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Missimer A, DiMarco DM, Andersen CJ, Murillo AG, Vergara-Jimenez M, Fernandez ML. Consuming Two Eggs per Day, as Compared to an Oatmeal Breakfast, Decreases Plasma Ghrelin while Maintaining the LDL/HDL Ratio. Nutrients 2017; 9:nu9020089. [PMID: 28146063 PMCID: PMC5331520 DOI: 10.3390/nu9020089] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 12/24/2016] [Accepted: 01/13/2017] [Indexed: 12/16/2022] Open
Abstract
Eggs contain high quality protein, vitamins, minerals and antioxidants, yet regular consumption is still met with uncertainty. Therefore, the purpose of this study was to compare the effects of consuming two eggs per day or a heart-healthy oatmeal breakfast on biomarkers of cardiovascular disease (CVD) risk and satiety measures in a young, healthy population. Fifty subjects participated in a randomized crossover clinical intervention; subjects were randomly allocated to consume either two eggs or one packet of oatmeal per day for breakfast for four weeks. After a three-week washout period, participants were allocated to the alternative breakfast. Fasting blood samples were collected at the end of each intervention period to assess plasma lipids and plasma ghrelin. Subjects completed visual analog scales (VAS) concurrent to dietary records to assess satiety and hunger. Along with an increase in cholesterol intake, there were significant increases in both low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol following the egg consumption period (p < 0.01). However, there was no difference in the LDL/HDL ratio, a recognized biomarker of CVD risk, nor in the plasma glucose, triglycerides or liver enzymes, between diet periods. Several self-reported satiety measures were increased following the consumption of eggs, which were associated with lower plasma ghrelin concentrations (p < 0.05). These results demonstrate that compared to an oatmeal breakfast, two eggs per day do not adversely affect the biomarkers associated with CVD risk, but increase satiety throughout the day in a young healthy population.
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Affiliation(s)
- Amanda Missimer
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA.
| | - Diana M DiMarco
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA.
| | | | - Ana Gabriela Murillo
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA.
| | | | - Maria Luz Fernandez
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA.
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152
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DiMarco DM, Missimer A, Murillo AG, Lemos BS, Malysheva OV, Caudill MA, Blesso CN, Fernandez ML. Intake of up to 3 Eggs/Day Increases HDL Cholesterol and Plasma Choline While Plasma Trimethylamine-N-oxide is Unchanged in a Healthy Population. Lipids 2017; 52:255-263. [PMID: 28091798 DOI: 10.1007/s11745-017-4230-9] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 12/20/2016] [Indexed: 12/22/2022]
Abstract
Eggs are a source of cholesterol and choline and may impact plasma lipids and trimethylamine-N-oxide (TMAO) concentrations, which are biomarkers for cardiovascular disease (CVD) risk. Therefore, the effects of increasing egg intake (0, 1, 2, and 3 eggs/day) on these and other CVD risk biomarkers were evaluated in a young, healthy population. Thirty-eight subjects [19 men/19 women, 24.1 ± 2.2 years, body mass index (BMI) 24.3 ± 2.5 kg/m2] participated in this 14-week crossover intervention. Participants underwent a 2-week washout with no egg consumption, followed by intake of 1, 2, and 3 eggs/day for 4 weeks each. Anthropometric data, blood pressure (BP), dietary records, and plasma biomarkers (lipids, glucose, choline, and TMAO) were measured during each intervention phase. BMI, waist circumference, systolic BP, plasma glucose, and plasma triacylglycerol did not change throughout the intervention. Diastolic BP decreased with egg intake (P < 0.05). Compared to 0 eggs/day, intake of 1 egg/day increased HDL cholesterol (HDL-c) (P < 0.05), and decreased LDL cholesterol (LDL-c) (P < 0.05) and the LDL-c/HDL-c ratio (P < 0.01). With intake of 2-3 eggs/day, these changes were maintained. Plasma choline increased dose-dependently with egg intake (P < 0.0001) while fasting plasma TMAO was unchanged. These results indicate that in a healthy population, consuming up to 3 eggs/day results in an overall beneficial effect on biomarkers associated with CVD risk, as documented by increased HDL-c, a reduced LDL-c/HDL-c ratio, and increased plasma choline in combination with no change in plasma LDL-c or TMAO concentrations.
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Affiliation(s)
- Diana M DiMarco
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Amanda Missimer
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Ana Gabriela Murillo
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Bruno S Lemos
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Olga V Malysheva
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, 14850, USA
| | - Marie A Caudill
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, 14850, USA
| | - Christopher N Blesso
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Maria Luz Fernandez
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT, 06269, USA.
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153
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Egg consumption and heart health: A review. Nutrition 2016; 37:79-85. [PMID: 28359368 DOI: 10.1016/j.nut.2016.12.014] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 12/08/2016] [Accepted: 12/17/2016] [Indexed: 12/20/2022]
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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154
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Alexander DD, Miller PE, Vargas AJ, Weed DL, Cohen SS. Meta-analysis of Egg Consumption and Risk of Coronary Heart Disease and Stroke. J Am Coll Nutr 2016; 35:704-716. [DOI: 10.1080/07315724.2016.1152928] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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155
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Jampolis MB, Rothkopf MM, Li Z, Diamond SJ, Allen K, Abdelhadi RA, Kahana DD, McClave SA. Principles of Healthful Eating. Curr Nutr Rep 2016. [DOI: 10.1007/s13668-016-0168-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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156
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Karupaiah T, Chuah KA, Chinna K, Matsuoka R, Masuda Y, Sundram K, Sugano M. Comparing effects of soybean oil- and palm olein-based mayonnaise consumption on the plasma lipid and lipoprotein profiles in human subjects: a double-blind randomized controlled trial with cross-over design. Lipids Health Dis 2016; 15:131. [PMID: 27535127 PMCID: PMC4989497 DOI: 10.1186/s12944-016-0301-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 08/03/2016] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Mayonnaise is used widely in contemporary human diet with widespread use as a salad dressing or spread on breads. Vegetable oils used in its formulation may be a rich source of ω-6 PUFAs and the higher-PUFA content of mayonnaise may be beneficial in mediating a hypocholesterolemic effect. This study, therefore, evaluated the functionality of mayonnaise on cardiometabolic risk within a regular human consumption scenario. METHODS Subjects underwent a randomized double-blind crossover trial, consuming diets supplemented with 20 g/day of either soybean oil-based mayonnaise (SB-mayo) or palm olein-based mayonnaise (PO-mayo) for 4 weeks each with a 2-week wash-out period. The magnitude of changes for metabolic outcomes between dietary treatments was compared with PO-mayo serving as the control. The data was analyzed by ANCOVA using the GLM model. Analysis was adjusted for weight changes. RESULTS Treatments resulted in significant reductions in TC (diff = -0.25 mmol/L; P = 0.001), LDL-C (diff = -0.17 mmol/L; P = 0.016) and HDL-C (diff = -0.12 mmol/L; P < 0.001) in SB-mayo compared to PO-mayo without affecting LDL-C:HDL-C ratio (P > 0.05). Lipoprotein particle change was significant with large LDL particles increasing after PO-mayo (diff = +63.2 nmol/L; P = 0.007) compared to SB-mayo but small LDL particles remained unaffected. Plasma glucose, apolipoproteins and oxidative stress markers remained unchanged. CONCLUSIONS Daily use with 20 g of linoleic acid-rich SB-mayo elicited reductions in TC and LDL-C concentrations without significantly changing LDL-C:HDL-C ratio or small LDL particle distributions compared to the PO-mayo diet. TRIAL REGISTRATION This clinical trial was retrospectively registered with the National Medical Research Register, National Institute of Health, Ministry of Health Malaysia, (NMRR-15-40-24035; registered on 29/01/2015; https://www.nmrr.gov.my/fwbPage.jsp?fwbPageId=ResearchISRForm&fwbAction=Update&fwbStep=10&pk.researchID=24035&fwbVMenu=3&fwbResearchAction=Update ). Ethical approval was obtained from the National University of Malaysia's Medical Ethics Committee (UKM 1.5.3.5/244/SPP/NN-054-2011, approved on 25/05/2011).
