The US dietary guidelines may recommend replacing whole eggs with egg whites/substitutes or alternative protein sources for facilitating cardiovascular health...
MedicalResearch.com Interview with:
Jean-Philippe Drouin-Chartier, RD PhD
Assistant Professor, Faculty of Pharmacy, Université Laval
Researcher, NUTRISS Center of INAF, Université Laval
Visiting Scientist, Department of Nutrition
Harvard TH Chan School of Public HealthMedicalResearch.com: What is the background for this study? Response: Cardiovascular disease (CVD) is a leading cause of death worldwide. Eggs are a major source of dietary cholesterol, but they are also an affordable source of high-quality protein, iron, unsaturated fatty acids, phospholipids, and carotenoids. However, because of the cholesterol content in eggs, the association between egg intake and CVD risk has been a topic of intense debate in the past decades. Many prospective studies on the association between egg intake and cardiovascular disease risk have provided conflicting findings.
The aim of our study was to prospectively examine the association between egg consumption and risk of CVD in three cohorts of US men and women, and to conduct a systematic review and a meta-analysis of prospective cohort studies on eggs and CVD.(more…)
MedicalResearch.com Interview with:
Jyrki Virtanen, PhD
Assistant professor of nutritional epidemiology
University of Eastern Finland
Institute of Public Health and Clinical Nutrition
Kuopio, Finland
MedicalResearch.com: What is the background for this study? What are the main findings?Response: We have previously found in this same eastern Finnish male study population that higher egg intake was associated with lower risk of developing dementia and with better performance in tests assessing cognitive capacity. Eggs are a major source of choline, especially phosphatidylcholine, and choline (which is an essential nutrient) is necessary for the formation of acetylcholine, which is a neurotransmitter.
Earlier studies have linked choline intake with better cognitive processing but there was no information whether choline intake would also be associated with lower risk of developing dementia. So the purpose of our current study was to investigate whether higher choline intake would associate with better cognitive performance and with lower risk of dementia, which would support our previous findings with egg intake.
And in the current study we did find that especially higher phosphatidylcholine intake was associated with a lower risk of developing dementia and also with better performance in tests measuring memory and linguistic abilities of the men in the study.
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MedicalResearch.com Interview with:
Victor Wenze Zhong, Ph.D.
Postdoctoral fellow
Department of Preventive Medicine
Feinberg School of Medicine
Northwestern University
Chicago, IL 60611MedicalResearch.com: What is the background for this study? Response: Dietary cholesterol is a common nutrient in human diet. Eggs, specially egg yolks, are the single richest source of dietary cholesterol among all commonly consumed foods. The associations between dietary cholesterol consumption and cardiovascular disease and mortality remain controversial despite decades of research. Eating less than 300 mg of dietary cholesterol per day was the guideline recommendation before 2015. However, the most recent 2015-2020 Dietary Guidelines for Americans no longer include a daily consumption limit for dietary cholesterol and recommend weekly egg consumption as part of the healthy US-style eating pattern. Whether these recommendations are appropriate have been intensely debated.
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MedicalResearch.com Interview with:
Edwin Kim, MD MS
Assistant Professor of Medicine
Division of Rheumatology, Allergy and Immunology
Director, UNC Allergy and Immunology Clinic
University of North Carolina at Chapel Hill
Chapel Hill, NCMedicalResearch.com: What is the background for this study? What are the main findings?Response: The background is that egg allergy remains one of the most common food allergies in childhood and although most patients will outgrow the allergy, it seems that many will carry into their teen years. As a result patients still have many years of risk of anaphylaxis, poor quality of life and potential nutritional deficits. The ability to introduce some amount of egg into the diet could have profound benefit to allergy patients.
The main findings are that after completing up to 4 years of egg oral immunotherapy (OIT), most patients are able to introduce at least baked egg products into the diet. The subset of patients who showed a lasting benefit by passing a food challenge 4-6 weeks after stopping the OIT, generally did even better by being able to introduce lightly cooked egg like scrambled, boiled, or fried in addition to baked egg products. This benefit to the diet seemed to last up to 5 years after stopping egg oral immunotherapy. In addition to the safety, quality of life and nutrition benefits, recent data suggesting that bringing baked egg into the diet can speed up outgrowing the allergy provides a further benefit. (more…)
MedicalResearch.com Interview with:Nick Fuller PhD
Charles Perkins Centre Research Program Director
University of Sydney
MedicalResearch.com: What is the background for this study? What are the main findings?Response: There is a disparity in research findings between epidemiological studies and randomised controlled trials in those with type 2 diabetes mellitus. A lot of the research showing that a high egg consumption (6 or more eggs per week) is detrimental to a person’s health was conducted at a time when we were told to avoid eggs. People that were eating a high egg diet during that time were also likely to have other poor eating habits, such as one high in saturated fat and low in wholegrain carbohydrates. These studies did not control for such confounding factors.
As a result of this disparity in findings between epidemiological and controlled studies this has resulted in differing guidelines for recommended egg intake between countries.
