Dietary cholesterol provided by eggs and plasma lipoproteins in healthy populations

Department of Nutritional Sciences, University of Connecticut, Storrs, Connecticut 06269, USA.
Current Opinion in Clinical Nutrition and Metabolic Care (Impact Factor: 3.99). 02/2006; 9(1):8-12. DOI: 10.1097/
Source: PubMed


Extensive research has not clearly established a link between egg consumption and risk for coronary heart disease. The effects of egg intake on plasma lipids and low-density lipoprotein (LDL) atherogenicity in healthy populations need to be addressed.
The lack of connection between heart disease and egg intake could partially be explained by the fact that dietary cholesterol increases the concentrations of both circulating LDL and high-density lipoprotein (HDL) cholesterol in those individuals who experience an increase in plasma cholesterol following egg consumption (hyperresponders). It is also important to note that 70% of the population experiences a mild increase or no alterations in plasma cholesterol concentrations when challenged with high amounts of dietary cholesterol (hyporesponders). Egg intake has been shown to promote the formation of large LDL, in addition to shifting individuals from the LDL pattern B to pattern A, which is less atherogenic. Eggs are also good sources of antioxidants known to protect the eye; therefore, increased plasma concentrations of lutein and zeaxanthin in individuals consuming eggs are also of interest, especially in those populations susceptible to developing macular degeneration and eye cataracts.
For these reasons, dietary recommendations aimed at restricting egg consumption should not be generalized to include all individuals. We need to acknowledge that diverse healthy populations experience no risk in developing coronary heart disease by increasing their intake of cholesterol but, in contrast, they may have multiple beneficial effects by the inclusion of eggs in their regular diet.

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Available from: Maria Luz Fernandez, Jan 30, 2014
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    • "The published literature on the role of dietary cholesterol from both egg and non-egg sources and biomarkers of CHD risk, such as lipoproteins, among healthy individuals is extensive and has previously been reviewed. The overall evidence from human studies has documented the lack of effect of dietary cholesterol on lipoprotein levels among healthy individuals.72,73 On the other hand while there is a possibility that diabetics transport cholesterol differently than healthy individuals, providing a possible explanation for the apparent observed association between egg consumption and CHD risk among diabetics,21 the biological mechanism underlying this relationship remains elusive. "
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    ABSTRACT: This study reviewed epidemiological and experimental evidence on the relationship between egg consumption and cardiovascular disease (CVD) risks among type II diabetes mellitus (T2DM) individuals, and T2DM risk in nondiabetic subjects. Four of the six studies that examined CVD and mortality and egg consumption among diabetics found a statistically significant association. Of the eight studies evaluating incident T2DM and egg consumption, four prospective studies found a statistically significant association. Lack of adjustment for dietary confounders was a common study limitation. A small number of experimental studies examined the relationship between egg intake and CVD risk biomarkers among diabetics or individuals with T2DM risk factors. Studies among healthy subjects found suggestive evidence that dietary interventions that include eggs may reduce the risk of T2DM and metabolic syndrome. Differences in study design, T2DM status, exposure measurement, subject age, control for confounders and follow-up time present significant challenges for conducting a meta-analysis. Conflicting results, coupled with small sample sizes, prevent broad interpretation. Given the study limitations, these findings need to be further investigated.
    Full-text · Article · Mar 2014 · Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
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    • "Another dietary strategy that is compatible with carbohydrate-restricted diets and has been associated with improvements in lipoprotein particle characteristics is daily egg consumption. In healthy populations, daily egg intake consistently shifts the proportion of small LDL and small HDL subclasses towards their larger, more buoyant forms [12]. Furthermore, daily egg intake has been shown to increase lecithin-cholesterol acyltransferase (LCAT) activity, potentially improving reverse cholesterol transport [13] [14]. "
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    ABSTRACT: Objective: We investigated if daily egg feeding, along with carbohydrate restriction, would alter lipoprotein metabolism and influence atherogenic lipoprotein profiles and insulin resistance in men and women with metabolic syndrome (MetS). Methods: In a randomized, single-blind, parallel design, participants consumed either 3 whole eggs/day (EGG, n=20) or the equivalent amount of yolk-free egg substitute (SUB, n=17), as part of a moderately carbohydrate-restricted diet (25%-30% energy) for 12 weeks. Plasma lipids, apolipoproteins (apos), oxidized LDL (oxLDL), cholesteryl ester transfer protein (CETP) and lecithin-cholesterol acyltransferase (LCAT) activities were assessed at baseline and week 12. Lipoprotein particle concentrations and sizes were measured by nuclear magnetic resonance spectroscopy. Results: Atherogenic dyslipidemia improved for all individuals as evidenced by reductions in plasma triglycerides, apoC-III, apoE, oxLDL, VLDL particle diameter, large VDL, total IDL, small LDL, and medium LDL particles (P<0.05). Furthermore, there were increases in HDL-cholesterol, large LDL and large HDL particles (P<0.05) for all individuals. However, there were greater increases in HDL-cholesterol and large HDL particles, and reductions in total VLDL and medium VLDL particles for those consuming EGG compared to SUB (P<0.05). Plasma insulin and insulin resistance (HOMA-IR) were reduced, while LCAT activity, and both HDL and LDL diameters increased over time in the EGG group only (P<0.05). Conclusions: Incorporating daily whole egg intake into a moderately carbohydrate-restricted diet provides further improvements in the atherogenic lipoprotein profile and in insulin resistance in individuals with MetS.
    Full-text · Article · Sep 2012 · Metabolism: clinical and experimental
    • "Conclusions This review has identified that eggs are a low energy, nutrient-dense food source that contribute to diet quality, particularly intakes of selenium and vitamin D. For most individuals, egg consumption will have little or no influence on cholesterol levels (Fernandez, 2006) or CHD risk (Hu et al., 1999). For the general population, there are clear nutritional benefits to eating eggs on a regular basis. "
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    ABSTRACT: Purpose – Advice about the role of eggs in the diet has changed several times over the decades. The purpose of this paper is to evaluate published evidence reporting associations between egg consumption, egg nutrients and health. Design/methodology/approach – The scientific literature was searched using Medline and key words relevant to eggs and egg nutrients. In addition, a new secondary analysis of the UK National Diet and Nutrition Survey (NDNS) was undertaken to examine nutritional and health differences between consumers and non-consumers of eggs. Findings – Eggs are a rich source of protein and several essential nutrients, particularly vitamin D, vitamin B12, selenium and choline. Emerging evidence suggests that eating eggs is associated with satiety, weight management and better diet quality. In addition, antioxidants found in egg yolk may help prevent age-related macular degeneration. The secondary analysis showed that regular egg consumers with a low red and processed meat (RPM) intake ate healthier diets and had a better micronutrient status than those who did not eat eggs but who had a high RPM intake. It was concluded that egg consumption, at a range of intakes, was associated with nutrition and health benefits. Research limitations/implications – More research on eggs, and egg nutrients, is needed to confirm the health benefits. Future studies should control for other dietary and lifestyle factors. Originality/value – This paper develops knowledge about egg consumption beyond cholesterol content and provides new evidence from a secondary analysis of a large national dietary database.
    No preview · Article · May 2010 · Nutrition & Food Science
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