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Affiliation(s)
- Tilakavati Karupaiah
- Dietetics Program, School of Healthcare Sciences, Faculty of Health Sciences, National University of Malaysia, Kuala Lumpur, Malaysia.
| | - Khun-Aik Chuah
- Nutrition Program, School of Healthcare Sciences, Faculty of Health Sciences, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Karuthan Chinna
- Julius Center, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ryosuke Matsuoka
- R&D Division, Kewpie Corporation, Sengawa Kewport, 2-5-7, Sengawa-cho, Chofu-shi, Tokyo, Japan
| | - Yasunobu Masuda
- R&D Division, Kewpie Corporation, Sengawa Kewport, 2-5-7, Sengawa-cho, Chofu-shi, Tokyo, Japan
| | | | - Michihiro Sugano
- Kyushu University, and Prefectual University of Kumamoto, Kyushu, Japan
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157
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Kromhout D, Spaaij CJK, de Goede J, Weggemans RM. The 2015 Dutch food-based dietary guidelines. Eur J Clin Nutr 2016; 70:869-78. [PMID: 27049034 PMCID: PMC5399142 DOI: 10.1038/ejcn.2016.52] [Citation(s) in RCA: 241] [Impact Index Per Article: 30.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 02/09/2016] [Accepted: 02/10/2016] [Indexed: 02/08/2023]
Abstract
The objective of this study was to derive food-based dietary guidelines for the Dutch population. The dietary guidelines are based on 29 systematic reviews of English language meta-analyses in PubMed summarizing randomized controlled trials and prospective cohort studies on nutrients, foods and food patterns and the risk of 10 major chronic diseases: coronary heart disease, stroke, heart failure, diabetes, breast cancer, colorectal cancer, lung cancer, chronic obstructive pulmonary disease, dementia and depression. The committee also selected three causal risk factors for cardiovascular diseases or diabetes: systolic blood pressure, low-density lipoprotein cholesterol and body weight. Findings were categorized as strong or weak evidence, inconsistent effects, too little evidence or effect unlikely for experimental and observational data separately. Next, the committee selected only findings with a strong level of evidence for deriving the guidelines. Convincing evidence was based on strong evidence from the experimental data either or not in combination with strong evidence from prospective cohort studies. Plausible evidence was based on strong evidence from prospective cohort studies only. A general guideline to eat a more plant food-based dietary pattern and limit consumption of animal-based food and 15 specific guidelines have been formulated. There are 10 new guidelines on legumes, nuts, meat, dairy produce, cereal products, fats and oils, tea, coffee and sugar-containing beverages. Three guidelines on vegetables, fruits, fish and alcoholic beverages have been sharpened, and the 2006 guideline on salt stayed the same. A separate guideline has been formulated on nutrient supplements. Completely food-based dietary guidelines can be derived in a systematic and transparent way.
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Affiliation(s)
- D Kromhout
- The Health Council of the Netherlands, The Hague, The Netherlands
| | - C J K Spaaij
- The Health Council of the Netherlands, The Hague, The Netherlands
| | - J de Goede
- The Health Council of the Netherlands, The Hague, The Netherlands
| | - R M Weggemans
- The Health Council of the Netherlands, The Hague, The Netherlands
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158
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Abstract
PURPOSE OF REVIEW Modulation of diet is the primary lifestyle approach for reducing cardiovascular disease (CVD) risk, with a major focus of current guidelines being to lower LDL cholesterol by reducing intake of saturated fatty acids. However, dietary effects on lipid-related CVD risk factors extend beyond LDL cholesterol, with growing emphasis on the prevention and management of atherogenic dyslipidemia, which includes elevated triglyceride, small dense LDL, and reduced HDL cholesterol, and which is associated with excess adiposity and insulin resistance. We here review recent studies of dietary macronutrient effects on CVD risk that may act through effects on plasma lipid and lipoprotein metabolism. RECENT FINDINGS Effects of reducing saturated fatty acids on CVD risk have been evaluated both in terms of the replacement macronutrient(s) and the food and dietary context in which the macronutrients are consumed. Although weight loss remains the most important goal for reducing cardiometabolic risk among overweight and obese individuals, a variety of lines of evidence support limitation of added sugars and processed starches for improving features of atherogenic dyslipidemia. SUMMARY Increasing understanding of the complexity of nutrient-disease relationships has shifted the framework for CVD prevention from a focus on macronutrient content of diets to foods and dietary patterns.
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159
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Stewart RAH, Wallentin L, Benatar J, Danchin N, Hagström E, Held C, Husted S, Lonn E, Stebbins A, Chiswell K, Vedin O, Watson D, White HD. Dietary patterns and the risk of major adverse cardiovascular events in a global study of high-risk patients with stable coronary heart disease. Eur Heart J 2016; 37:1993-2001. [PMID: 27109584 PMCID: PMC4929377 DOI: 10.1093/eurheartj/ehw125] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 12/09/2015] [Accepted: 03/03/2016] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES To determine whether dietary pattern assessed by a simple self-administered food frequency questionnaire is associated with major adverse cardiovascular events (MACE) in high-risk patients with stable coronary artery disease. BACKGROUND A Mediterranean dietary pattern has been associated with lower cardiovascular (CV) mortality. It is less certain whether foods common in western diets are associated with CV risk. METHODS At baseline, 15 482 (97.8%) patients (mean age 67 ± 9 years) with stable coronary heart disease from 39 countries who participated in the Stabilisation of atherosclerotic plaque by initiation of darapladib therapy (STABILITY) trial completed a life style questionnaire which included questions on common foods. A Mediterranean diet score (MDS) was calculated for increasing consumption of whole grains, fruits, vegetables, legumes, fish, and alcohol, and for less meat, and a 'Western diet score' (WDS) for increasing consumption of refined grains, sweets and deserts, sugared drinks, and deep fried foods. A multi-variable Cox proportional hazards models assessed associations between MDS or WDS and MACE, defined as CV death, non-fatal myocardial infarction, or non-fatal stroke. RESULTS After a median follow-up of 3.7 years MACE occurred in 7.3% of 2885 subjects with an MDS ≥15, 10.5% of 4018 subjects with an MDS of 13-14, and 10.8% of 8579 subjects with an MDS ≤12. A one unit increase in MDS >12 was associated with lower MACE after adjusting for all covariates (+1 category HR 0.95, 95% CI 0.91, 0.98, P = 0.002). There was no association between WDS (adjusted model +1 category HR 0.99, 95% CI 0.97, 1.01) and MACE. CONCLUSION Greater consumption of healthy foods may be more important for secondary prevention of coronary artery disease than avoidance of less healthy foods typical of Western diets.
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Affiliation(s)
- Ralph A H Stewart
- Green Lane Cardiovascular Service, Auckland City Hospital, University of Auckland, Private Bag 92024, Auckland 1030, New Zealand
| | - Lars Wallentin
- Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center (UCR), Uppsala University, Uppsala, Sweden
| | - Jocelyne Benatar
- Green Lane Cardiovascular Service, Auckland City Hospital, University of Auckland, Private Bag 92024, Auckland 1030, New Zealand
| | - Nicolas Danchin
- Hôpital Européen Georges Pompidou, Assistance Publique Hôpitaux de Paris, INSERM U-970, Université Paris Descartes, Paris, France
| | - Emil Hagström
- Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center (UCR), Uppsala University, Uppsala, Sweden
| | - Claes Held
- Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center (UCR), Uppsala University, Uppsala, Sweden
| | - Steen Husted
- Medical Department, Hospital Unit West, Herning/Holstebro, Denmark
| | - Eva Lonn
- Department of Medicine and Population Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - Amanda Stebbins
- Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA
| | - Karen Chiswell
- Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA
| | - Ola Vedin
- Department of Medical Sciences, Cardiology, Uppsala Clinical Research Center (UCR), Uppsala University, Uppsala, Sweden
| | - David Watson
- Metabolic Pathways and Cardiovascular Therapeutic Area, GlaxoSmithKline, Research Triangle Park, NC, USA
| | - Harvey D White
- Green Lane Cardiovascular Service, Auckland City Hospital, University of Auckland, Private Bag 92024, Auckland 1030, New Zealand
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160
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Wallin A, Forouhi NG, Wolk A, Larsson SC. Egg consumption and risk of type 2 diabetes: a prospective study and dose-response meta-analysis. Diabetologia 2016; 59:1204-13. [PMID: 26993632 PMCID: PMC4861752 DOI: 10.1007/s00125-016-3923-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 02/17/2016] [Indexed: 02/05/2023]
Abstract
AIMS/HYPOTHESIS In this study, we aimed to investigate the association between egg consumption and type 2 diabetes risk in the Cohort of Swedish Men and to conduct a meta-analysis to summarise available prospective evidence on this association. METHODS We followed 39,610 men (aged 45-79 years) from 1998 up to 2012 for incident type 2 diabetes. Egg consumption was assessed at baseline using a food frequency questionnaire. HRs (95% CIs) were estimated using Cox proportional hazards regression models. We searched PubMed (up to 14 December 2015) and reference lists of retrieved articles to identify eligible studies for meta-analysis. RESULTS During the 15 years of follow up, 4,173 men were diagnosed with type 2 diabetes. Compared with men who consumed eggs <1 time/week, the multivariable-adjusted HRs were 0.98 (95% CI 0.92, 1.05), 1.11 (95% CI 0.99, 1.24) and 1.11 (95% CI 0.95, 1.29) for egg consumption 1-2, 3-4 and ≥5 times/week, respectively (p trend = 0.06). In a random-effects dose-response meta-analysis, heterogeneity in the overall estimate was partly explained by differences across regions. The overall HRs for type 2 diabetes for each 3 times/week increment in consumption were 1.18 (95% CI 1.13, 1.24) in five US studies (I (2) = 0%) and 0.97 (95% CI 0.90, 1.05) in seven non-US studies. CONCLUSIONS/INTERPRETATION Our findings in Swedish men do not support an association between egg consumption and risk of type 2 diabetes. In a meta-analysis, frequent egg consumption was associated with a higher risk of type 2 diabetes in US studies only. Egg consumption habits and associated overall dietary patterns may differ between populations and could potentially explain the discrepancies between reported results. Given the inconsistent results, this relationship warrants further study.
