between eggs consumption and stroke after adjustment for physical activity, body mass index (BMI), smoking, systolic blood pressure (SBP), diastolic blood pressure (DBP), using alcohol, lipid profile, diabetes, and the intake of energy, lipid, protein, carbohydrate, and cholestrol (OR:1.007, 95% CI:1.001–1.013, P = 0.03). No association was found between egg consumption with hypertension, cardiac ischemia, and myocardial infarction. Conclusions There was a significant association between the consumption of eggs and stroke. However, more studies are needed to examine the effect of eggs on CVDs.
... (15) Until 2015, dietary recommendations have limited whole eggs because of concerns of eggs' high cholesterol content that may increase risk for cardiovascular disease (CVD). (44)(45)(46) In 2015, taking into account the newer scientific evidence that dietary cholesterol does not promote risk for CVD, the 2015-2020 Dietary Guidelines removed the dietary restriction on high-cholesterol foods like eggs. Additionally, the 2020-2025 Dietary Guidelines specifically recommend nutrient-rich eggs for inclusion in a healthy diet. ...
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Dietary interventions designed to examine the role of nutrition on childhood bone accrual have often focused on the role of individual micronutrients (e.g., calcium, vitamin D, and zinc), and macronutrients (e.g., protein). The osteogenic benefits of whole foods, such as eggs, are not well understood despite eggs being a source of high‐quality nutrients and bioactive compounds known to positively influence bone. A significant positive cross‐sectional association between whole egg consumption and tibia cortical bone mass has recently been shown in young children; however, randomized controlled trials (RCTs) have not been conducted. This study is a double‐blind RCT in male and female children ages 9–13 years of different ancestries, designed to determine if consuming food products with whole eggs (equivalent to 8–10 eggs/wk) vs. foods with milk or gelatin (placebo) over a 9‐month period will improve measures of bone strength. Total body less head (TBLH) and lumbar spine bone mineral content (BMC), and areal bone mineral density (aBMD) were assessed using dual‐energy x‐ray absorptiometry (DXA). DXA Z‐scores were computed using published pediatric growth charts and were adjusted for height‐for‐age Z‐score (HAZ). Mid‐tibia cortical volumetric BMD, BMC, cortical area, total bone area, cortical thickness, and strength strain index were measured using peripheral quantitative computed tomography. Overall, there were no significant intervention effects for any bone outcomes. The increase in spine BMC HAZ Z‐score in the egg group vs the gelatin group approached significance (P = 0.07). Significant time effects in TBLH aBMD HAZ Z‐score occurred as all groups decreased over 9 months (P < 0.03). Most tibia cortical bone outcomes increased over time (all P < 0.02), but changes did not differ across intervention groups. Whole eggs provide important nutritional benefits for children, but the bone responses to consumption of 8–10 eggs/wk over a period of 9 months in children entering the early stages of puberty were small. This article is protected by copyright. All rights reserved.
... They are nearperfect, incredibly nutrient-dense and nature for all people and for all ages [2]. Eggs are among the healthiest foods/ feed, and is safe for humans and animals [3]. They are rich in high-quality protein, healthy fats and many essential vitamins and minerals, enzymes, antioxidants and other biologically active materials including growth promoting factors and defense factors which protect animal and human body systems from disease invasion [4,2]. ...
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Major nutrient levels in the table eggs of exotic chicken (Gallus domestica), guinea fowl (Numida meleagris) and quail (Coturnix cortunix), was compared to serve as a guide to literate and health conscious consumers. A total of 90 layers comprising of 30 for each of the three species of birds were purchased at age near point-of-lay, and were raised under the same condition and fed similar layer feed until they began to lay eggs. Two months after assumption of lay 30 eggs composed of 10 from each of the three species were randomly selected for analyses. Yolk and egg white levels of total cholesterol, triglycerides, glucose, potassium and proteins were analyzed following standard procedures. Results showed that the yolk total cholesterol and triglycerides of guinea fowls was significantly higher (p=0.000) than those of chicken and quails. The yolk glucose levels of quail eggs was significantly (p=0.000) higher than that of the chicken and guinea fowl eggs. Yolk potassium levels in quail eggs was significantly (p=0.000) higher than the potassium levels in the yolk of chicken and guinea fowl eggs. Yolk total protein of chicken eggs was significantly (p=0.010) lower than that of quail eggs. Potassium levels in egg white were highest in guinea fowl eggs which was significantly higher (p=0.000) than that recorded for chicken and quail egg white. There were no significant variations (p>0.05) between the egg white glucose and protein levels of the three species. It was concluded that there are significant differences in the levels of some of the major nutrients of the eggs of chicken, guinea fowl and quail.
... Similarly, eggs are an important element of most western diets (Münger et al., 2018), but contrarily to fruit and vegetable consumption, for which research agrees that a higher consumption is desirable, there is debate regarding egg consumption as to whether it has a positive or negative impact on health. Until a few years ago, the assumption was that high egg consumption was more likely to be detrimental to health (Li et al., 2012); more recently, there is evidence that egg consumption may not be as harmful as assumed (Clayton et al., 2017;Mah et al., 2020). Thus, the assessment of egg consumption is the focus of current research and for this reason is considered in more detail in this study. ...
Article
Retrospective self‐reports are commonly used to assess dietary intake. Yet, their use is criticized as it is unclear whether the underlying assumptions for valid self‐reports are met: Individuals have to consider the behavior of all days in the retention interval and weigh the behavior of all days equally. This study examines whether these assumptions for retrospective self‐reports are met and whether interindividual differences in self‐report performance are relevant regarding these assumptions. Ninety‐two participants aged 18–61 years participated in seven sequential 24‐h recalls and one retrospective 7‐day recall concerning their intake of fruit, vegetables, and eggs. A multiple linear regression approach was used to examine the relation between the daily reported dietary intake and the 7‐day recall. In the overall sample, the requirements for retrospective self‐reports were not tenable. Distinguishing good and poor self‐reporters based on a rational criterion showed that the requirements can be taken as given for good self‐reporters, whereas poor self‐reporters base their retrospective self‐reports mostly on recency effects. The underlying requirements for retrospective self‐reports appear to be met in two thirds of the sample, supporting the use of retrospective self‐reports to capture dietary behavior. Future research should investigate characteristics separating good from poor self‐reporters.
... Egg is one of the main kinds of animal product consumed with high cholesterol content consumed in human diets (Geiker et al., 2018). However, there is a controversy on the increased risk of cardiovascular disease by egg overconsumption since individuals indicate different levels of sensitivity to cholesterolinduced cardiovascular disease (Clayton et al., 2017). Moreover, the dietary guidelines for Americans (from 2015 to 2020) suggested that the intake of cholesterol should be as little as possible (USDA\DHHS, 2016). ...
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This study aimed to investigate the effect of supplementing 300 mg/kg tea polyphenols (TP) on yolk cholesterol content and production performance of laying hens during the egg-laying period. A total of 600 Roman laying hens aged 24 weeks were randomly divided into two dietary treatment groups. The feeding experiment lasted for 48 weeks. Layers fed basal diet supplemented with 0 (control group) and 300mg/kg TP (TP group) diet, respectively. The yolk cholesterol content, laying performance, and egg quality were determined at 28, 38, 48, 58, and 68 weeks of age. The yolk cholesterol content in the TP group was significantly decreased at 28-68 weeks of age (p<0.01), compared to the control group. There was a significant increase in laying rate in the TP group at 38 weeks of age (p<0.05), compared to the control group, while no significant differences during the other laying periods were obtained (p>0.05). The FCR significantly decreased in the TP group at 38 weeks of age whereas AEW significantly increased in the TP group at 58 weeks of age (p<0.05). Similarly, the eggshell thickness and eggshell strength in the TP group significantly increased (p<0.05), compared with the control group at 38 weeks of age. The albumen height and Haugh unit significantly increased at 28 weeks of age (p<0.05). In conclusion, the results showed that the diet supplemented with 300 mg/kg TP had positive effects on production performance of layers during the egg-laying period, and could lessen yolk cholesterol content significantly at 28-68 weeks of age. Keywords: Cholesterol content; Laying hens; Production performance; Tea polyphenols
... As a common and rich in nutrients food item, the egg contains high-quality protein, several vitamins and micronutrients, which could contribute to the overall health of the public [3]. Meanwhile, the high cholesterol content in eggs motivates more caution among the general population, and some epidemiologic studies have associated higher egg consumption (especially cholesterol in yolk) with a wide range of morbidity and mortality 2 of 12 outcomes [4][5][6]. Due to the dual role of egg intake on public health, there is no consensus on egg intake recommendations across countries. ...
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Whether egg consumption plays a beneficial/detrimental role in affecting human health and longevity has been debated for decades. Large-scale cohort evidence from low- and middle-income populations are scarce. In this study, we aimed to assess the association of egg consumption with mortality in Chinese adults. A nationwide cohort of 30,835 participants ages 16–110 years were enrolled from 25 provincial regions in China’s mainland. Dietary intake (e.g., egg, meat, vegetable) was assessed by a food-frequency questionnaire. Cox proportional hazards models were used to examine associations between egg consumption and mortality, adjusting for demographic characteristics, dietary factors and health status. Dose–response relationships were investigated using the smoothing function of restricted cubic splines. Several subgroup analyses were performed. A total of 1651 all-cause deaths occurred during a median follow-up of 8.1 years. Egg consumption was associated with lower risks of mortality, with the lowest risk occurring in the group of moderate egg intake (3–6 times/week). Compared with non-consumers, the hazard ratios (95% confidence intervals) for mortality were 0.84 (0.72–0.97) for 3–6 times/week and 0.82 (0.69–0.98) for ≥7 times/week, whereas no significant associations were observed among the lower egg intake group (1–2/week). An approximately inverted J-shaped association was observed in three models, while restricting our analysis in the multivariable model (model 3) did not identify a significant violation for the linear relationship (p for nonlinear = 0.122). There were no statistically significant effect modifications in the subgroup analyses. Egg consumption may be associated with lower risks of mortality in Chinese adults. Our findings found moderate-to-high egg consumption might be beneficial for improving long-term health and longevity.