To address a lack of randomised controlled trials in this field we conducted a large study over 12-months to assess the effect of a high egg consumption (12 eggs per week) on heart disease and diabetes risk factors in a group of people at high risk of cardiovascular heart disease – diagnosed with pre-diabetes or type 2 diabetes mellitus. 140 people were randomised to a high egg diet (12 eggs per week) or a low egg diet (less than 2 eggs per week) and advised on the principles of a healthy diet. For example, including plenty of wholegrain and low glycemic index carbohydrate sources and swapping sources of saturated fat (e.g. butter) for sources of poly and mono-unsaturated fat (e.g. avocado or olive oil). They followed their respective high or low egg diet for 12 months and over the time we measured a comprehensive list of risk factors for heart disease and type 2 diabetes.
Both the low and high egg groups had the same improvements in the health at the end of the 12 months and the high egg diet did not result in an increased risk of cardiovascular disease.
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MedicalResearch.com Interview with:Dr Robert Boyle
Senior lecturer in paediatric allergy
honorary consultant, Paediatric allergist
Imperial College Healthcare NHS Trust
MedicalResearch.com: What is the background for this study? What are the main findings?Editors' note: Please discuss food introduction with your child's pediatrician before embarking on any new foods.
Response: Food allergy is a common problem which may be getting more common.
We have known for over 100 years that feeding egg to animals such as guinea pigs can prevent egg allergy. However randomised trials of allergenic food introduction for preventing food allergy in human infants have not been done until the past 5 years, and have so far yielded mixed results. One trial for peanut allergy was positive, with less peanut allergy in infants who were fed the food from early in life compared with infants who avoided it for 5 years. Other trials have yielded null findings, but may have been too small to yield a conclusive result. We used a technique called meta-analysis to combine the results of all previous trials of timing of allergenic food introduction and risk of food allergy. We also evaluated other allergic and autoimmune diseases.
Our analysis yielded conclusive results for both egg and peanut – that early introduction of these foods into an infant’s diet might reduce their risk of egg and peanut allergy by around 40-70%. We were surprised to see null findings in our meta-analysis of timing of gluten or wheat introduction and risk of coeliac disease (gluten intolerance) which is a different type of allergy to egg and peanut allergy. This suggests that early introduction of allergenic foods does not reduce risk of all types of food allergy.
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MedicalResearch.com Interview with:
Susanna C. Larsson PhD, Associate Professor
Associate professor, Nutritional Epidemiology
Institute of Environmental Medicine
Karolinska Institutet
Stockholm, Sweden
Medical Research: What are the main findings?
Dr. Larsson: A high dietary cholesterol intake has been postulated to increase the risk of cardiovascular disease. Egg is a rich source of dietary cholesterol and has been positively associated with risk of heart failure in previous prospective studies. High consumption of eggs has also been associated with a higher risk of myocardial infarction in diabetic patients.
Medical Research: What is the background for this study?
Dr. Larsson: We investigated the association between egg consumption and risk of cardiovascular diseases in two population-based prospective cohort studies of approximately 38,000 Swedish men and 33,000 Swedish women. Findings from our study indicate that egg consumption does not increase the risk of myocardial infarction, ischemic stroke, or hemorrhagic stroke. High egg consumption (one or more times per day) was associated with an elevated risk of heart failure in men but not in women. Egg consumption was not associated with an increased risk of heart failure, myocardial infarction, or stroke in individuals with diabetes.
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MedicalResearch.com Interview with:
David L. Katz, MD MPH FACPM FACP
President of the American College of Lifestyle MedicineYale University Prevention Research Center
Derby, CT; Griffin Hospital, Derby, CT
Medical Research: What is the background for this study? What are the main findings?
Dr. Katz: We have long advised patients at risk for heart disease to avoid eggs- but have thought relatively little about what they might wind up eating instead. While coronary care units banish eggs, they routinely serve white bread, bagels, pancakes, etc. In general, the exclusion of eggs from the diet may result in more sugary, starchy foods- and if so, might do net harm. We have previously studied egg intake in healthy and dyslipidemic adults, and seen no adverse effects on blood flow or biomarkers in the short term (6 wks). This study examined this issue in adults with coronary artery disease- and again, no adverse effects were seen.
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MedicalResearch.com Interview with: David L. Katz, MD, MPH, FACPM, FACP
Director, Yale University Prevention Research Center
Griffin Hospital
Medical Research: What are the main findings of the study?Dr. Katz: We did not see any adverse effects of short-term, daily egg ingestion in adults with established coronary artery disease.
Medical Research: What was most surprising about the results?Dr. Katz: Eggs are routinely banned from 'heart healthy diets.' in particular eggs are always absent from cardiac care units, with egg beaters substituting. However, these same units routinely serve products with refined starch and added sugar. The scientific basis for excluding eggs from diets to improve cardiac health has long been suspect. Here, we show that in the short term at least, there are no discernible harms of daily egg ingestion even in adults with heart disease.
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