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Affiliation(s)
- Alice Wallin
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, 171 77, Stockholm, Sweden.
| | - Nita G Forouhi
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, UK
| | - Alicja Wolk
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, 171 77, Stockholm, Sweden
| | - Susanna C Larsson
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, 171 77, Stockholm, Sweden
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161
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Aadland EK, Graff IE, Lavigne C, Eng Ø, Paquette M, Holthe A, Mellgren G, Madsen L, Jacques H, Liaset B. Lean Seafood Intake Reduces Postprandial C-peptide and Lactate Concentrations in Healthy Adults in a Randomized Controlled Trial with a Crossover Design. J Nutr 2016; 146:1027-34. [PMID: 27099232 DOI: 10.3945/jn.115.229278] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 03/07/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Recently we showed that lean seafood consumption reduced circulating triacylglycerol (TG) and VLDL concentrations and prevented an elevated total-to-HDL-cholesterol ratio relative to intake of a nonseafood diet. OBJECTIVE We aimed to elucidate whether diet-induced altered carbohydrate metabolism could be a contributing factor to the previously observed different lipoprotein patterns. METHODS This was a secondary outcome and explorative randomized controlled trial with a crossover design in 20 healthy adults (7 men and 13 women) that were 50.6 ± 3.4 (mean ± SEM) y old, weighed 75.7 ± 2.5 kg, and had a body mass index (BMI, in kg/m(2)) of 25.6 ± 0.7. After a 3-wk run-in period and separated by a 5-wk wash-out period, the participants consumed 2 balanced diets [in percentage of energy (energy%); 29% fat, 52% carbohydrates, 19% protein] for 4 wk. The diets varied in the main protein sources; 60 energy% of total protein was from either lean seafood or nonseafood sources. On the first and last day of each diet period, fasting and postprandial blood samples were collected before and after consumption of test meals (in energy%; 28% fat, 52% carbohydrates, 20% protein) with cod or lean beef. RESULTS The diets did not alter serum insulin and glucose concentrations. However, relative to the nonseafood diet period, the lean seafood diet period reduced postprandial C-peptide (P = 0.04) and lactate (P = 0.012) concentrations and fasting and postprandial TG/HDL-cholesterol ratios (P = 0.002). Hence, different postprandial lactate levels occurred at equal glucose concentrations. CONCLUSIONS Even though the diets did not alter serum insulin and glucose concentrations, intake of the lean seafood compared with the nonseafood diet reduced postprandial concentrations of C-peptide and lactate and the TG/HDL-cholesterol ratio in healthy adults in a manner that may affect the long-term development of insulin resistance, type 2 diabetes, and cardiovascular disease. This trial was registered at www.clinicaltrials.gov as NCT01708681.
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Affiliation(s)
- Eli K Aadland
- National Institute of Nutrition and Seafood Research, Bergen, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway; Faculty of Education, Bergen University College, Bergen, Norway
| | - Ingvild E Graff
- National Institute of Nutrition and Seafood Research, Bergen, Norway
| | - Charles Lavigne
- National Institute of Nutrition and Seafood Research, Bergen, Norway
| | - Øyvin Eng
- Haukeland University Hospital, Hormone Laboratory, Bergen, Norway
| | | | - Asle Holthe
- Faculty of Education, Bergen University College, Bergen, Norway
| | - Gunnar Mellgren
- Department of Clinical Science, University of Bergen, Bergen, Norway; Haukeland University Hospital, Hormone Laboratory, Bergen, Norway
| | - Lise Madsen
- National Institute of Nutrition and Seafood Research, Bergen, Norway
| | - Hélène Jacques
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Bjørn Liaset
- National Institute of Nutrition and Seafood Research, Bergen, Norway;
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162
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Abstract
Eggs have one of the lowest energy to nutrient density ratios of any food, and contain a quality of protein that is superior to beef steak and similar to dairy. From a nutritional perspective, this must qualify eggs as 'good'. The greater burden of proof has been to establish that eggs are not 'bad', by increasing awareness of the difference between dietary and blood cholesterol, and accumulating sufficient evidence to exonerate eggs from their associations with CVD and diabetes. After 60 years of research, a general consensus has now been reached that dietary cholesterol, chiefly from eggs, exerts a relatively small effect on serum LDL-cholesterol and CVD risk, in comparison with other diet and lifestyle factors. While dietary guidelines have been revised worldwide to reflect this view, associations between egg intake and the incidence of diabetes, and increased CVD risk in diabetes, prevail. These associations may be explained, in part, by residual confounding produced by other dietary components. The strength of evidence that links egg intake to increased CVD risk in diabetes is also complicated by variation in the response of serum LDL-cholesterol to eggs and dietary cholesterol in types 1 and 2 diabetes. On balance, the answer to the question as to whether eggs are 'bad', is probably 'no', but we do need to gain a better understanding of the effects of dietary cholesterol and its association with CVD risk in diabetes.
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163
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Egg consumption and risk of incident type 2 diabetes: a dose–response meta-analysis of prospective cohort studies. Br J Nutr 2016; 115:2212-8. [DOI: 10.1017/s000711451600146x] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractExperimental data suggest that egg intake could have a beneficial impact on several risk factors for type 2 diabetes. In contrast, some recent epidemiological studies have concluded that egg consumption may increase diabetes risk. We performed a dose–response meta-analysis of prospective cohorts on the relation of egg consumption with incident type 2 diabetes. We searched for cohort studies that assessed egg consumption and diabetes risk up to June 2015. We identified 416 articles and extracted data independently and in duplicate from ten eligible studies. We used random-effects generalised least squares models for pooled dose–response estimation based on thirteen estimates. Our study included 251 213 individuals and 12 156 incident type 2 diabetes cases. Egg intake was associated with incident type 2 diabetes (risk ratio (RR)/egg per d 1·13; 95 % CI 1·04, 1·22). We identified study location as a major source of heterogeneity. For studies conducted in the USA, we observed a stronger association (RR 1·47; 95 % CI 1·32, 1·64), whereas results were null for studies conducted elsewhere. Studies considered to be of high quality yielded null findings (RR 0·94; 95 % CI 0·74, 1·19). The association of egg intake with increased risk of incident type 2 diabetes may be restricted to US cohort studies. There are limited data to support a biological mechanism that could underlie this association; thus, the possibility that these results may be due to residual confounding by dietary behaviours restricted to certain populations cannot be excluded.
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164
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Virtanen JK, Mursu J, Virtanen HE, Fogelholm M, Salonen JT, Koskinen TT, Voutilainen S, Tuomainen TP. Associations of egg and cholesterol intakes with carotid intima-media thickness and risk of incident coronary artery disease according to apolipoprotein E phenotype in men: the Kuopio Ischaemic Heart Disease Risk Factor Study. Am J Clin Nutr 2016; 103:895-901. [PMID: 26864369 DOI: 10.3945/ajcn.115.122317] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 12/31/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In general populations, the effects of dietary cholesterol on blood cholesterol concentrations are modest. However, the relation is stronger in those with an ɛ4 allele in the apolipoprotein E gene (APOE). There is little information on the association between cholesterol intake and the risk of coronary artery disease (CAD) among those with the ApoE4 phenotype. OBJECTIVE We investigated the associations of intakes of cholesterol and eggs, a major source of dietary cholesterol, with carotid intima-media thickness and the risk of incident CAD in middle-aged and older men from eastern Finland. DESIGN The study included 1032 men aged 42-60 y in 1984-1989 at the baseline examinations of the prospective, population-based Kuopio Ischaemic Heart Disease Risk Factor Study. Data on common carotid artery intima-media thickness (CCA-IMT) were available for 846 men. Dietary intakes were assessed with 4-d food records. Associations with incident CAD and baseline CCA-IMT were analyzed by using Cox regression and ANCOVA, respectively. RESULTS The ApoE4 phenotype was found in 32.5% of the men. During the average follow-up of 20.8 y, 230 CAD events occurred. Egg or cholesterol intakes were not associated with the risk of CAD. Each 1 additional egg (55 g)/d was associated with a multivariable-adjusted HR of 1.17 (95% CI: 0.85, 1.61) in the ApoE4 noncarriers and an HR of 0.93 (95% CI: 0.50, 1.72) in the ApoE4 carriers (P-interaction = 0.34). Each 100-mg/d higher cholesterol intake was associated with an HR of 1.04 (95% CI: 0.89, 1.22) in the ApoE4 noncarriers and an HR of 0.95 (95% CI: 0.73, 1.25) in the ApoE4 carriers (P-interaction = 0.81). Egg or cholesterol intakes were also not associated with increased CCA-IMT. CONCLUSION Egg or cholesterol intakes were not associated with increased CAD risk, even in ApoE4 carriers (i.e., in highly susceptible individuals).
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Affiliation(s)
- Jyrki K Virtanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; and
| | - Jaakko Mursu
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; and
| | - Heli Ek Virtanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; and
| | - Mikael Fogelholm
- Faculty of Agriculture and Forestry, Department of Food and Environmental Sciences, and
| | - Jukka T Salonen
- Faculty of Medicine, Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Timo T Koskinen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; and
| | - Sari Voutilainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; and
| | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; and
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165
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Djoussé L, Khawaja OA, Gaziano JM. Egg consumption and risk of type 2 diabetes: a meta-analysis of prospective studies. Am J Clin Nutr 2016; 103:474-80. [PMID: 26739035 DOI: 10.3945/ajcn.115.119933] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 09/28/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Observational data on the association between egg consumption and risk of type 2 diabetes mellitus (DM) have been inconsistent. Because eggs are a good source of protein and micronutrients and are inexpensive, it is important to clarify their role in the risk of developing DM. OBJECTIVE We conducted a meta-analysis of published prospective cohort studies to evaluate the relation of egg consumption with the risk of DM. DESIGN We searched PubMed, Ovid, Cochrane, and Google Scholar (up to October 2015) to retrieve published studies. We used RRs from extreme categories of egg consumption for the main analysis but also evaluated dose response by using cubic splines and generalized least squares regression. RESULTS We identified 12 cohorts for a total of 219,979 subjects and 8911 cases of DM. When comparing the highest with the lowest category of egg intake, pooled multivariate RRs of DM were 1.09 (95% CI: 0.99, 1.20) using the fixed-effect model and 1.06 (95% CI: 0.86, 1.30) using the random-effect model. There was evidence for heterogeneity (I(2) = 73.6%, P < 0.001). When stratified by geographic area, there was a 39% higher risk of DM (95% CI: 21%, 60%) comparing highest with lowest egg consumption in US studies (I(2) = 45.4%, P = 0.089) and no elevated risk of DM with egg intake in non-US studies (RR = 0.89; 95% CI: 0.79, 1.02 using the fixed-effect model, P < 0.001 comparing US with non-US studies). In a dose-response assessment using cubic splines, elevated risk of DM was observed in US studies among people consuming ≥3 eggs/wk but not in non-US studies. CONCLUSIONS Our meta-analysis shows no relation between infrequent egg consumption and DM risk but suggests a modest elevated risk of DM with ≥3 eggs/wk that is restricted to US studies.