... The effects of dietary cholesterol and egg intake, as a part of the usual diet, on disease risk and longevity have been debated for decades. Eggs contain essential amino acids, B vitamins, unsaturated fatty acids, choline, lutein, and zeaxanthin (2), some of which (e.g., choline) have CVDprotective effects. However, eggs are also a rich source of dietary cholesterol (186 mg of cholesterol per egg) (3). ...
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Objective This systematic review and meta-analysis of prospective cohort studies examined the associations between egg and dietary cholesterol intake and the risk of mortality from all causes, including cardiovascular disease (CVD) and cancer. Methods We searched PubMed, Scopus, ISI Web of Knowledge, and Google Scholar until April 2021, as well as references to the relevant articles retrieved. Random-effects models were used to calculate summary relative risk (RR) and 95% confidence intervals (CIs) for the highest vs. lowest categories of egg and dietary cholesterol intake. Also, linear and non-linear dose–response analyses were conducted to examine the dose-response relationships. Results We included 55 studies, comprising data from 2,772,486 individuals with 228,425, 71,745, and 67,211 cases of all-cause, CVD, and cancer mortality, respectively. Intake of each additional egg per day was associated with a 7% higher risk of all-cause (1.07, 95% CI: 1.02–1.12, I ² = 84.8%) and a 13% higher risk of cancer mortality (1.13, 95% CI: 1.06–1.20, I ² = 54.2%), but was not associated with CVD mortality (1.00, 95% CI: 0.92–1.09, I ² = 81.5%). Non-linear analyses showed increased risks for egg consumption of more than 1.5 and 0.5 eggs/day, respectively. Each 100 mg/day increment in dietary cholesterol intake was associated with a 6% higher risk of all-cause mortality (1.06, 95% CI: 1.03–1.08, I ² = 34.5%) and a 6% higher risk of cancer mortality (1.06, 95% CI: 1.05–1.07, I ² = 0%), but was not associated with CVD mortality (1.04, 95% CI: 0.99–1.10, I ² = 85.9%). Non-linear analyses demonstrated elevated risks of CVD and cancer mortality for intakes more than 450 and 250 mg/day, respectively. Conclusions and Relevance High-dietary intake of eggs and cholesterol was associated with all-cause and cancer mortality. Little evidence for elevated risks was seen for intakes below 0.5 egg/day or 250 mg/day of dietary cholesterol. Our findings should be considered with caution because of small risk estimates and moderate between-study heterogeneity. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=252564 , PROSPERO, identifier: CRD42021252564.
... The link between egg-derived cholesterol and disease is subject to much investigation. Many population studies and clinical interventions show that egg intake does not increase the risk for cardiovascular diseases despite being rich in dietary cholesterol [1][2][3]. Recently, the Dietary Guidelines for Americans released by USDA in January 2016 removed the 300 mg/d limits for dietary cholesterol, shifting the focus to other components of eggs that may positively influence health [4]. Egg yolks contain the bioavailable forms of the potent antioxidant carotenoids lutein and zeaxanthin, which protect against the development of metabolic diseases by increasing the mRNA expression of antioxidant enzymes and decreasing pro-inflammatory cytokines [5]. ...
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We previously demonstrated that intake of three eggs/d for 4 weeks increased plasma choline and decreased inflammation in subjects with metabolic syndrome (MetS). The purpose of the current study was to further explore the effects of phosphatidylcholine (PC) provided by eggs versus a choline bitartrate (CB) supplement on the gut microbiota, trimethylamine N-oxide (TMAO) formation, and plasma carotenoids lutein and zeaxanthin in MetS. This randomized, controlled crossover clinical trial included 23 subjects with MetS. Following a washout period of 2 weeks without consuming any choline-containing foods, subjects were randomly allocated to consume either three eggs/d or a CB supplement for 4 weeks (both diets had a choline equivalent of 400 mg/day). DNA was extracted from stool samples to sequence the 16S rRNA gene region for community analysis. Operational taxonomic units (OTUs) and the α-diversity of the community were determined using QIIME software. Plasma TMAO, methionine, betaine, and dimethylglycine (DMG) were quantified by stable isotope dilution liquid chromatography with tandem mass spectrometry. Plasma carotenoids, lutein, and zeaxanthin were measured using reversed-phase high-performance liquid chromatography. There were significant increases in plasma lutein and zeaxanthin after egg intake compared to the baseline or intake of CB supplement (p < 0.01). In contrast, TMAO was not different between treatments compared to the baseline (p > 0.05). Additionally, while diet intervention had no effects on microbiota diversity measures or relative taxa abundances, a correlation between bacterial biodiversity and HDL was observed. Following egg intake, the observed increases in plasma lutein and zeaxanthin may suggest additional protection against oxidative stress, a common condition in MetS.
... 3 Findings from observational studies have suggested that higher egg consumption in adults is associated with an increased risk of diabetes in both males and females. [4][5][6] Moreover, higher egg consumption has been shown to be associated with increased risk of CVD in Korean patients with type 2 diabetes (T2DM). 7 Other, more some recent studies have reported that egg consumption was associated with reduced risk of T2DM and hypertension. ...
Article
Background: Dietary recommendations regarding egg intake remain controversial topic for public health. We hypothesized that there was a positive association between egg consumption and all-cause mortality. Methods: To test this hypothesis, we enrolled 9885 adults from a community-based cohort in Anhui Province, China during 2003-05. Egg consumption was assessed by food questionnaire. Stratified analyses were performed for age, sex, body mass index (BMI), blood pressure, smoking, drinking and laboratory tests. Results: After an average follow-up of 14.1 years, 9444 participants were included for analysis. A total of 814 deaths were recorded. Participants' BMI and lipid profile had no significantly difference between three egg consumption groups. BMI was 21.6±2.7 of the whole population, especially BMI>24 was only 17.3%. A bivariate association of egg consumption >6/week with increased all-cause mortality was observed compared with ≤6/week (RR: 1.35, 95% CI: 1.05, 1.73, P = 0.018). A significant interaction was observed for BMI ≥ 21.2 kg/m2 vs. BMI<21.2 kg/m2 (P for interaction: 0.001). No other significant interactions were found. Conclusions: In this study, consuming >6 eggs/week increased risk of all-cause mortality, even among lean participants, especially who with BMI ≥ 21.2 kg/m2. Eggs are an easily accessible and constitute an affordable food source in underdeveloped regions. Consuming <6 eggs/week may be the most suitable intake mode.
... High cardiovascular risk participants who consumed 2-4 eggs per week had no increased CVD risk (24). No more than four yolks per week are also suggested by Dietary Approaches to Stop Hypertension (DASH) diet (25). Since the Lithuanian FBDG does not provide specific quantities for egg consumption a week, we decided to follow other EU countries (19) that had defined this frequency, and chose "optimal" consumption as 2-4 times per week (e.g., Belgium (Flanders region), Ireland-no more than seven, Greece, Romania-up to 4, Spain−4-5, Croatia−3-4, Italy, Malta−2-4, Cyprus, the Netherlands, Austria, Finland-up to three eggs per week). ...
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A healthy and balanced diet is an important factor contributing to overall health and wellness. The aim of this study was to develop a Healthy Diet Index (HDI) score and assess its association with various chronic diseases and lifestyle risk factors. A cross-sectional survey included 1,111 adults aged 18 years and older. Information on dietary habits was collected using a questionnaire. Additional demographic, socioeconomic and lifestyle risk factors data were also collected. Sixteen food groups were used to develop the HDI score for the residents of Kaunas city, Lithuania based on the national recommendations, World Health Organization (WHO) and other guidance on a healthy diet. We used logistic regression models to assess the association of the HDI score with chronic diseases, obesity and lifestyle risk factors. We found that both males and females were lacking the optimal consumption of the base components of a healthy diet–fruits and vegetables, starchy carbohydrates, and proteins. We also observed significant associations between the HDI score and several outcomes such as hypertension, arrhythmia, physical activity, and obesity. The suggested HDI score could serve as a valuable tool in assessing and improving dietary habits beneficial for promoting health and preventing many diseases.
... Egg yolk is also rich in choline (147 mg), an essential nutrient for liver and muscle functions. 25,448 The impact of egg consumption on lipid profile is quite variable. 449 In healthy adolescents, the consumption of more than 3 eggs per week is not associated with changes in lipid profile. ...
... Both are rich in proteins and protected with different layers of thin membranes. It is commonly consumed in boiled, fried, poached, cooked, or raw form (Clayton, Fusco, & Kern, 2017). Despite many health advantages, the chicken egg appears as one of the important eight food allergens. ...
Article
Immune-mediated food allergy and non-immune mediated food intolerance are categorized as the most common adverse reactions resulting from the ingestion of certain foods. As there is no standard treatment, the possible remedy to avoid exposure to these adverse reactions is adhering to a strict diet that eliminates allergic and intolerant foods. The commonly consumed foods including dairy products, egg, fish, shellfish, tree nuts, peanut, soybean, and wheat-based products are proven to cause food allergy. Foods containing lactose, gluten, high FODMAPs, biogenic amines, and certain food additives leads to potential health risks in intolerant individuals. Besides, there are various foods whose mechanism of action in triggering food allergy and intolerance is yet to be defined. However, the public in-depth understanding of natural foods, processed foods, and packaged food products that induce allergic reactions and intolerance remains low. Therefore, awareness of diet that partially or completely excludes the intake of certain foods associated with these reactions should be widespread among the consumers.
... Dietary recommendations in relation to egg consumption have evolved over time. For many years, dietary guidelines suggested restricting dietary cholesterol intake and avoiding eggs to reduce cardiovascular disease (CVD) risk, but this is no longer the case (Clayton et al. 2017). In the UK, there is no specific recommendation or limit for egg consumption; eggs are now recognised as nutritious, and a good choice as part of a healthy, balanced diet (NHS 2018a). ...