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Affiliation(s)
- Luc Djoussé
- Division of Aging, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, and
| | - Owais A Khawaja
- Department of Cardiology, Mercy St. Vincent Medical Center, Toledo, OH
| | - J Michael Gaziano
- Division of Aging, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, and
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166
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Abstract
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.
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Affiliation(s)
- Dariush Mozaffarian
- From Friedman School of Nutrition Science & Policy, Tufts University, Boston, MA.
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167
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Schoenaker DAJM, Mishra GD, Callaway LK, Soedamah-Muthu SS. The Role of Energy, Nutrients, Foods, and Dietary Patterns in the Development of Gestational Diabetes Mellitus: A Systematic Review of Observational Studies. Diabetes Care 2016; 39:16-23. [PMID: 26696657 DOI: 10.2337/dc15-0540] [Citation(s) in RCA: 134] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Diet may influence the risk of gestational diabetes mellitus (GDM), but inconsistent findings have been reported. The purpose of this study was to synthesize evidence from observational studies on the associations between dietary factors and GDM. RESEARCH DESIGN AND METHODS Medline and Embase were searched for articles published until January 2015. We included observational studies of reproductive-aged women that reported on associations of maternal dietary intake before or during pregnancy, including energy, nutrients, foods, and dietary patterns, with GDM. All relevant results were extracted from each article. The number of comparable studies that adjusted for confounders was insufficient to perform a meta-analysis. RESULTS The systematic review included 34 articles comprising 21 individual studies (10 prospective cohort, 6 cross-sectional, and 5 case-control). A limited number of prospective cohort studies adjusting for confounders indicated associations with a higher risk of GDM for replacing 1-5% of energy from carbohydrates with fat and for high consumption of cholesterol (≥300 mg/day), heme iron (≥1.1 mg/day), red and processed meat (increment of 1 serving/day), and eggs (≥7 per week). A dietary pattern rich in fruit, vegetables, whole grains, and fish and low in red and processed meat, refined grains, and high-fat dairy was found to be beneficial. The current evidence is based on a limited number of studies that are heterogeneous in design, exposure, and outcome measures. CONCLUSIONS The findings support current dietary guidelines to limit consumption of foods containing saturated fat and cholesterol, such as processed meat and eggs, as part of an overall balanced diet. Further large prospective studies are warranted.
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Affiliation(s)
| | - Gita D Mishra
- School of Public Health, University of Queensland, Brisbane, Australia
| | - Leonie K Callaway
- School of Medicine, University of Queensland, Brisbane, Australia Departments of Obstetric and Internal Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia
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168
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Njike VY, Ayettey RG, Rajebi H, Treu JA, Katz DL. Egg ingestion in adults with type 2 diabetes: effects on glycemic control, anthropometry, and diet quality-a randomized, controlled, crossover trial. BMJ Open Diabetes Res Care 2016; 4:e000281. [PMID: 28074139 PMCID: PMC5220274 DOI: 10.1136/bmjdrc-2016-000281] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 10/05/2016] [Accepted: 10/09/2016] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The inclusion of eggs as part of a healthful diet for adults with diabetes is controversial. We examined the effects of including eggs in the diet of adults with type 2 diabetes on cardiometabolic risk factors. METHODS Randomized, controlled, single-blind, crossover trial of 34 adults (mean age 64.5 years; 14 postmenopausal women, 20 men) with type 2 diabetes assigned to one of two possible sequence permutations of two different 12-week treatments (two eggs/day inclusion or egg exclusion), with 6-week washout periods. For the egg inclusion phase, participants received advice from a dietitian on how to preserve an isocaloric condition relative to the egg exclusion phase. The primary outcome was glycemic control as measured by glycated hemoglobin. Secondary measures included anthropometry, blood pressure, and diet quality. RESULTS Compared with the exclusion of eggs in the habitual diet, the inclusion of eggs did not measurably affect glycated hemoglobin (0.01±0.5% vs -0.24±0.7%; p=0.115) and systolic blood pressure (-0.8±13.0 vs -3.0±10.0 mm Hg; p=0.438); and significantly reduced body mass index (0.06±0.8 vs -0.4±0.8 kg/m²; p=0.013) and visceral fat rating (0.2±1.1 vs -0.4±1.0; p=0.016). The inclusion of eggs in the habitual diet of diabetics significantly reduced waist circumference (-0.4±1.2 cm; p=0.004) and percent body fat (-0.7±1.8; p=0.033) from baseline. CONCLUSIONS Short-term daily inclusion of eggs in the habitual diet of adults with type 2 diabetes does not improve glycemic control but can improve anthropometric measures. TRIAL REGISTRATION NUMBER NCT02052037; results.
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Affiliation(s)
- Valentine Y Njike
- Yale University Prevention Research Center, Derby, Connecticut, USA
- Griffin Hospital, Derby, Connecticut, USA
| | - Rockiy G Ayettey
- Yale University Prevention Research Center, Derby, Connecticut, USA
- Griffin Hospital, Derby, Connecticut, USA
| | | | - Judith A Treu
- Yale University Prevention Research Center, Derby, Connecticut, USA
- Griffin Hospital, Derby, Connecticut, USA
| | - David L Katz
- Yale University Prevention Research Center, Derby, Connecticut, USA
- Griffin Hospital, Derby, Connecticut, USA
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169
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The 2015 Dietary Guidelines Advisory Committee Report Concerning Dietary Cholesterol. Am J Cardiol 2015; 116:1479-80. [PMID: 26341187 DOI: 10.1016/j.amjcard.2015.07.077] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 07/29/2015] [Accepted: 07/29/2015] [Indexed: 11/23/2022]
Abstract
The most recent 2015 Dietary Guidelines Advisory Committee report indicated that "cholesterol is not considered a nutrient of concern for overconsumption." However, this statement may be too general as it does not acknowledge conflicting findings in literature regarding cardiovascular risk in certain populations. Current research suggests that dietary cholesterol may increase an subject's risk of developing diabetes, increases a diabetic patient's risk of cardiovascular disease, and may worsen coronary risk factors in subjects who are "hyper-responders" to dietary cholesterol. In conclusion, we suggest that a more cautious approach to dietary cholesterol intake is warranted, especially in high-risk populations.
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170
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Larsson SC, Åkesson A, Wolk A. Egg consumption and risk of heart failure, myocardial infarction, and stroke: results from 2 prospective cohorts. Am J Clin Nutr 2015; 102:1007-13. [PMID: 26399866 DOI: 10.3945/ajcn.115.119263] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 08/21/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Some studies have found that egg consumption is associated with a higher risk of ischemic heart disease in patients with diabetes. Epidemiologic studies of egg consumption in relation to risk of heart failure (HF) and stroke types are scarce. OBJECTIVE The aim of this study was to examine whether egg consumption is associated with incidence of HF, myocardial infarction (MI), or stroke types. DESIGN In prospective cohorts of 37,766 men (Cohort of Swedish Men) and 32,805 women (Swedish Mammography Cohort) who were free of cardiovascular disease (CVD), egg consumption was assessed at baseline with a food-frequency questionnaire. Incident CVD cases were identified through linkage with the Swedish National Patient and Cause of Death Registers. The data were analyzed with the use of a Cox proportional hazards regression model. RESULTS During 13 y of follow-up, we ascertained 1628 HFs, 3262 MIs, 2039 ischemic strokes, and 405 hemorrhagic strokes in men and 1207 HFs, 1504 MIs, 1561 ischemic strokes, and 294 hemorrhagic strokes in women. There was no statistically significant association between egg consumption and risk of MI or any stroke type in either men or women or HF in women. In men, consumption of ≤6 eggs/wk was not associated with HF risk; however, daily egg consumption (≥1/d) was associated with a 30% higher risk of HF (RR: 1.30; 95% CI: 1.01, 1.67). Egg consumption was not associated with any CVD outcome in individuals with diabetes. CONCLUSIONS Daily egg consumption was not associated with risk of MI or any stroke type in either men or women or with HF in women. Consumption of eggs ≥1 time/d, but not less frequent consumption, was associated with an elevated risk of HF in men.
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Affiliation(s)
- Susanna C Larsson
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Agneta Åkesson
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Alicja Wolk
- Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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171
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Jacobson TA, Maki KC, Orringer CE, Jones PH, Kris-Etherton P, Sikand G, La Forge R, Daniels SR, Wilson DP, Morris PB, Wild RA, Grundy SM, Daviglus M, Ferdinand KC, Vijayaraghavan K, Deedwania PC, Aberg JA, Liao KP, McKenney JM, Ross JL, Braun LT, Ito MK, Bays HE, Brown WV. National Lipid Association Recommendations for Patient-Centered Management of Dyslipidemia: Part 2. J Clin Lipidol 2015; 9:S1-122.e1. [DOI: 10.1016/j.jacl.2015.09.002] [Citation(s) in RCA: 315] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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172
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Haring B, Misialek JR, Rebholz CM, Petruski-Ivleva N, Gottesman RF, Mosley TH, Alonso A. Association of Dietary Protein Consumption With Incident Silent Cerebral Infarcts and Stroke: The Atherosclerosis Risk in Communities (ARIC) Study. Stroke 2015; 46:3443-50. [PMID: 26514185 DOI: 10.1161/strokeaha.115.010693] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 10/01/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND PURPOSE The effect of dietary protein on the risk of stroke has shown inconsistent results. We aimed to evaluate the relationship of dietary protein sources with the risk of stroke and silent cerebral infarcts in a large community-based cohort. METHODS We studied 11601 adults (age, 45-64 years at baseline in 1987-1989) enrolled in the Atherosclerosis Risk in Communities (ARIC) Study, free of diabetes mellitus and cardiovascular disease. Dietary protein intake was assessed with validated food frequency questionnaires at baseline and after 6 years of follow-up. Incident stroke events were identified through hospital discharge codes and stroke deaths and physician-adjudicated through December 31, 2011. A subset of participants (n=653) underwent brain magnetic resonance imaging in 1993 to 1995 and in 2004 to 2006. Cox proportional hazard models and logistic regression were used for statistical analyses. RESULTS During a median follow-up of 22.7 years, there were 699 stroke events. In multivariable analyses, total, animal, and vegetable protein consumption was not associated with risk of stroke. Red meat consumption was associated with increased stroke risk, particularly ischemic events. The hazard ratios (95% confidence interval) for risk of ischemic stroke across ascending quintiles of red meat consumption were 1 (ref), 1.13 (0.85-1.49), 1.44 (1.09-1.90), 1.33 (0.99-1.79), and 1.47 (1.06-2.05); Ptrend=0.01. No association of major dietary protein sources with silent cerebral infarcts was detected. CONCLUSIONS This study supports the notion that consumption of red meat may increase the risk of ischemic stroke. No association between dietary protein intake and silent cerebral infarcts was found.
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Affiliation(s)
- Bernhard Haring
- From the Department of Internal Medicine I, Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Bavaria, Germany (B.H.); Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis (J.R.M., A.A.); Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (C.M.R.); Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill (N.P.-I.); Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD (R.F.G.); and Department of Neurology, University of Mississippi Medical Center, Jackson (T.H.M.).
| | - Jeffrey R Misialek
- From the Department of Internal Medicine I, Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Bavaria, Germany (B.H.); Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis (J.R.M., A.A.); Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (C.M.R.); Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill (N.P.-I.); Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD (R.F.G.); and Department of Neurology, University of Mississippi Medical Center, Jackson (T.H.M.)
| | - Casey M Rebholz
- From the Department of Internal Medicine I, Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Bavaria, Germany (B.H.); Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis (J.R.M., A.A.); Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (C.M.R.); Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill (N.P.-I.); Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD (R.F.G.); and Department of Neurology, University of Mississippi Medical Center, Jackson (T.H.M.)
| | - Natalia Petruski-Ivleva
- From the Department of Internal Medicine I, Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Bavaria, Germany (B.H.); Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis (J.R.M., A.A.); Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (C.M.R.); Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill (N.P.-I.); Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD (R.F.G.); and Department of Neurology, University of Mississippi Medical Center, Jackson (T.H.M.)
| | - Rebecca F Gottesman
- From the Department of Internal Medicine I, Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Bavaria, Germany (B.H.); Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis (J.R.M., A.A.); Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (C.M.R.); Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill (N.P.-I.); Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD (R.F.G.); and Department of Neurology, University of Mississippi Medical Center, Jackson (T.H.M.)
| | - Thomas H Mosley
- From the Department of Internal Medicine I, Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Bavaria, Germany (B.H.); Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis (J.R.M., A.A.); Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (C.M.R.); Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill (N.P.-I.); Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD (R.F.G.); and Department of Neurology, University of Mississippi Medical Center, Jackson (T.H.M.)
| | - Alvaro Alonso
- From the Department of Internal Medicine I, Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Bavaria, Germany (B.H.); Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis (J.R.M., A.A.); Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (C.M.R.); Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill (N.P.-I.); Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD (R.F.G.); and Department of Neurology, University of Mississippi Medical Center, Jackson (T.H.M.)
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173
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McNamara DJ. The Fifty Year Rehabilitation of the Egg. Nutrients 2015; 7:8716-22. [PMID: 26506379 PMCID: PMC4632449 DOI: 10.3390/nu7105429] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 09/17/2015] [Accepted: 10/15/2015] [Indexed: 12/13/2022] Open
Abstract
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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Affiliation(s)
- Donald J McNamara
- Eggs for Health Consulting, 5905 Cozumel Pl., Las Vegas, NV 89131, USA.
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174
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Anand SS, Hawkes C, de Souza RJ, Mente A, Dehghan M, Nugent R, Zulyniak MA, Weis T, Bernstein AM, Krauss RM, Kromhout D, Jenkins DJA, Malik V, Martinez-Gonzalez MA, Mozaffarian D, Yusuf S, Willett WC, Popkin BM. Food Consumption and its Impact on Cardiovascular Disease: Importance of Solutions Focused on the Globalized Food System: A Report From the Workshop Convened by the World Heart Federation. J Am Coll Cardiol 2015; 66:1590-1614. [PMID: 26429085 PMCID: PMC4597475 DOI: 10.1016/j.jacc.2015.07.050] [Citation(s) in RCA: 283] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 07/16/2015] [Accepted: 07/20/2015] [Indexed: 02/07/2023]
Abstract
Major scholars in the field, on the basis of a 3-day consensus, created an in-depth review of current knowledge on the role of diet in cardiovascular disease (CVD), the changing global food system and global dietary patterns, and potential policy solutions. Evidence from different countries and age/race/ethnicity/socioeconomic groups suggesting the health effects studies of foods, macronutrients, and dietary patterns on CVD appear to be far more consistent though regional knowledge gaps is highlighted. Large gaps in knowledge about the association of macronutrients to CVD in low- and middle-income countries particularly linked with dietary patterns are reviewed. Our understanding of foods and macronutrients in relationship to CVD is broadly clear; however, major gaps exist both in dietary pattern research and ways to change diets and food systems. On the basis of the current evidence, the traditional Mediterranean-type diet, including plant foods and emphasis on plant protein sources provides a well-tested healthy dietary pattern to reduce CVD.
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Affiliation(s)
- Sonia S Anand
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada
| | - Corinna Hawkes
- Centre for Food Policy, City University, London, United Kingdom
| | - Russell J de Souza
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Andrew Mente
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada
| | - Mahshid Dehghan
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada
| | - Rachel Nugent
- Department of Global Health, University of Washington, Seattle, Washington
| | | | - Tony Weis
- Department of Geography, University of Western Ontario, London, Ontario, Canada
| | - Adam M Bernstein
- Center for Lifestyle Medicine, Cleveland Clinic, Lyndhurst, Ohio
| | - Ronald M Krauss
- Children's Hospital Oakland Research Institute, Oakland, California
| | - Daan Kromhout
- Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
| | - David J A Jenkins
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Clinical Nutrition & Risk Factor Modification Center, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Vasanti Malik
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts
| | | | - Dariush Mozaffarian
- Friedman School of Nutrition Science & Policy, Tufts University, Boston, Massachusetts
| | - Salim Yusuf
- Population Health Research Institute, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada
| | - Walter C Willett
- Departamento de Medicina Preventiva y Salud Publica, Universidad de Navarra-CIBEROBN, Pamplona, Spain
| | - Barry M Popkin
- Department of Nutrition, School of Public Health, University of North Carolina, Chapel Hill, North Carolina.
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175
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Vega-López S, Pignotti GAP, Todd M, Keller C. Egg Intake and Dietary Quality among Overweight and Obese Mexican-American Postpartum Women. Nutrients 2015; 7:8402-12. [PMID: 26445060 PMCID: PMC4632422 DOI: 10.3390/nu7105402] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 09/14/2015] [Accepted: 09/22/2015] [Indexed: 01/13/2023] Open
Abstract
Despite their low cost and high nutrient density, the contribution of eggs to nutrient intake and dietary quality among Mexican-American postpartum women has not been evaluated. Nutrient intake and dietary quality, as assessed by the Healthy Eating Index 2010 (HEI-2010), were measured in habitually sedentary overweight/obese (body mass index (BMI) = 29.7 ± 3.5 kg/m²) Mexican-American postpartum women (28 ± 6 years) and compared between egg consumers (n = 82; any egg intake reported in at least one of three 24-h dietary recalls) and non-consumers (n = 57). Egg consumers had greater intake of energy (+808 kJ (193 kcal) or 14%; p = 0.033), protein (+9 g or 17%; p = 0.031), total fat (+9 g or 19%; p = 0.039), monounsaturated fat (+4 g or 24%; p = 0.020), and several micronutrients than non-consumers. Regarding HEI-2010 scores, egg consumers had a greater total protein foods score than non-consumers (4.7 ± 0.7 vs. 4.3 ± 1.0; p = 0.004), and trends for greater total fruit (2.4 ± 1.8 vs. 1.9 ± 1.7; p = 0.070) and the total composite HEI-2010 score (56.4 ± 12.6 vs. 52.3 ± 14.4; p = 0.082). Findings suggest that egg intake could contribute to greater nutrient intake and improved dietary quality among postpartum Mexican-American women. Because of greater energy intake among egg consumers, recommendations for overweight/obese individuals should include avoiding excessive energy intake and incorporating eggs to a nutrient-dense, fiber-rich dietary pattern.