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Dietary habits are constantly evolving with changes in culture, economics and the food supply. In the UK, red meat intakes have been declining for more than a decade, while egg consumption has increased in tandem with interest in healthy, sustainable diets. To explore current dietary habits of egg consumers and non‐consumers and potential implications for nutrition and health, we analysed dietary records from 647 adults participating in Year 9 (2017) of the UK National Diet and Nutrition Survey (NDNS). Mean consumption of eggs and egg dishes was 29 g/day (3.5 eggs/week). Female egg consumers (n = 224; mean 46 g/day, 5 eggs/week) ate more fruit, vegetables and fish and had significantly higher dietary intakes of protein, monounsaturated fatty acids, n‐3 polyunsaturated fatty acids and most micronutrients, notably vitamin D, most B vitamins, vitamin C, iron, zinc and selenium, compared with non‐consumers (n = 150). They also had higher plasma levels of 25‐hydroxyvitamin D, total carotenoids, selenium and ferritin and were less likely to be anaemic. Female egg consumers had a lower mean body mass index and waist circumference, despite reporting a higher mean energy intake than non‐consumers. Male egg consumers (n = 159; mean 54 g/day, 6 eggs/week) had higher dietary intakes of vitamin D, biotin, iodine and selenium but similar micronutrient status and bodyweight to non‐consumers (n = 114). There were no significant differences in cardiometabolic risk factors for either sex. Egg consumption appears to be associated with signs of higher dietary quality, better nutritional status, and slightly lower body mass index among women participating in the latest NDNS.
... Nutritional risk factors have been considered of paramount importance to prevent the global burden of CVD [2,3]. Among the many factors widely studied over the last decades, dietary cholesterol has been the focus of major attention due to the relationship between blood cholesterol and increased risk of CVD firstly observed in the Framingham Heart Study nearly half century ago and ever since considered as risk factor [4]. Eggs, as major sources of dietary cholesterol (200-300 mg/100 g, about 180 mg per medium egg), have been subsequently advised to be consumed in moderation to lower dietary cholesterol intake [5]. However, current evidence on the association between dietary cholesterol and CVD risk is not consistent [6]. ...
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Purpose: Cardiovascular disease (CVD) is a leading cause of mortality globally and is strongly influenced by dietary risk factors. The aim was to assess the association between egg consumption and risk of CVD risk/mortality, including coronary heart disease (CHD), stroke, and heart failure. Methods: MEDLINE, Embase, and Web of Science databases were searched through April 2020 for prospective studies. Two independent reviewers screened and extracted the data through standardized methods. Size effects were calculated as summary relative risks (SRRs) in a dose-response fashion through random-effects meta-analyses. Results: Thirty-nine studies including nearly 2 million individuals and 85,053 CHD, 25,103 stroke, 7536 heart failure, and 147,124 CVD cases were included. The summary analysis including 17 datasets from 14 studies conducted on CVD (incidence and/or mortality) showed that intake of up to six eggs per week is inversely associated with CVD events, when compared to no consumption [for four eggs per week, SRR = 0.95 (95% CI: 0.90; 1.00)]; a decreased risk of CVD incidence was observed for consumption of up to one egg per day [SRR = 0.94 (95% CI: 0.89; 0.99)]. The summary analysis for CHD incidence/mortality including 24 datasets from 16 studies showed a decreased risk up to two eggs per week [(SRR = 0.96 (95% CI: 0.91; 1.00)]. No associations were retrieved with risk of stroke. The summary analysis for heart failure risk including six datasets from four studies showed that intake of one egg per day was associated with increased risk raising for higher intakes compared to no consumption [for 1 egg per day, SRR = 1.15 (95% CI:1.02; 1.30)]. After considering GRADE criteria for strength of the evidence, it was rated low for all outcomes but stroke, for which it was moderate (yet referring to no risk). Conclusion: There is no conclusive evidence on the role of egg in CVD risk, despite the fact that higher quality studies are warranted to obtain stronger evidence for a possible protection of CVD associated with moderate weekly egg consumption compared to no intake; equally, future studies may strengthen the evidence for increased heart failure risk associated with high regular egg consumption.
... College of Cardiology (ACC) emphasized restriction of dietary cholesterol (Clayton, Fusco, & Kern, 2017). In the current Dietary Guidelines for Americans (2015)(2016)(2017)(2018)(2019)(2020), the recommendations for healthy individuals to limit dietary cholesterol intake has been removed, due to poor relationships between dietary cholesterol and increased CVD risk (2015-2020 Dietary Guidelines for Americans. ...
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Diverse notions exist regarding egg intake, which is one of the main sources of dietary cholesterol, and its effect on blood lipids. We conducted this study to update the previous meta‐analysis for their flaw in calculated effect size. PubMed, Scopus, ISI, and Cochrane were searched up to April 2019, for relevant randomized controlled clinical trials. Mean changes in total cholesterol (TC), LDL‐cholesterol (LDL‐C), HDL‐cholesterol (HDL‐C), triglyceride (TG), very low‐density lipoprotein cholesterol (VLDL‐C), LDL‐C/HDL‐C, TC/HDL‐C, apolipoprotein (apo)A1, and apoB100 were assessed. Meta‐analysis of 66 RCTs with 3,185 participants revealed that egg consumption can significantly increase TC, LDL‐C, HDL‐C, TC/HDL‐C, apoA1/and B100, but there was no significant effect on other serum lipids. Dose‐response analysis showed a linear effect for TC, HDL‐C, ApoA1, ApoB100, and nonlinear for LDL‐C, and TC/HDL‐C. In conclusion, intake of more than one egg daily in less than 12 weeks may increase some blood lipids without any changes in the ratio of LDL‐C/HDL‐C. Practical applications There are controversies reports for egg intake, which is one of the main sources of dietary cholesterol. This study provides comprehensive information about the effect of the number of eggs consumed per day (dietary cholesterol) on blood lipids for nutritionists, physicians, researchers, and the general population. In this regard, our results indicated that there is a linear correlation between consumption of greater than one egg per day in a short time (no long time) and increasing lipid profiles which may increase the risk of cardiovascular diseases. However, consumption of one egg daily can be safe and this can be a useful recommendation for prevention of cardiovascular disease and promotion of healthy life which indeed are the potential or actual uses of this research.
... It has been linked with the high cholesterol diet mimicking the modern Western diet (Morgantini et al., 2018). One of the rich dietary cholesterol sources is egg yolk containing 141-234 mg per egg, relying on the size and type of egg yolk (Clayton et al., 2017). This study used Quail egg yolk to disrupt total cholesterol metabolism. ...
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Purpose This study aims to evaluate the effect of the combination of tempeh and red ginger flour in hypercholesterolemic rats. Design/methodology/approach Sprague Dawley male rats ( n = 30; body weight 150-200 g) were randomly divided by five groups ( n = 6), consist of negative control (K−) group: group fed by normal diet (laboratory standard diet laboratory, 4.35 kcal/g, 0% cholesterol); positive control (K+) group: group fed by high cholesterol diet (5.28 kcal/g, 12.1% cholesterol); Treatment 1 (P1) group: group fed by high cholesterol diet and treated by tempeh flour (TF) 1.9 g/200 g body weight; Treatment 2 (P2) group: group fed by high cholesterol diet and treated by red ginger flour (RGF) 0.036 g/200 g body weight; and Treatment 3 (P3) group: group fed by high cholesterol diet and treated by a combination TF 0.95 g/200 g body weight and red ginger 0.018 g/200 g body weight. The lipid profiles and malondialdehyde (MDA) were assessed. Findings The combination of tempeh and red ginger has successfully exerted the total cholesterol (121.9 ± 3.41 mg/dL; p < 0.01), triglycerides (TG) (89.3 ± 2.94 mg/dL; p < 0.01), low-density lipoprotein (39.1 ± 1.59 mg/dL) and MDA (2.0 ± 0.24 mg/dL; p < 0.01) lower than the other treatments. Also, the combination of tempeh and red ginger treatment appeared the highest high-density lipoprotein concentration (63.4 ± 2.26 mg/dL; p < 0.01) compared to the other treatment groups. Total cholesterol and TG were predicted as the increasing of MDA concentration. Originality/value The combination treatments successfully improved the lipid profiles and MDA. Furthermore, the combination of tempeh and red ginger could be effective in supporting therapy as the hypolipidemic condition.
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Metabolic-associated steatotic liver disease (MASLD), the hepatic manifestation of metabolic syndrome, represents a growing global health concern. The intricate pathogenesis of MASLD, driven by genetic, metabolic, epigenetic, and environmental factors, leads to considerable clinical variability. Dysregulation of hepatic lipid metabolism, particularly cholesterol homeostasis, is a critical factor in the progression of MASLD and its more severe form, metabolic dysfunction-associated steatohepatitis (MASH). This review elucidates the multifaceted roles of cholesterol metabolism in MASLD, focusing on its absorption, transportation, biosynthesis, efflux, and conversion. We highlight recent advancements in understanding these processes and explore the therapeutic potential of natural products such as curcumin, berberine, and resveratrol in modulating cholesterol metabolism. By targeting key molecular pathways, these natural products offer promising strategies for MASLD management. Finally, this review also covers the clinical studies of natural products in MASLD, providing new insights for future research and clinical applications.
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Over the last decades, the Mediterranean diet gained enormous scientific, social, and commercial attention due to proven positive effects on health and undeniable taste that facilitated a widespread popularity. Researchers have investigated the role of Mediterranean-type dietary patterns on human health all around the world, reporting consistent findings concerning its benefits. However, what does truly define the Mediterranean diet? The myriad of dietary scores synthesizes the nutritional content of a Mediterranean-type diet, but a variety of aspects are generally unexplored when studying the adherence to this dietary pattern. Among dietary factors, the main characteristics of the Mediterranean diet, such as consumption of fruit and vegetables, olive oil, and cereals should be accompanied by other underrated features, such as the following: (i) specific reference to whole-grain consumption; (ii) considering the consumption of legumes, nuts, seeds, herbs and spices often untested when exploring the adherence to the Mediterranean diet; (iii) consumption of eggs and dairy products as common foods consumed in the Mediterranean region (irrespectively of the modern demonization of dietary fat intake). Another main feature of the Mediterranean diet includes (red) wine consumption, but more general patterns of alcohol intake are generally unmeasured, lacking specificity concerning the drinking occasion and intensity (i.e., alcohol drinking during meals). Among other underrated aspects, cooking methods are rather simple and yet extremely varied. Several underrated aspects are related to the quality of food consumed when the Mediterranean diet was first investigated: foods are locally produced, minimally processed, and preserved with more natural methods (i.e., fermentation), strongly connected with the territory with limited and controlled impact on the environment. Dietary habits are also associated with lifestyle behaviors, such as sleeping patterns, and social and cultural values, favoring commensality and frugality. In conclusion, it is rather reductive to consider the Mediterranean diet as just a pattern of food groups to be consumed decontextualized from the social and geographical background of Mediterranean culture. While the methodologies to study the Mediterranean diet have demonstrated to be useful up to date, a more holistic approach should be considered in future studies by considering the aforementioned underrated features and values to be potentially applied globally through the concept of a “Planeterranean” diet.