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Affiliation(s)
- Sonia Vega-López
- School of Nutrition and Health Promotion, Arizona State University, 500 North 3rd Street, Phoenix, AZ 85004, USA.
- Southwestern Interdisciplinary Research Center, Arizona State University, 411 North Central Avenue, Suite #720, Phoenix, AZ 85004, USA.
| | - Giselle A P Pignotti
- Department of Nutrition, Food Science and Packaging, San Jose State University, One Washington Square, San Jose, CA 95192-0058, USA.
| | - Michael Todd
- College of Nursing and Health Innovation, Arizona State University, 500 North 3rd Street, Phoenix, AZ 85004, USA.
| | - Colleen Keller
- Southwestern Interdisciplinary Research Center, Arizona State University, 411 North Central Avenue, Suite #720, Phoenix, AZ 85004, USA.
- College of Nursing and Health Innovation, Arizona State University, 500 North 3rd Street, Phoenix, AZ 85004, USA.
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176
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Abstract
Egg consumption is a major source of dietary cholesterol, a nutrient that may disrupt glucose metabolism. We prospectively evaluated the relation between egg consumption and cholesterol-intake and diabetes in 65 364 French disease-free women who responded to a validated diet history questionnaire in 1993. Egg consumption included hardboiled eggs and eggs consumed in an omelette or a mixed dish, and dietary cholesterol was estimated using a French nutrient database. Over 14 years of follow-up, 1803 incident diabetes cases were identified through self-reports, supplementary questionnaires and drug reimbursement information. Multivariable Cox regression models were adjusted for age, education, menopause, menopausal hormone therapy, hypertension and hypercholesterolaemia, BMI, physical activity, smoking, alcohol, fruit, vegetables, processed red meat, coffee and sugar and artificially sweetened beverages. No association was observed between egg consumption and risk of type 2 diabetes. When comparing women who consumed at least five eggs per week with non-consumers, the multivariable hazard ratio (HR) was found to be 1·00 (95 % CI 0·78, 1·29; across categories, P trend=0·11). Women in the highest quintile of dietary cholesterol had a 40 % higher rate of diabetes compared with those in the lowest quintile (HR 1·40; 95 % CI 1·19, 1·63; across quintiles, P trend<0·0001). A 100 mg increase of dietary cholesterol per 4184 kJ (or 1000 kcal) was associated with a 14 % increase in the risk of diabetes (HR 1·14; 95 % CI 1·02, 1·26). In this large prospective cohort, we observed an association between dietary cholesterol and type 2 diabetes, but no association with egg consumption. In the absence of a clear underlying mechanism and potential residual confounding, these results should be interpreted with caution.
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177
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Egg Consumption and Human Cardio-Metabolic Health in People with and without Diabetes. Nutrients 2015; 7:7399-420. [PMID: 26404366 PMCID: PMC4586539 DOI: 10.3390/nu7095344] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Revised: 08/20/2015] [Accepted: 08/26/2015] [Indexed: 12/15/2022] Open
Abstract
The guidelines for dietary cholesterol and/or egg intake for both the general population and those at higher risk of cardiovascular disease (for example, people with type 2 diabetes mellitus (T2DM)) differ between countries, and even for different specialist societies in a country. The disparity between these guidelines is at least in part related to the conflicting evidence as to the effects of eggs in the general population and in those with T2DM. This review addresses the effect of eggs on cardiovascular disease (CVD) risk from both epidemiological research and controlled prospective studies, in people with and without cardio-metabolic disease. It also examines the nutritional qualities of eggs and whether they may offer protection against chronic disease. The evidence suggests that a diet including more eggs than is recommended (at least in some countries) may be used safely as part of a healthy diet in both the general population and for those at high risk of cardiovascular disease, those with established coronary heart disease, and those with T2DM. In conclusion, an approach focused on a person's entire dietary intake as opposed to specific foods or nutrients should be the heart of population nutrition guidelines.
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178
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Choi Y, Chang Y, Lee JE, Chun S, Cho J, Sung E, Suh BS, Rampal S, Zhao D, Zhang Y, Pastor-Barriuso R, Lima JA, Shin H, Ryu S, Guallar E. Egg consumption and coronary artery calcification in asymptomatic men and women. Atherosclerosis 2015; 241:305-12. [DOI: 10.1016/j.atherosclerosis.2015.05.036] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Revised: 05/21/2015] [Accepted: 05/22/2015] [Indexed: 10/23/2022]
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179
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Horne BD, Muhlestein JB, Anderson JL. Health effects of intermittent fasting: hormesis or harm? A systematic review. Am J Clin Nutr 2015; 102:464-70. [PMID: 26135345 DOI: 10.3945/ajcn.115.109553] [Citation(s) in RCA: 133] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 05/27/2015] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Intermittent fasting, alternate-day fasting, and other forms of periodic caloric desistance are gaining popularity in the lay press and among animal research scientists. Whether clinical evidence exists for or is strong enough to support the use of such dietary regimens as health interventions is unclear. OBJECTIVE This review sought to identify rigorous, clinically relevant research studies that provide high-quality evidence that therapeutic fasting regimens are clinically beneficial to humans. DESIGN A systematic review of the published literature through January 2015 was performed by using sensitive search strategies to identify randomized controlled clinical trials that evaluated the effects of fasting on either clinically relevant surrogate outcomes (e.g., weight, cholesterol) or actual clinical event endpoints [e.g., diabetes, coronary artery disease (CAD)] and any other studies that evaluated the effects of fasting on clinical event outcomes. RESULTS Three randomized controlled clinical trials of fasting in humans were identified, and the results were published in 5 articles, all of which evaluated the effects of fasting on surrogate outcomes. Improvements in weight and other risk-related outcomes were found in the 3 trials. Two observational clinical outcomes studies in humans were found in which fasting was associated with a lower prevalence of CAD or diabetes diagnosis. No randomized controlled trials of fasting for clinical outcomes were identified. CONCLUSIONS Clinical research studies of fasting with robust designs and high levels of clinical evidence are sparse in the literature. Whereas the few randomized controlled trials and observational clinical outcomes studies support the existence of a health benefit from fasting, substantial further research in humans is needed before the use of fasting as a health intervention can be recommended.
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Affiliation(s)
- Benjamin D Horne
- Intermountain Heart Institute, Intermountain Medical Center, Salt Lake City, UT; and Genetic Epidemiology Division and
| | - Joseph B Muhlestein
- Intermountain Heart Institute, Intermountain Medical Center, Salt Lake City, UT; and Cardiology Division, Department of Medicine, University of Utah, Salt Lake City, UT
| | - Jeffrey L Anderson
- Intermountain Heart Institute, Intermountain Medical Center, Salt Lake City, UT; and Cardiology Division, Department of Medicine, University of Utah, Salt Lake City, UT
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180
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Affiliation(s)
- Robert H Eckel
- Divisions of Endocrinology, Metabolism, and Diabetes and Cardiology, University of Colorado School of Medicine, University of Colorado, Aurora, CO
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181
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Moslehi N, Hosseini-Esfahani F, Hosseinpanah F, Mirmiran P, Azizi F. Patterns of food consumption and risk of type 2 diabetes in an Iranian population: A nested case-control study. Nutr Diet 2015. [DOI: 10.1111/1747-0080.12189] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Nazanin Moslehi
- Nutrition and Endocrine Research Centre; Shahid Beheshti University of Medical Sciences; Tehran Iran
- Obesity Research Centre; Shahid Beheshti University of Medical Sciences; Tehran Iran
| | - Firoozeh Hosseini-Esfahani
- Nutrition and Endocrine Research Centre; Shahid Beheshti University of Medical Sciences; Tehran Iran
- Obesity Research Centre; Shahid Beheshti University of Medical Sciences; Tehran Iran
| | - Farhad Hosseinpanah
- Obesity Research Centre; Shahid Beheshti University of Medical Sciences; Tehran Iran
| | - Parvin Mirmiran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute; Shahid Beheshti University of Medical Sciences; Tehran Iran
| | - Fereidoun Azizi
- Endocrine Research Centre, Research Institute for Endocrine Sciences; Shahid Beheshti University of Medical Sciences; Tehran Iran
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182
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Ribeiro SML, Luz SDS, Aquino RDC. The Role of Nutrition and Physical Activity in Cholesterol and Aging. Clin Geriatr Med 2015. [PMID: 26195099 DOI: 10.1016/j.cger.2015.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Cholesterol is a precursor of several substances with important biologic activities; however, it is common to associate this molecule only with bad outcomes. This article reviews the cholesterol metabolism, its functions in the human body, its pathogenicity, and its elimination. The modifications in biochemical paths of cholesterol in aging are highlighted. Finally, the role of diet, physical activity, and exercise in cholesterol management is discussed.
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Affiliation(s)
- Sandra Maria Lima Ribeiro
- Research Group of Nutrition, Physical Activity and Aging Processes, Department of Gerontology, University of São Paulo, Avenue Arlindo Bettio 1000, Ermelino Matarazzo, São Paulo, CEP 03828-000, Brazil.
| | - Silmara Dos Santos Luz
- Research Group of Nutrition, Physical Activity and Aging Processes, University of São Paulo, Avenue Arlindo Bettio 1000, Ermelino Matarazzo, São Paulo, CEP 03828-000, Brazil
| | - Rita de Cássia Aquino
- Nutrition Department, São Judas Tadeu University, Rua Taquari, 546-Mooca, São Paulo, CEP 03166-000, Brazil
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183
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Ballesteros MN, Valenzuela F, Robles AE, Artalejo E, Aguilar D, Andersen CJ, Valdez H, Fernandez ML. One Egg per Day Improves Inflammation when Compared to an Oatmeal-Based Breakfast without Increasing Other Cardiometabolic Risk Factors in Diabetic Patients. Nutrients 2015; 7:3449-63. [PMID: 25970149 PMCID: PMC4446761 DOI: 10.3390/nu7053449] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 04/26/2015] [Accepted: 05/05/2015] [Indexed: 11/16/2022] Open
Abstract
There is concern that egg intake may increase blood glucose in patients with type 2 diabetes mellitus (T2DM). However, we have previously shown that eggs reduce inflammation in patients at risk for T2DM, including obese subjects and those with metabolic syndrome. Thus, we hypothesized that egg intake would not alter plasma glucose in T2DM patients when compared to oatmeal intake. Our primary endpoints for this clinical intervention were plasma glucose and the inflammatory markers tumor necrosis factor (TNF)-α and interleukin 6 (IL-6). As secondary endpoints, we evaluated additional parameters of glucose metabolism, dyslipidemias, oxidative stress and inflammation. Twenty-nine subjects, 35–65 years with glycosylated hemoglobin (HbA1c) values <9% were recruited and randomly allocated to consume isocaloric breakfasts containing either one egg/day or 40 g of oatmeal with 472 mL of lactose-free milk/day for five weeks. Following a three-week washout period, subjects were assigned to the alternate breakfast. At the end of each period, we measured all primary and secondary endpoints. Subjects completed four-day dietary recalls and one exercise questionnaire for each breakfast period. There were no significant differences in plasma glucose, our primary endpoint, plasma lipids, lipoprotein size or subfraction concentrations, insulin, HbA1c, apolipoprotein B, oxidized LDL or C-reactive protein. However, after adjusting for gender, age and body mass index, aspartate amino-transferase (AST) (p < 0.05) and tumor necrosis factor (TNF)-α (p < 0.01), one of our primary endpoints were significantly reduced during the egg period. These results suggest that compared to an oatmeal-based breakfast, eggs do not have any detrimental effects on lipoprotein or glucose metabolism in T2DM. In contrast, eggs reduce AST and TNF-α in this population characterized by chronic low-grade inflammation.
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Affiliation(s)
| | - Fabrizio Valenzuela
- Centro de Investigacion y Desarrollo (CIAD), Hermosillo, Sonora, 83304, Mexico.
| | - Alma E Robles
- Centro de Investigacion y Desarrollo (CIAD), Hermosillo, Sonora, 83304, Mexico.
| | - Elizabeth Artalejo
- Centro de Investigacion y Desarrollo (CIAD), Hermosillo, Sonora, 83304, Mexico.
| | - David Aguilar
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA.
| | - Catherine J Andersen
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA.
| | | | - Maria Luz Fernandez
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA.
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184
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Virtanen JK, Mursu J, Tuomainen TP, Virtanen HE, Voutilainen S. Egg consumption and risk of incident type 2 diabetes in men: the Kuopio Ischaemic Heart Disease Risk Factor Study. Am J Clin Nutr 2015; 101:1088-96. [PMID: 25832339 DOI: 10.3945/ajcn.114.104109] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 03/10/2015] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The prevalence of type 2 diabetes (T2D) is increasing around the world. Eggs are a major source of cholesterol, which has been associated with elevated blood glucose and an increased risk of T2D. However, there are limited and conflicting data from prospective population studies on the association between egg consumption and risk of T2D. OBJECTIVE We investigated the association between egg consumption and risk of incident T2D in middle-aged and older men from eastern Finland. DESIGN The study included 2332 men aged 42-60 y in 1984-1989 at the baseline examinations of the prospective, population-based Kuopio Ischaemic Heart Disease Risk Factor Study. Dietary intakes were assessed with 4-d food records at baseline. Incident T2D was assessed by self-administered questionnaires; by fasting and 2-h oral-glucose-tolerance-test blood glucose measurement at re-examination rounds 4, 11, and 20 y after baseline; and by record linkage to a hospital discharge registry and reimbursement register of diabetes medication expenses. Cox proportional hazards regression analyses were used to estimate associations with the risk of incident T2D. Associations with the metabolic risk markers at baseline and at the 4-y examinations were analyzed by ANCOVA. RESULTS During an average follow-up of 19.3 y, 432 men developed T2D. After adjustment for potential confounders, those in the highest compared with the lowest egg intake quartile had a 38% (95% CI: 18%, 53%; P-trend across quartiles <0.001) lower risk of incident T2D. Analyses with metabolic risk markers also suggested an inverse association with fasting plasma glucose and serum C-reactive protein but not with serum insulin. The associations between cholesterol intake and risk of T2D, plasma glucose, serum insulin, and C-reactive protein were mainly nonsignificant, especially after accounting for egg consumption. CONCLUSION Higher egg intake was associated with a lower risk of T2D in this cohort of middle-aged and older men.
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Affiliation(s)
- Jyrki K Virtanen
- From the Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jaakko Mursu
- From the Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Tomi-Pekka Tuomainen
- From the Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Heli Ek Virtanen
- From the Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Sari Voutilainen
- From the Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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185
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Djoussé L, Petrone AB, Hickson DA, Talegawkar SA, Dubbert PM, Taylor H, Tucker KL. Egg consumption and risk of type 2 diabetes among African Americans: The Jackson Heart Study. Clin Nutr 2015; 35:679-84. [PMID: 25971658 DOI: 10.1016/j.clnu.2015.04.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 04/09/2015] [Accepted: 04/23/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND & AIMS Type 2 diabetes (DM) disproportionally affects African Americans. Data on the association between egg consumption and risk of DM are sparse. We sought to examine whether egg consumption is associated with the prevalence and incidence of DM among African Americans. METHODS We analyzed baseline data from 4568 participants of the Jackson Heart Study. Egg consumption was obtained using a food frequency questionnaire designed for this population. We used generalized estimating equations to calculate adjusted prevalence ratios of DM and Cox regression to estimate hazard ratios of DM with corresponding 95% confidence intervals (CI). RESULTS The average age was 55 ± 13 years and 64% of subjects were women. The median frequency of egg consumption was 2/week for men and 1/week for women. The prevalence of DM was 22% overall (21% of men and 23% of women). Multivariable adjusted prevalence ratio [PR (95% CI)] for DM were: 1.00 (ref), 1.14 (0.90-1.44), 1.33 (1.04-1.70), 1.33 (1.06-1.68), 1.26 (0.99-1.61), and 1.52 (1.17-1.97) for egg consumption of <1/month, 1-3/month, 1/week, 2/week, 3-4/week, and 5+/week, respectively, p for linear trend 0.0024. Corresponding multivariable adjusted hazard ratios were 1.00 (ref), 0.88 (0.65-1.19), 0.94 (0.68-1.30), 0.91 (0.66-1.25), 1.11 (0.81-1.52), and 1.17 (0.81-1.70), respectively, during a mean follow up of 7.3 years (p for linear trend 0.22). CONCLUSIONS While egg consumption was positively associated with prevalent DM, prospective analysis did not show an association of egg intake with incidence of DM among African Americans.
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Affiliation(s)
- Luc Djoussé
- Brigham and Women's Hospital, Boston, MA, USA; Boston Veterans Affairs Healthcare System, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
| | | | - DeMarc A Hickson
- University of Mississippi Medical Center, Jackson, MS, USA; My Brother's Keeper, Inc, Ridgeland, MS, USA
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186
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Abstract
PURPOSE OF REVIEW To reinforce the key role of diet and lifestyle modification as the first-line treatment for the reduction of raised serum low-density lipoprotein cholesterol (LDL-C) and prevention of cardiovascular disease. Also, to counter recent claims that the current dietary guidelines for the treatment of cardiovascular disease have misplaced emphasis on the importance of removing dietary saturated fat instead of sugar. RECENT FINDINGS This review provides new insight into the effects of diet and lifestyle factors with established efficacy in lowering serum LDL-C. This includes energy-restricted weight loss and new findings on the effects of alternative day fasting; novel metabolic and molecular effects of replacing palmitic acid with oleic acid; evidence for a dose-response relationship between the intake of dietary stanols and LDL-C; and identification of a unique metabolic pathway for the excretion of cholesterol. SUMMARY The review reports new evidence for the efficacy of alternate day fasting, reassurance that the current dietary guidelines are not misguided by recommending removal of saturated fat, that a high intake of dietary stanols can achieve a reduction in LDL-C of up to 18%, and describes a pathway of cholesterol excretion that may help to explain variation in the response of serum LDL-C to dietary fat and cholesterol.