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Eggs are an important source of animal protein for humans. However, their physico-chemical and nutritional characteristics vary across and within breeds. The aim of this study was to determine the physico-chemical and nutritional quality of 109 eggs from local guinea fowl (Numida Meleagris, L.) in Burkina Faso. For the that purpose, the following parameters were collected for each egg: egg weight albumen, yolk, and shell weights, egg length and width, pH, shape, and coloration of the shell and yolk. The physical parameter values analyzed showed that local guinea fowl lay small eggs with average weight of 34.91 g (± 3.33 g). The length and width were 46.95 ± 2.48 mm and 36.80 ± 1.09 mm, respectively. The egg a shape index was 0.79. The majority of eggs were oval in shape (90.83%) and reddish in color (70.64%). The albumen, yolk, and shell weighed on average 14.79 ± 3.47 g, 13.17 ± 2.28 g, and 5.95 ± 0.84 g respectively. The majority of eggs had a pH ranging between 9 and 10 for the yolk and around 7 for the albumen. The yolk had a light-yellow color with an average index of 4.66. Water and ash contents were higher in the albumen than in the yolk and while the dry matter content was higher in the yolk. These results, although limited in terms of the number of parameters studied, represent a very interesting basis for assessing the nutritional quality of local guinea fowl eggs consumed by Burkina Faso population.
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Kardiyovasküler hastalıklar; ülkemizde ve dünyada halk sağlığını tehdit eden bulaşıcı olmayan hastalıklar arasındadır. Kardiyovasküler hastalıkların gelişiminde tütün kullanımı ve fiziksel inaktivite yanında sağlıksız beslenme alışkanlıkları da önemli bir yer almaktadır. Kötü diyet kalitesi artmış kardiyovasküler hastalık riski ile ilişkilidir. Bu derlemede; diyet örüntüleri kanıta dayalı ele alınarak; kardiyometabolik sağlığı iyileştirmeye yönelik sekiz öneri geliştirilmiştir. Bu öneriler arasında; enerji alımının ayarlanması, sağlıklı vücut ağırlığının korunması, yeterli miktarda ve çeşitte sebze ve meyvelerin tüketilmesi, tam tahıllı besinlerin, sağlıklı protein kaynaklarının ve sağlıklı bitkisel yağların tercih edilmesi, işlenmiş besin, eklenmiş şeker ve tuz tüketiminin azaltılması yer almaktadır. Geliştirilen bu önerilere uyumun artırılmasının kardiyovasküler hastalık riskinin azaltılmasına katkı sağlayacağı düşünülmektedir.
Chapter
Historically as early as 7000 BC, the use of lipids as a cosmetic was well established and later its use as an industrial oil was also done. However, the importance of lipids in human diets and their role in health was only recognised in the late nineteenth century. Etymologically the word lipid is derived from the Greek word “λίπος; lipos”, which means fat, and the word was first used in 1923 by the French pharmacologist Gabriel Bertrand, where he combined the concept of traditional fats (glycerides), and also included “lipoids”, which have a complex constitution. Though the existence of cholesterol had been known for nearly 200 years, the term “lipid”, which includes cholesterol, was only introduced in 1943 by Bloor. Cholesterol was named “cholesterine” (Greek for bile-solid) by Chevreul in 1816, and in human blood it was first reported in 1833 by Félix-Henri Boudet (Fig. 8.1).
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The effects of dietary garlic oil coated granules (GOCG) on egg production, egg quality, yolk antioxidant capacity, yolk cholesterol, yolk fatty acids, blood biochemistry and hepatic enzyme activities were investigated. Forty 36-week-old Hisex brown laying hens were randomly assigned to one of the five dietary treatment groups including: (1) basal diet+0 g GOCG/kg diet (GOCG0, control), (2) basal diet+7.5 g GOCG/kg diet (GOCG7.5), (3) basal diet+15 g GOCG/kg diet (GOCG15), (4) basal diet+30 g GOCG/kg diet (GOCG30) and (5) basal diet+60 g GOCG/kg diet (GOCG60), for four weeks. It was found that egg production, egg mass and feed conversion ratio (FCR) improved linearly (P < 0.05) with increasing dietary GOCG levels. Egg weight, albumen weight, yolk color intensity and Haugh units increased linearly (P < 0.05) and there were quadratic effects (P < 0.05) on yolk weight, shell weight, shell thickness and albumen pH. Dietary GOCG increased yolk antioxidant capacity measured by the phosphomolybdenum method and lowered thiobarbituric acid reactive substances (TBARS) (linearly, P < 0.05). Significant decreases were especially noted in terms of mg/100 g yolk of yolk cholesterol at 7, 14, and 28 days, and overall (quadratic P < 0.05, linearly P < 0.05, linear and quadratic P < 0.05 and linear and quadratic P < 0.05, respectively). Yolk fatty acid compositions, however, did not differ by treatment. Serum total cholesterol (Total-C) and triglyceride decreased linearly (P < 0.05) at 28 days. Hepatic 3-hydroxy-3-methylglutaryl-CoA reductase (HMGRC) activity due to treatment decreased (linear and quadratic, P < 0.05), but fatty acid synthase (FAS) activity increased linearly (P < 0.05). Pearson's correlations with mg/100 g yolk of yolk cholesterol at 28 days were statistically significant (P < 0.01) for the reduction of HMGCR activity. Hence, based on the minimum content of yolk cholesterol (mg/100 g yolk) and dietary GOCG levels tested, a dietary GOCG30 is recommended, as this had no negative impacts on other important parameters of egg production for consumption.
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Animal-derived protein production is one of the major traditional protein supply methods, which continues to face increasing challenges to satisfy global needs due to population growth, augmented individual protein consumption, and aggravated environmental pollution. Thus, ensuring a sustainable protein source is a considerable challenge. The emergence and development of food synthetic biology has enabled the establishment of cell factories that effectively synthesize proteins, which is an important way to solve the protein supply problem. This review aims to discuss the existing problems of traditional protein supply and to elucidate the feasibility of synthetic biology in the process of protein synthesis. Moreover, using artificial bioengineered milk and artificial bioengineered eggs as examples, the progress of food protein supply transition based on synthetic biology has been systematically summarized. Additionally, the future of food synthetic biology as a potential source of protein has been also discussed. By strengthening and innovating the application of food synthetic biology technologies, including genetic engineering and high-throughput screening methods, the current limitations of artificial foods for protein synthesis and production should be addressed. Therefore, the development and industrial production of new food resources should be explored to ensure safe, high-quality, and sustainable global protein supply.
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This study evaluated the associations between selected dietary habits and lipid profiles in a group of 800 randomly selected patients hospitalized in the Nitra Cardio Center, Slovakia. Patients were aged 20–101 years (only men, the average age was 61.13 ± 10.47 years). The data necessary for the detection of dietary habits were obtained by a questionnaire method in closed-ended format. Data collection was carried out simultaneously with the somatometric and biochemical examinations of the respondents ensured by the Nitra Cardio Center. The following parameters were evaluated: total cholesterol (T-C), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, and blood glucose. Statistical comparisons between groups were performed using one-way analysis of variance (one-way ANOVA), followed by Tukey’s post hoc test. We detected significant differences (p < 0.05) in the influence of the number of daily meals on T-C and LDL-C, which were higher in men who consumed 1–2 meals compared with 3–4 or 5–6 meals. In the consumption of meat, eggs, and fish, there was no significant effect on the biochemical parameters of blood (p > 0.05). We recorded a significant effect (p < 0.001) on T-C and LDL-C levels between low-fat and whole-fat milk consumption. Except for the impact of fruit consumption on the HDL-C level (p < 0.001), the different frequencies of fruit consumption showed non-significant changes for the lipid profile levels. We detected a significant effect (p = 0.017) of the consumption of vegetables 1–2 times/week on LDL-C in favor of daily consumption. Our results support that monitoring the lipid profile is an important determinant in the prevention and treatment of cardiovascular disease. The conducted research emphasizes the importance of diet dependence on the improvement of the quality of treatment and nutrition of people with this type of disease.
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Meat represents an important source of high-quality dietary protein for a large proportion of the global population. Also, red meat, in particular, significantly contributes to the intake of a wide range of micronutrients, including iron, zinc, selenium, vitamin D, and vitamin B12. Excessive consumption of meat and meat products is often associated with overconsumption of energy and fat, resulting in excess weight, obesity, and an increased risk of chronic diseases, such as cardiovascular disease and type 2 diabetes. This study aims to evaluate the relationship between meat and processed meat consumption frequencies and lipid profile in a group of 800 randomly selected patients hospitalized in the Cardiocentre Nitra. Patients were 20 – 101 years, (men, the average age was 61.13 ±10.47 years). The data necessary for the detection of dietary habits were obtained by a questionnaire method. Statistical comparisons between groups were made utilizing a one-way analysis of variance (one-way ANOVA) followed by Tukey's post hoc test. Our results show, that most respondents consume meat 1 – 2 times per week, while we did not notice a significant effect (p >0.05) of the type of meat on the lipid profile. The highest T-C, LDL-C, and TG values were seen in men who consume pork 3 – 4 times per week. Statistically significant was only the effect of pork meat on total cholesterol and triglycerides (p <0.05). In the consumption of beef and poultry, there was a non-significant effect on biochemical parameters of blood (p >0.05). We recorded a significant effect (p ˂0.05) of the consumption of frankfurters between consumption 1 – 2 times per week and 3 – 4 times per week. Up to 40.2% of respondents consume salami 3 – 4 times per week, and we recorded a significant effect on LDL levels between consumption 1 – 2 times per week and sometimes (p ˂0.05). Respondents who consume sausage, headcheese, and others products 1 – 2 times a week have non-significant higher T-C, LDL, TG, and lower HDL compared to less frequent consumption. High consumption of meat, mainly pork and processed meat seems to be associated with higher levels of total cholesterol, LDL cholesterol, and triglycerides.
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Background: Several systematic reviews and meta-analyses have assessed the association between egg consumption and human health, but the evidence is often conflicting. Methods: We conducted a systematic literature search to find all systematic reviews and meta-analyses that assess the association between egg consumption and any type of health outcome. We used AMSTAR to evaluate the methodological quality of the reviews, and GRADE to determine the quality of evidence. We visualized the results using a human anatomy diagram and evidence mapping. Results: Our search revealed 29 systematic reviews and meta-analyses. Eight studies were of high methodological quality, 16 studies of medium quality, and five studies of low quality. We identified 34 primary outcomes from the included 29 reviews, which were combined into a total of 22 different health outcomes. Two of the primary outcomes were based on high-quality evidence, 18 on moderate-quality evidence, and 14 on low-quality evidence. Egg consumption was associated with an increased risk of two diseases and decreased risk of six outcomes. For ten outcomes, no significant association was found, and for four outcomes, different reviews came to conflicting conclusions. Conclusions: The association between egg consumption and the risk of cancer, diabetes, cardiovascular diseases and other related diseases has been studied in several meta-analyses. The evidence from different studies on the same topic was often conflicting, which can complicate the making of dietary recommendations.
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The purpose of this study was to investigate the effects of different drying methods, including ultrasonic vacuum drying, vacuum drying, vacuum freeze-drying, hot-air drying and spray drying, on the structure and emulsifying capacity of egg yolk lecithin based on Raman spectra. The results showed that ultrasonic vacuum drying and spray drying can induce the vibration of C–N bonds in the polar O–C–C–N⁺ head skeleton of egg yolk lecithin. The shift of the peak attributed to the C–N bond from 717 cm⁻¹ to 774 and 772 cm⁻¹ indicated that the vibration of some C–N bonds in the O–C–C–N⁺ skeleton had transformed from gauche to trans. Ultrasonic vacuum drying exerted the most intense effect on the C–C skeleton of egg yolk lecithin, with the greatest vibration peaks at 1062 cm⁻¹, 1128 cm⁻¹, and 1097 cm⁻¹ in the Raman spectra of egg yolks. Specifically, it relieved gauche vibration and strengthened trans vibration in the C–C skeleton. Hence, the Igauche/Itrans ratio of the egg yolk lecithin processed through ultrasonic vacuum drying decreased. Ultrasonic vacuum drying and spray drying decreased the I2850/I2878 ratio of the vibration peak of C–H bonds in the lipid chains of egg yolk lecithin. The weakening of the symmetric stretching vibration of the C–H bond and the strengthening of antisymmetric stretching vibration indicated that orderliness among the molecular chains of lipid bilayer membranes had increased, whereas liquidity had decreased. The emulsifying capacities were highly significantly different among various egg yolk lecithin samples, in which the highest emulsifying capacity (49.58 m²/g) was shown for the egg yolk lecithin prepared through vacuum freeze-drying, and ultrasonic vacuum drying produced the lowest emulsifying capacity (14.77 m²/g). This study demonstrated that ultrasonic vacuum drying and spray drying drastically affected the structure of egg yolk lecithin. The appropriate drying method can be selected based on sample volume and production situation. © 2020, Chinese Society of Agricultural Engineering. All rights reserved.
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The association of egg consumption and serum cholesterol concentrations in healthy people has been discussed for a long time. In this study, we aimed to explore association of egg consumption with on low-density lipoprotein cholesterol (LDL-c) and high-density lipoprotein cholesterol (HDL-c) concentrations and the LDL-c/HDL-c ratio through meta-analysis. This systematic review only included randomized controlled trials (RCTs) investigating egg consumption in healthy populations without combination therapy. We extracted mean and standard deviation for LDL-c/HDL-c ratio, LDL-c/HDL-c. The extracted data were pooled in a random-effects model and were presented as mean difference (MD) with 95% confidence interval (CI). Moreover, subgroup analyses were conducted for understanding effects of more egg consumption (MEC) on different intervention periods, egg-consumption levels, classification of responders. Overall, 17 RCTs met the eligibility criteria and pooled results showed MEC group had a higher LDL-c/HDL-c ratio than the control group (MD = 0.14, p = 0.001, I 2 = 25%). The MEC group also had higher LDL-c than the control group (MD = 8.14, p < 0.0001, I 2 = 18%). Moreover, for the subset of intervention over two months, the MEC group seemed to have a larger effect size than the subset of intervention within two months. This synthesis, the largest meta-analysis on this topic, shows the impact of egg consumption on lipid profiles among healthy subjects. Notably, longer time with MEC may lead to higher LDL-c/HDL-c ratio and LDL-c. However, RCTs with long tern follow-up are needed to guarantee the association between egg consumption and human health.
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Non‐alcoholic fatty liver disease (NAFLD) is a major cause of cardiovascular disease. The relationship between egg consumption and NAFLD is still controversial for its high cholesterol content. In this study, we examined the effects of different egg components (egg white (EW), egg yolk (EY), and whole egg (WE)) on NAFLD using oleic acid (OA)‐induced HepG2 cells with UPLC‐ESI‐MS/MS approach. The results showed EY could affect the lipid profile effectively by increasing phosphocholine (PC), phosphatidylglycerol (PG), and carnitine (CAR). Orthogonal projections to latent structures−discriminate analysis (OPLS‐DA) combined with S‐plot analysis selected 10, 82, and 20 potential biomarkers in EW, EY, and WE group, respectively. Up‐regulated TG, DG and down‐regulated lysophosphatidylcholines (lysoPC), lysophosphatidylethanolamine (lysoPE) biomarkers were found in EY group, while down‐regulated regulated TG and FFA were found in EW and WE group. Glycerolipid and choline metabolism were the most involved pathways affected by EY and WE. In addition, the mechanism was associated with the expression of Pla2g15, Pnpla6‐1, Gad1 and involved lipogenic genes ABC1 and PPARα. Our study suggests that WE treatment could ameliorate OA‐induced hepatic steatosis by inhibiting TG accumulation, while EY seems slightly accelerate hepatic steatosis. Furthermore, the effects are closely associated with its effects on glycerolipid metabolism. Practical applications : Nonalcoholic fatty liver disease (NAFLD) is a worldwide disease, while the associations between egg consumption and NAFLD are still poorly understood. This study investigated the effects of egg components on NAFLD in oleic acid (OA)‐induced HepG2 cells based on a targeted lipidomics approach. The results indicate that WE (whole egg) treatment could ameliorate OA‐induced hepatic steatosis by inhibiting TG and FFA accumulation, which was closely associated with glycerolipid metabolism. The results provide knowledge and understanding of the effects of egg on NAFLD and involved mechanism, and further provided nutritional guidelines for egg consumption. This article is protected by copyright. All rights reserved
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Background and aims: We evaluated the association of egg consumption with liver tests (LTs) and non-alcoholic fatty liver disease (NAFLD). This relationship is poorly documented. Methods: The National Health and Nutrition Examination Survey (NHANES, 2005-2010) database was used. Analysis of covariance, adjusted linear and logistic regression models were used. Results: Of the 14,369 participants, 46.8% were men and 45.2% had NAFLD. After correction for several variables including: age, gender, race, education, poverty to income ratio, alcohol intake, energy intake, smoking, and physical activity - fatty liver index (FLI), serum aspartate aminotransferase (AST) alanine aminotransferase (ALT) were 36.9, 25.8 (U/L) and 23.9 (U/L), respectively, in the first tertile (T1) reaching 68.7, 34.9 and 36.5, respectively, in the third tertile (T3) (p<0.001 for all comparisons). In the model with same covariates, there was significant positive linear relationship between FLI (standard β coefficient (β): 0.196), AST (β: 0.099) and ALT (β: 0.112) with egg consumption and participants in the highest tertile (T3) of egg consumption had 11% higher chance of NAFLD compared with T1 (odds ratio: 1.11 and 95% confidence interval: 1.07-1.17). Of note, after more correction for triglycerides, hypertension and diabetes, the significant link between egg consumption and LTs and/or NAFLD attenuated and disappeared. Conclusion: Our findings highlight the adverse role of egg consumption on LTs and likelihood of NAFLD. These associations seem to be attributable to cardio-metabolic risk factors. These findings require confirmation to improve our understanding of the role of egg consumption in the pathogenesis of NAFLD.
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The 1968 American Heart Association announced a dietary recommendation that all individuals consume less than 300 mg of dietary cholesterol per day and no more than three whole eggs per week. This recommendation has not only significantly impacted the dietary patterns of the population, but also resulted in the public limiting a highly nutritious and affordable source of high quality nutrients, including choline which was limited in the diets of most individuals. The egg industry addressed the egg issue with research documenting the minimal effect of egg intake on plasma lipoprotein levels, as well as research verifying the importance of egg nutrients in a variety of issues related to health promotion. In 2015 dietary cholesterol and egg restrictions have been dropped by most health promotion agencies worldwide and recommended to be dropped from the 2015 Dietary Guidelines for Americans.
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Egg consumption is often discouraged due to cholesterol content; however, recent studies have not demonstrated a clear adverse influence of eggs on blood lipids. Furthermore, exercise training promotes improved lipids and blood pressure. The purpose of the study was to examine the effect of eating an isoenergetic (400 kcal) egg-based (including two eggs per day) versus bagel-based breakfasts, daily, combined with resistance training three times per week, prior to breakfast, on plasma lipids, glucose, insulin, insulin sensitivity and blood pressure in untrained individuals. Twenty-five healthy adult men and women (18-35 years of age) participated in the twelve week study following random assignment to study groups. Lipids and blood pressure were examined at baseline and after 6 and 12 weeks. Plasma triglycerides (TG) decreased significantly in the egg- based breakfast (EBB) group from baseline to six weeks (p = 0.011) and from six to twelve weeks (p = 0.045). A significant (p = 0.033) decrease in insulin sensitivity was observed in the bagel-based breakfast (BBB) group from zero to six weeks. No significant effects on systolic blood pressure, diastolic blood pressure, total cholesterol, high density lipoprotein- cholesterol or low density lipoprotein cholesterol were detected. Overall, daily breakfasts including two eggs for twelve weeks did not adversely affect lipids during a resistance training program and promoted improvements in plasma TG.
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Egg yolk contains bioactive components that improve plasma inflammatory markers and HDL profiles in metabolic syndrome (MetS) under carbohydrate restriction. We further sought to determine whether egg yolk intake affects peripheral blood mononuclear cell (PBMC) inflammation and cholesterol homeostasis in MetS, as HDL and its associated lipid transporter ATP-binding cassette transporter A1 (ABCA1) reduce the inflammatory potential of leukocytes through modulation of cellular cholesterol content and distribution. Thirty-seven men and women classified with MetS consumed a moderate carbohydrate-restricted diet (25%–30% of energy) for 12 weeks, in addition to consuming either three whole eggs per day (EGG) or the equivalent amount of yolk-free egg substitute (SUB). Interestingly, lipopolysaccharide-induced PBMC IL-1β and TNFα secretion increased from baseline to week 12 in the SUB group only, despite increases in PBMC toll-like receptor 4 (TLR4) mRNA expression in the EGG group. Compared to baseline, ABCA1 and 3-hydroxy-3-methyl-glutaryl (HMG)-CoA reductase mRNA expression increased by week 12 in the EGG group only, whereas changes in PBMC total cholesterol positively correlated with changes in lipid raft content. Together, these findings suggest that intake of whole eggs during carbohydrate restriction alters PBMC inflammation and cholesterol homeostasis in MetS.
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The prevalence of diabetes increases with age, driven in part by an absolute increase in incidence among adults aged 65 years and older. Individuals with diabetes are at higher risk for cardiovascular disease, and age strongly predicts cardiovascular complications. Inflammation and oxidative stress appear to play some role in the mechanisms underlying aging, diabetes, cardiovascular disease, and other complications of diabetes. However, the mechanisms underlying the age-associated increase in risk for diabetes and diabetes-related cardiovascular disease remain poorly understood. Moreover, because of the heterogeneity of the older population, a lack of understanding of the biology of aging, and inadequate study of the effects of treatments on traditional complications and geriatric conditions associated with diabetes, no consensus exists on the optimal interventions for older diabetic adults. The Association of Specialty Professors, along with the National Institute on Aging, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Heart, Lung, and Blood Institute, and the American Diabetes Association, held a workshop, summarized in this Perspective, to discuss current knowledge regarding diabetes and cardiovascular disease in older adults, identify gaps, and propose questions to guide future research.
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Background: It is important to understand whether eating eggs, which are a major source of dietary choline, results in increased exposure to trimethylamine-N-oxide (TMAO), which is purported to be a risk factor for developing heart disease. Objective: We determined whether humans eating eggs generate TMAO and, if so, whether there is an associated increase in a marker for inflammation [ie, high-sensitivity C-reactive protein (hsCRP)] or increased oxidation of low-density lipoprotein (LDL). Design: In a longitudinal, double-blind, randomized dietary intervention, 6 volunteers were fed breakfast doses of 0, 1, 2, 4, or 6 egg yolks. Diets were otherwise controlled on the day before and day of each egg dose with a standardized low-choline menu. Plasma TMAO at timed intervals (immediately before and 1, 2, 4, 8, and 24 h after each dose), 24-h urine TMAO, predose and 24-h postdose serum hsCRP, and plasma oxidized LDL were measured. Volunteers received all 5 doses with each dose separated by >2-wk washout periods. Results: The consumption of eggs was associated with increased plasma and urine TMAO concentrations (P < 0.01), with ∼14% of the total choline in eggs having been converted to TMAO. There was considerable variation between individuals in the TMAO response. There was no difference in hsCRP or oxidized LDL concentrations after egg doses. Conclusions: The consumption of ≥2 eggs results in an increased formation of TMAO. Choline is an essential nutrient that is required for normal human liver and muscle functions and important for normal fetal development. Additional study is needed to both confirm the association between TMAO and atherosclerosis and identify factors, microbiota and genetic, that influence the generation of TMAO before policy and medical recommendations are made that suggest reduced dietary choline intake.
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The effects of breakfast type on body weight and blood lipids were evaluated in university freshman. Seventy-three subjects were instructed to consume a breakfast with eggs (Egg Breakfast, EB, n = 39) or without (Non-Egg Breakfast, NEB, n = 34), five times/week for 14 weeks. Breakfast composition, anthropometric measurements and blood lipids were measured at multiple times. During the study, mean weight change was 1.6 ± 5.3 lbs (0.73 ± 2.41 kg), but there was no difference between groups. Both groups consumed similar calories for breakfast at all time-points. The EB group consumed significantly more calories at breakfast from protein, total fat and saturated fat, but significantly fewer calories from carbohydrate at every time-point. Cholesterol consumption at breakfast in the EB group was significantly higher than the NEB group at all time points. Breakfast food choices (other than eggs) were similar between groups. Blood lipids were similar between groups at all time points, indicating that the additional 400 mg/day of dietary cholesterol did not negatively impact blood lipids.
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There have been contradictory reports regarding resistance exercise and central arterial compliance. The American Heart Association has recommended its use in preventing/treating cardiovascular diseases. We examined the effects of long-term endurance running and intense resistance training on central hemodynamics, compared with healthy control (CON). Sixty-nine male participants, 25-50 years [19 intense resistance trained (IRT) group, 21 endurance runners, and 29 CON] were investigated by radial tonometry-pulse wave analysis, pulse wave velocity (PWV), and echocardiogram. Data were expressed as mean ± SE (median). Differences were tested by analysis of variance and analysis of covariance was used to adjust for confounding variables. There were no differences among groups regarding age, height (Ht), brachial and central blood pressure. Resting heart rate (HR) was lower and high-density lipoprotein cholesterol (HDL-C) higher in endurance runners. Weight, peripheral pulse pressure, and pulse pressure amplification were higher and HDL-C lower in the IRT group. Left ventricular mass and creatine phosphokinase were higher in trained participants. Relative wall thickness was similar among groups. The ratio of the velocity of peak E and A waves (E/A) was higher and PWV significantly lower in endurance runners (7.2 ± 0.14 m/s) and IRT (7.5 ± 0.14 m/s) as compared with CON (8.2 ± 0.16 m/s) even after adjustments for age, Ht, HR and mean arterial pressure (MAP), or mean systolic pressure. Differences in central augmentation pressure (cAP) adjusted for age, height, systolic or MAP, PWV, and HR (IRT equal to 0.08 ± 0.9, CON equal to 3.4 ± 0.9 and endurance running equal to 3.6 ± 1) were no longer significant after further adjustments to aortic diameter or weight. Long-term resistance training in men is associated with preserved cardiac structure/function, decreased aortic stiffness, and lower cAP.
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There is a direct relationship between chronically elevated cholesterol levels (dyslipidaemia) and coronary heart disease. A reduction in total cholesterol is considered the gold standard in preventative cardiovascular medicine. Exercise has been shown to have positive impacts on the pathogenesis, symptomatology and physical fitness of individuals with dyslipidaemia, and to reduce cholesterol levels. The optimal mode, frequency, intensity and duration of exercise for improvement of cholesterol levels are, however, yet to be identified. This review assesses the evidence from 13 published investigations and two review articles that have addressed the effects of aerobic exercise, resistance training and combined aerobic and resistance training on cholesterol levels and the lipid profile. The data included in this review confirm the beneficial effects of regular activity on cholesterol levels and describe the impacts of differing volumes and intensities of exercise upon different types of cholesterol. Evidence-based exercise recommendations are presented, aimed at facilitating the prescription and delivery of interventions in order to optimize cholesterol levels.
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Aims: Eggs are a good source of lutein and zeaxanthin, carotenoids known for their antioxidant properties. Mexican children have been shown to consume limited amounts of fruit and vegetables. The purpose of the current study is to determine whether the inclusion of eggs in the diet increases plasma carotenoids in this population. Study Design: This study is a follow up on the effects of high egg intake on plasma lipids and atherogenic lipoproteins in children. Fifty four Mexican children (25 boys/29 girls) aged 8-12 y were randomly assigned to consume either 2 eggs/d (518 mg additional dietary cholesterol) (EGG period) or the equivalent amount of egg whites (SUB Period) in a cross-over design for 4 wk. After a 3 wk washout, children were crossed over to the alternate treatment. Methodology: 3-day dietary records, plasma carotenoids and apolipoproteins were measured at the end of the EGG and SUB Periods. Results: In agreement with the lack of effects of eggs in increasing atherogenic Research Article 2204 lipoprotein profiles, plasma apolipoprotein B concentrations did not change between periods indicating that increases in plasma cholesterol were not associated with higher number of LDL particles. Although the values for apo C-III were high compared to other pediatric populations, they were not affected by egg intake. Dietary records indicated low intake of carotenoids, especially during the SUB period. Plasma lutein and zeaxanthin were increased during the EGG period from 0.235 ± 0.071 to 0.280 ± 0.147 µmol/L (P<0.001) and 0.044 ± 0.019 to 0.051 ± 0.031 µmol/L (P<0.001), respectively. Conclusions: These results suggest that the eggs are a good source of lutein and zeaxanthin in this population and that the increases in LDL size during the egg period may also be related to a better transport of these carotenoids in plasma.
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BACKGROUND: The associations of egg consumption with cardiovascular disease (CVD) and diabetes are still unclear. OBJECTIVE: We aimed to quantitatively summarize the literature on egg consumption and risk of CVD, cardiac mortality, and type 2 diabetes by conducting a meta-analysis of prospective cohort studies. DESIGN: A systematic literature review was conducted for published studies in PubMed and EMBASE through March 2012. Additional information was retrieved through Google or a hand review of the reference from relevant articles. Studies were included if they had a prospective study design, were published in English-language journals, and provided HRs and 95% CIs for the associations of interest. Data were independently extracted by 2 investigators, and the weighted HRs and 95% CIs for the associations of interest were estimated by using a random-effects model. RESULTS: A total of 22 independent cohorts from 16 studies were identified, including participants ranging in number from 1600 to 90,735 and in follow-up time from 5.8 to 20.0 y. Comparison of the highest category (≥1 egg/d) of egg consumption with the lowest (<1 egg/wk or never) resulted in a pooled HR (95% CI) of 0.96 (0.88, 1.05) for overall CVD, 0.97 (0.86, 1.09) for ischemic heart disease, 0.93 (0.81, 1.07) for stroke, 0.98 (0.77, 1.24) for ischemic heart disease mortality, 0.92 (0.56, 1.50) for stroke mortality, and 1.42 (1.09, 1.86) for type 2 diabetes. Of the studies conducted in diabetic patients, the pooled HR (95% CI) was 1.69 (1.09, 2.62) for overall CVD. CONCLUSION: This meta-analysis suggests that egg consumption is not associated with the risk of CVD and cardiac mortality in the general population. However, egg consumption may be associated with an increased incidence of type 2 diabetes among the general population and CVD comorbidity among diabetic patients.
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Intestinal microbiota metabolism of choline and phosphatidylcholine produces trimethylamine (TMA), which is further metabolized to a proatherogenic species, trimethylamine-N-oxide (TMAO). We demonstrate here that metabolism by intestinal microbiota of dietary l-carnitine, a trimethylamine abundant in red meat, also produces TMAO and accelerates atherosclerosis in mice. Omnivorous human subjects produced more TMAO than did vegans or vegetarians following ingestion of l-carnitine through a microbiota-dependent mechanism. The presence of specific bacterial taxa in human feces was associated with both plasma TMAO concentration and dietary status. Plasma l-carnitine levels in subjects undergoing cardiac evaluation (n = 2,595) predicted increased risks for both prevalent cardiovascular disease (CVD) and incident major adverse cardiac events (myocardial infarction, stroke or death), but only among subjects with concurrently high TMAO levels. Chronic dietary l-carnitine supplementation in mice altered cecal microbial composition, markedly enhanced synthesis of TMA and TMAO, and increased atherosclerosis, but this did not occur if intestinal microbiota was concurrently suppressed. In mice with an intact intestinal microbiota, dietary supplementation with TMAO or either carnitine or choline reduced in vivo reverse cholesterol transport. Intestinal microbiota may thus contribute to the well-established link between high levels of red meat consumption and CVD risk.
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We recently demonstrated that daily whole egg consumption during moderate carbohydrate restriction leads to greater increases in plasma HDL-cholesterol (HDL-C) and improvements in HDL profiles in metabolic syndrome (MetS) when compared to intake of a yolk-free egg substitute. We further investigated the effects of this intervention on HDL composition and function, hypothesizing that the phospholipid species present in egg yolk modulate HDL lipid composition to increase the cholesterol-accepting capacity of subject serum. Men and women classified with MetS were randomly assigned to consume either three whole eggs (EGG, n = 20) per day or the equivalent amount of egg substitute (SUB, n = 17) throughout a 12-week moderate carbohydrate-restricted (25-30 % of energy) diet. Relative to other HDL lipids, HDL-cholesteryl ester content increased in all subjects, with greater increases in the SUB group. Further, HDL-triacylglycerol content was reduced in EGG group subjects with normal baseline plasma HDL-C, resulting in increases in HDL-CE/TAG ratios in both groups. Phospholipid analysis by mass spectrometry revealed that HDL became enriched in phosphatidylethanolamine in the EGG group, and that EGG group HDL better reflected sphingomyelin species present in the whole egg product at week 12 compared to baseline. Further, macrophage cholesterol efflux to EGG subject serum increased from baseline to week 12, whereas no changes were observed in the SUB group. Together, these findings suggest that daily egg consumption promotes favorable shifts in HDL lipid composition and function beyond increasing plasma HDL-C in MetS.
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To investigate and quantify the potential dose-response association between egg consumption and risk of coronary heart disease and stroke. Dose-response meta-analysis of prospective cohort studies. PubMed and Embase prior to June 2012 and references of relevant original papers and review articles. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Prospective cohort studies with relative risks and 95% confidence intervals of coronary heart disease or stroke for three or more categories of egg consumption. Eight articles with 17 reports (nine for coronary heart disease, eight for stroke) were eligible for inclusion in the meta-analysis (3 081 269 person years and 5847 incident cases for coronary heart disease, and 4 148 095 person years and 7579 incident cases for stroke). No evidence of a curve linear association was seen between egg consumption and risk of coronary heart disease or stroke (P=0.67 and P=0.27 for non-linearity, respectively). The summary relative risk of coronary heart disease for an increase of one egg consumed per day was 0.99 (95% confidence interval 0.85 to 1.15; P=0.88 for linear trend) without heterogeneity among studies (P=0.97, I(2)=0%). For stroke, the combined relative risk for an increase of one egg consumed per day was 0.91 (0.81 to 1.02; P=0.10 for linear trend) without heterogeneity among studies (P=0.46, I(2)=0%). In a subgroup analysis of diabetic populations, the relative risk of coronary heart disease comparing the highest with the lowest egg consumption was 1.54 (1.14 to 2.09; P=0.01). In addition, people with higher egg consumption had a 25% (0.57 to 0.99; P=0.04) lower risk of developing hemorrhagic stroke. Higher consumption of eggs (up to one egg per day) is not associated with increased risk of coronary heart disease or stroke. The increased risk of coronary heart disease among diabetic patients and reduced risk of hemorrhagic stroke associated with higher egg consumption in subgroup analyses warrant further studies.
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Lutein has been shown to be protective against age-related macular degeneration; however, the antiinflammatory and antioxidant effects of this carotenoid in aortas are less known. Guinea pigs were fed a hypercholesterolemic diet (0.25 g cholesterol/100 g) and randomly allocated to a control group (n = 9) or a lutein group (n = 10) (0.1 g/100 g lutein) and fed the experimental diets for 12 wk. Plasma LDL cholesterol and TG did not differ between groups; however, the lutein group had lower concentrations of medium size LDL (P < 0.05). As expected, guinea pigs from the lutein group had higher concentrations of plasma and liver lutein than those from the control group (P < 0.0001). Aortic cholesterol and malondialdehyde concentrations were lower in the lutein group (9.6 ± 2.8 mmol/g and 1.69 ± 1.35 nmol/mg protein) compared to the control group (15.5 ± 2.3 mmol/g and 2.98 ± 1.45 nmol/mg protein) (P < 0.05). Hematoxilin and eosin staining indicated that aortas from the control group presented focal intimal thickening, whereas either less thickness or no visible thickness was present in aortas from the lutein group. Oxidized LDL (oxLDL) was lower both in plasma and aorta in the lutein group compared to the control group (P < 0.001). Aortic cytokines were also lower in the lutein group (P < 0.05). Plasma lutein and oxLDL (r = -0.79; P < 0.0001) and plasma lutein and aortic oxLDL (r = -0.64; P < 0.0001) were negatively correlated. These data suggest that lutein exerts potent antioxidant and antiinflammatory effects in aortic tissue that may protect against development of atherosclerosis in guinea pigs.
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Metabolomics studies hold promise for the discovery of pathways linked to disease processes. Cardiovascular disease (CVD) represents the leading cause of death and morbidity worldwide. Here we used a metabolomics approach to generate unbiased small-molecule metabolic profiles in plasma that predict risk for CVD. Three metabolites of the dietary lipid phosphatidylcholine--choline, trimethylamine N-oxide (TMAO) and betaine--were identified and then shown to predict risk for CVD in an independent large clinical cohort. Dietary supplementation of mice with choline, TMAO or betaine promoted upregulation of multiple macrophage scavenger receptors linked to atherosclerosis, and supplementation with choline or TMAO promoted atherosclerosis. Studies using germ-free mice confirmed a critical role for dietary choline and gut flora in TMAO production, augmented macrophage cholesterol accumulation and foam cell formation. Suppression of intestinal microflora in atherosclerosis-prone mice inhibited dietary-choline-enhanced atherosclerosis. Genetic variations controlling expression of flavin monooxygenases, an enzymatic source of TMAO, segregated with atherosclerosis in hyperlipidaemic mice. Discovery of a relationship between gut-flora-dependent metabolism of dietary phosphatidylcholine and CVD pathogenesis provides opportunities for the development of new diagnostic tests and therapeutic approaches for atherosclerotic heart disease.
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The role of dietary cholesterol in people with diabetes has been little studied. We investigated the effect of a hypoenergetic high-protein high-cholesterol (HPHchol) diet compared to a similar amount of animal protein (high-protein low-cholesterol, HPLchol) on plasma lipids, glycaemic control and cardiovascular risk markers in individuals with type 2 diabetes. A total of sixty-five participants with type 2 diabetes or impaired glucose tolerance (age 544 (sd 82)years; BMI 341 (sd 48)kg/m2; LDL-cholesterol (LDL-C) 267 (sd 010)mmol/l) were randomised to either HPHchol or HPLchol. Both hypoenergetic dietary interventions (6-7MJ; 14-17 Mcal) and total carbohydrate:protein:fat ratio of 40:30:30% were similar but differed in cholesterol content (HPHchol, 590mg cholesterol; HPLchol, 213mg cholesterol). HPHchol participants consumed two eggs per d, whereas HPHchol participants replaced the eggs with 100g of lean animal protein. After 12 weeks, weight loss was 60 (sd 04)kg (P<0001). LDL-C and homocysteine remained unchanged. All the subjects reduced total cholesterol (03 (sd 01)mmol/l, P<0001), TAG (04 (sd 01)mmol/l, P<0001), non-HDL-cholesterol (HDL-C, 04 (sd 01)mmol/l, P<0001), apo-B (004 (sd 002)mmol/l, P<001), HbA1c (06 (sd 01)%, P<0001), fasting blood glucose (05 (sd 02)mmol/l, P<001), fasting insulin (17 (sd 07)mIU/l, P<001), systolic blood pressure (76 (sd 17)mmHg, P<0001) and diastolic blood pressure (46 (sd 10)mmHg; P<0001). Significance was not altered by diet, sex, medication or amount of weight loss. HDL-C increased on HPHchol (+002 (sd 002)mmol/l) and decreased on HPLchol (007 (sd 003)mmol/l, P<005). Plasma folate and lutein increased more on HPHchol (P<005). These results suggest that a high-protein energy-restricted diet high in cholesterol from eggs improved glycaemic and lipid profiles, blood pressure and apo-B in individuals with type 2 diabetes.
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Risk factor modification remains as the principal aspect of care for stroke prevention. Understanding of risk factors has advanced and several options are now available to treat modifiable risk factors. However, effective treatment remains a challenging task in clinical practice. Prevention begins with awareness of risk factors by patients and clinicians. Risk factor assessment along with overall stroke risk estimation should be part of evaluation of patients with stroke, and used with careful clinical judgment. In this review, we discuss the impact of modifiable traditional vascular risk factors on ischemic stroke, interventions for stroke prevention, and evidence for early treatment of risk factors where available, as well as areas of research progress. Emphasis should be put on the education of patients, the community, and medical personnel. Future research in the field of genetic determinants of vascular risk factors and stroke will increase our understanding of the underlying mechanisms of cerebrovascular disease and likely result in development of new therapies and individualized programs for stroke prevention.
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Reverse cholesterol transport (RCT) is a term used to describe the efflux of excess cellular cholesterol from peripheral tissues and its return to the liver for excretion in the bile and ultimately the feces. It is believed to be a critical mechanism by which HDL exert a protective effect on the development of atherosclerosis. In this paradigm, cholesterol is effluxed from arterial macrophages to extracellular HDL-based acceptors through the action of transporters such as ABCA1 and ABCG1. After efflux to HDL, cholesterol may be esterified in the plasma by the enzyme lecithin:cholesterol acyltransferase and is ultimately transported from HDL to the liver, either directly via the scavenger receptor BI or after transfer to apolipoprotein B-containing lipoproteins by the cholesteryl ester transfer protein. Methods for assessing the integrated rate of macrophage RCT in animals have provided insights into the molecular regulation of the process and suggest that the dynamic rate of macrophage RCT is more strongly associated with atherosclerosis than the steady-state plasma concentration of HDL cholesterol. Promotion of macrophage RCT is a potential therapeutic approach to preventing or regressing atherosclerotic vascular disease, but robust measures of RCT in humans will be needed in order to confidently advance RCT-promoting therapies in clinical development.
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Population studies have shown that plasma HDL levels correlate inversely with cardiovascular disease risk. In recent years there has been intense interest in developing strategies for exploiting these cardioprotective properties by increasing HDL levels. While this approach has considerable merit, it is important to recognize that HDL are structurally and functionally diverse and consist of numerous, highly dynamic subpopulations of particles that do not all inhibit atherosclerosis to the same extent. For this reason it is essential to assess HDL subpopulation distribution and functionality when considering therapeutic interventions that raise HDL levels. This review documents what is known about the relationship between the metabolism and function of HDL subpopulations and how this affects their cardioprotective properties.
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Whereas limited and inconsistent findings have been reported on the relation between dietary cholesterol or egg consumption and fasting glucose, no previous study has examined the association between egg consumption and type 2 diabetes. This project sought to examine the relation between egg intake and the risk of type 2 diabetes in two large prospective cohorts. In this prospective study, we used data from two completed randomized trials: 20,703 men from the Physicians' Health Study I (1982-2007) and 36,295 women from the Women's Health Study (1992-2007). Egg consumption was ascertained using questionnaires, and we used the Cox proportional hazard model to estimate relative risks of type 2 diabetes. During mean follow-up of 20.0 years in men and 11.7 years in women, 1,921 men and 2,112 women developed type 2 diabetes. Compared with no egg consumption, multivariable adjusted hazard ratios for type 2 diabetes were 1.09 (95% CI 0.87-1.37), 1.09 (0.88-1.34), 1.18 (0.95-1.45), 1.46 (1.14-1.86), and 1.58 (1.25-2.01) for consumption of <1, 1, 2-4, 5-6, and > or =7 eggs/week, respectively, in men (P for trend <0.0001). Corresponding multivariable hazard ratios for women were 1.06 (0.92-1.22), 0.97 (0.83-1.12), 1.19 (1.03-1.38), 1.18 (0.88-1.58), and 1.77 (1.28-2.43), respectively (P for trend <0.0001). These data suggest that high levels of egg consumption (daily) are associated with an increased risk of type 2 diabetes in men and women. Confirmation of these findings in other populations is warranted.
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The "metabolic syndrome" (MetS) is a clustering of components that reflect overnutrition, sedentary lifestyles, and resultant excess adiposity. The MetS includes the clustering of abdominal obesity, insulin resistance, dyslipidemia, and elevated blood pressure and is associated with other comorbidities including the prothrombotic state, proinflammatory state, nonalcoholic fatty liver disease, and reproductive disorders. Because the MetS is a cluster of different conditions, and not a single disease, the development of multiple concurrent definitions has resulted. The prevalence of the MetS is increasing to epidemic proportions not only in the United States and the remainder of the urbanized world but also in developing nations. Most studies show that the MetS is associated with an approximate doubling of cardiovascular disease risk and a 5-fold increased risk for incident type 2 diabetes mellitus. Although it is unclear whether there is a unifying pathophysiological mechanism resulting in the MetS, abdominal adiposity and insulin resistance appear to be central to the MetS and its individual components. Lifestyle modification and weight loss should, therefore, be at the core of treating or preventing the MetS and its components. In addition, there is a general consensus that other cardiac risk factors should be aggressively managed in individuals with the MetS. Finally, in 2008 the MetS is an evolving concept that continues to be data driven and evidence based with revisions forthcoming.
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To test the hypotheses that an egg breakfast, in contrast to a bagel breakfast matched for energy density and total energy, would enhance weight loss in overweight and obese participants while on a reduced-calorie weight loss diet. Men and women (n=152), age 25-60 years, body mass index (BMI) >or=25 and <or=50 kg m(-2). Otherwise healthy overweight or obese participants were assigned to Egg (E), Egg Diet (ED), Bagel (B) or Bagel Diet (BD) groups, based on the prescription of either an egg breakfast containing two eggs (340 kcal) or a breakfast containing bagels matched for energy density and total energy, for at least 5 days per week, respectively. The ED and BD groups were suggested a 1000 kcal energy-deficit low-fat diet, whereas the B and E groups were asked not to change their energy intake. After 8 weeks, in comparison to the BD group, the ED group showed a 61% greater reduction in BMI (-0.95+/-0.82 vs -0.59+/-0.85, P<0.05), a 65% greater weight loss (-2.63+/-2.33 vs -1.59+/-2.38 kg, P<0.05), a 34% greater reduction in waist circumference (P<0.06) and a 16% greater reduction in percent body fat (P=not significant). No significant differences between the E and B groups on the aforementioned variables were obtained. Further, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and triglycerides, did not differ between the groups. The egg breakfast enhances weight loss, when combined with an energy-deficit diet, but does not induce weight loss in a free-living condition. The inclusion of eggs in a weight management program may offer a nutritious supplement to enhance weight loss.
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To evaluate the long term efficacy of diets in lowering serum cholesterol concentration. Descriptive overview of 16 published controlled trials of six months' duration or longer. Trials had been conducted in hospital clinics (6), industry (3), mental hospitals or institutions (3), and in general populations (4). Trials had been conducted in high risk subjects (5), in unselected healthy subjects (6), or for secondary prevention in patients with coronary heart disease (5). Women were included in only four trials. Diets equivalent to the step 1 diet were employed in eight trials, with individual intervention by dietitians (3) or occupational physicians (2) or with population advice (3). Intensive diets which were more rigorous than the step 2 diet were employed in eight trials. Net change in serum total cholesterol concentration in subjects receiving treatment with diet compared with values in control subjects after six months to 10 years. In five trials with the step 1 diet as individual intervention the net reduction in serum cholesterol concentration ranged from 0% to 4.0% over six months to six years. In trials with population education reductions in cholesterol concentrations were 0.6-2.0% over five to 10 years. When population and individual dietary advice were combined changes in cholesterol concentration ranged from a fall of 2.1% to a rise of 1.0% over four to 10 years. Diets more intensive than the step 2 diet reduced serum cholesterol concentration by 13% over five years in selected high risk men in the population; by 6.5-15.1% over two to five years in hospital outpatients; and by 12.8-15.5% over one to four and a half years in patients in institutions. The response to a step 1 diet is too small to have any value in the clinical management of adults with serum cholesterol concentrations above 6.5 mmol/l. Current guidelines recommend screening of serum cholesterol concentration in healthy subjects, followed by treatment with a step 1 diet. The guidelines should be reviewed to provide a more realistic estimate of the effect of a step 1 diet and of the likely need for lipid lowering drugs.
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Suboptimal nutrition is a leading cause of poor health. Nutrition and policy science have advanced rapidly, creating confusion yet also providing powerful opportunities to reduce the adverse health and economic impacts of poor diets. This review considers the history, new evidence, controversies, and corresponding lessons for modern dietary and policy priorities for cardiovascular diseases, obesity, and diabetes mellitus. Major identified themes include the importance of evaluating the full diversity of diet-related risk pathways, not only blood lipids or obesity; focusing on foods and overall diet patterns, rather than single isolated nutrients; recognizing the complex influences of different foods on long-term weight regulation, rather than simply counting calories; and characterizing and implementing evidence-based strategies, including policy approaches, for lifestyle change. Evidence-informed dietary priorities include increased fruits, nonstarchy vegetables, nuts, legumes, fish, vegetable oils, yogurt, and minimally processed whole grains; and fewer red meats, processed (eg, sodium-preserved) meats, and foods rich in refined grains, starch, added sugars, salt, and trans fat. More investigation is needed on the cardiometabolic effects of phenolics, dairy fat, probiotics, fermentation, coffee, tea, cocoa, eggs, specific vegetable and tropical oils, vitamin D, individual fatty acids, and diet-microbiome interactions. Little evidence to date supports the cardiometabolic relevance of other popular priorities: eg, local, organic, grass-fed, farmed/wild, or non-genetically modified. Evidence-based personalized nutrition appears to depend more on nongenetic characteristics (eg, physical activity, abdominal adiposity, gender, socioeconomic status, culture) than genetic factors. Food choices must be strongly supported by clinical behavior change efforts, health systems reforms, novel technologies, and robust policy strategies targeting economic incentives, schools and workplaces, neighborhood environments, and the food system. Scientific advances provide crucial new insights on optimal targets and best practices to reduce the burdens of diet-related cardiometabolic diseases.