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187
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Clifton PM. Does dietary cholesterol influence cardiovascular disease risk in people with type 2 diabetes? Am J Clin Nutr 2015; 101:691-2. [PMID: 25833967 DOI: 10.3945/ajcn.115.108415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Peter M Clifton
- From the School of Pharmacy and Medical Sciences, Sansom Institute, University of South Australia, Adelaide, Australia
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188
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Miranda JM, Anton X, Redondo-Valbuena C, Roca-Saavedra P, Rodriguez JA, Lamas A, Franco CM, Cepeda A. Egg and egg-derived foods: effects on human health and use as functional foods. Nutrients 2015; 7:706-29. [PMID: 25608941 PMCID: PMC4303863 DOI: 10.3390/nu7010706] [Citation(s) in RCA: 144] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 12/26/2014] [Accepted: 01/15/2015] [Indexed: 01/22/2023] Open
Abstract
Eggs are sources of protein, fats and micronutrients that play an important role in basic nutrition. However, eggs are traditionally associated with adverse factors in human health, mainly due to their cholesterol content. Nowadays, however, it is known that the response of cholesterol in human serum levels to dietary cholesterol consumption depends on several factors, such as ethnicity, genetic makeup, hormonal factors and the nutritional status of the consumer. Additionally, in recent decades, there has been an increasing demand for functional foods, which is expected to continue to increase in the future, owing to their capacity to decrease the risks of some diseases and socio-demographic factors such as the increase in life expectancy. This work offers a brief overview of the advantages and disadvantages of egg consumption and the potential market of functional eggs, and it explores the possibilities of the development of functional eggs by technological methods.
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Affiliation(s)
- Jose M Miranda
- Laboratorio de Higiene Inspección y Control de Alimentos, Dpto. de Química Analítica, Nutrición y Bromatología, Universidad de Santiago de Compostela, 27002 Lugo, Spain.
| | - Xaquin Anton
- Clavo congelados, S. A. Caldas de Reis, 36650 Pontevedra, Spain.
| | - Celia Redondo-Valbuena
- Laboratorio de Higiene Inspección y Control de Alimentos, Dpto. de Química Analítica, Nutrición y Bromatología, Universidad de Santiago de Compostela, 27002 Lugo, Spain.
| | - Paula Roca-Saavedra
- Laboratorio de Higiene Inspección y Control de Alimentos, Dpto. de Química Analítica, Nutrición y Bromatología, Universidad de Santiago de Compostela, 27002 Lugo, Spain.
| | - Jose A Rodriguez
- Centro de Investigaciones Químicas, Universidad Autónoma del Estado de Hidalgo, Carr. Pachuca-Tulancingo Km. 4.5, 42076 Pachuca, Hidalgo, Mexico.
| | - Alexandre Lamas
- Laboratorio de Higiene Inspección y Control de Alimentos, Dpto. de Química Analítica, Nutrición y Bromatología, Universidad de Santiago de Compostela, 27002 Lugo, Spain.
| | - Carlos M Franco
- Laboratorio de Higiene Inspección y Control de Alimentos, Dpto. de Química Analítica, Nutrición y Bromatología, Universidad de Santiago de Compostela, 27002 Lugo, Spain.
| | - Alberto Cepeda
- Laboratorio de Higiene Inspección y Control de Alimentos, Dpto. de Química Analítica, Nutrición y Bromatología, Universidad de Santiago de Compostela, 27002 Lugo, Spain.
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189
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Nicklas TA, O'Neil CE, Fulgoni VL. Differing statistical approaches affect the relation between egg consumption, adiposity, and cardiovascular risk factors in adults. J Nutr 2015; 145:170S-6S. [PMID: 25527676 DOI: 10.3945/jn.114.194068] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Associations between food patterns and adiposity are poorly understood. OBJECTIVE Two statistical approaches were used to examine the potential association between egg consumption and adiposity. METHODS Participants (n = 18,987) aged ≥19 y were from the 2001-2008 NHANES who provided 24-h diet recall data, body mass index (BMI) and waist circumference (WC)-determined adiposity measures, and blood pressure, circulating insulin, glucose, and lipid concentrations were considered cardiovascular risk factors (CVRFs). Covariate-adjusted least-squares means ± SEs were generated. RESULTS The first statistical approach categorized participants into egg consumers or nonconsumers. Consumers had higher mean BMI (in kg/m(2); 28.7 ± 0.19; P = 0.006) and WC (98.2 ± 0.43 cm; P = 0.002) than did nonconsumers (28.2 ± 0.10 and 96.9 ± 0.23 cm, respectively). Second, cluster analysis identified 8 distinct egg consumption patterns (explaining 39.5% of the variance in percentage of energy within the food categories). Only 2 egg patterns [egg/meat, poultry, fish (MPF)/grains/vegetables and egg/MPF/grains], consumed by ≤2% of the population, drove the association (compared with the no-egg pattern) between egg consumption and BMI and WC. Another analysis controlled for the standard covariates and the other food groups consumed with eggs in those 2 egg patterns. Only the egg/MPF/other-grains pattern remained associated with BMI and WC (both P ≤ 0.0063). The pattern analyses identified associations between an egg pattern (egg/MPF/other grains/potatoes/other beverages) and diastolic blood pressure (DBP) and serum LDL cholesterol (both P ≤ 0.0063). A final analysis was conducted by adding percentage of energy from fast foods and medication use for diabetes to the covariates. The association between the egg/MPF/grains pattern and BMI and the egg/MPF/potatoes/other beverages and DBP and LDL cholesterol disappeared. CONCLUSIONS Care needs to be taken with data interpretation of diet and health risk factors and the choice of statistical analyses and covariates used in the analyses because these studies are typically used to generate hypotheses. Additional studies are needed to better understand these relations.
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Affiliation(s)
- Theresa A Nicklas
- Department of Pediatrics, Baylor College of Medicine, USDA/Agricultural Research Service Children's Nutrition Research Center, Houston, TX;
| | - Carol E O'Neil
- School of Nutrition and Food Sciences, Louisiana State University Agricultural Center, Baton Rouge, LA; and
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190
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Zaheer K. An Updated Review on Chicken Eggs: Production, Consumption, Management Aspects and Nutritional Benefits to Human Health. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/fns.2015.613127] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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191
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Agrawal S, Millett CJ, Dhillon PK, Subramanian SV, Ebrahim S. Type of vegetarian diet, obesity and diabetes in adult Indian population. Nutr J 2014; 13:89. [PMID: 25192735 PMCID: PMC4168165 DOI: 10.1186/1475-2891-13-89] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 08/28/2014] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND To investigate the prevalence of obesity and diabetes among adult men and women in India consuming different types of vegetarian diets compared with those consuming non-vegetarian diets. METHODS We used cross-sectional data of 156,317 adults aged 20-49 years who participated in India's third National Family Health Survey (2005-06). Association between types of vegetarian diet (vegan, lacto-vegetarian, lacto-ovo vegetarian, pesco-vegetarian, semi-vegetarian and non-vegetarian) and self-reported diabetes status and measured body mass index (BMI) were estimated using multivariable logistic regression adjusting for age, gender, education, household wealth, rural/urban residence, religion, caste, smoking, alcohol use, and television watching. RESULTS Mean BMI was lowest in pesco-vegetarians (20.3 kg/m2) and vegans (20.5 kg/m2) and highest in lacto-ovo vegetarian (21.0 kg/m2) and lacto-vegetarian (21.2 kg/m2) diets. Prevalence of diabetes varied from 0.9% (95% CI: 0.8-1.1) in person consuming lacto-vegetarian, lacto-ovo vegetarian (95% CI:0.6-1.3) and semi-vegetarian (95% CI:0.7-1.1) diets and was highest in those persons consuming a pesco-vegetarian diet (1.4%; 95% CI:1.0-2.0). Consumption of a lacto- (OR:0.67;95% CI:0.58-0.76;p < 0.01), lacto-ovo (OR:0.70; 95% CI:0.51-0.96;p = 0.03) and semi-vegetarian (OR:0.77; 95% CI:0.60-0.98; p = 0.03) diet was associated with a lower likelihood of diabetes than a non-vegetarian diet in the adjusted analyses. CONCLUSIONS In this large, nationally representative sample of Indian adults, lacto-, lacto-ovo and semi-vegetarian diets were associated with a lower likelihood of diabetes. These findings may assist in the development of interventions to address the growing burden of overweight/obesity and diabetes in Indian population. However, prospective studies with better measures of dietary intake and clinical measures of diabetes are needed to clarify this relationship.
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Affiliation(s)
- Sutapa Agrawal
- />South Asia Network for Chronic Disease, Public Health Foundation of India, Fourth Floor, Plot no 47, Sector 44, Gurgaon (Haryana) 122002 New Delhi, India
| | - Christopher J Millett
- />South Asia Network for Chronic Disease, Public Health Foundation of India, Fourth Floor, Plot no 47, Sector 44, Gurgaon (Haryana) 122002 New Delhi, India
- />Department of Primary Care and Public Health, School of Public Health, Imperial College, London, UK
| | - Preet K Dhillon
- />South Asia Network for Chronic Disease, Public Health Foundation of India, Fourth Floor, Plot no 47, Sector 44, Gurgaon (Haryana) 122002 New Delhi, India
| | - SV Subramanian
- />Department of Society, Human Development and Health, Harvard School of Public Health, Harvard University, Boston, USA
| | - Shah Ebrahim
- />South Asia Network for Chronic Disease, Public Health Foundation of India, Fourth Floor, Plot no 47, Sector 44, Gurgaon (Haryana) 122002 New Delhi, India
- />Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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Affiliation(s)
- M. Murphy
- British Nutrition Foundation; London UK
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Berciano S, Ordovás JM. Nutrition and cardiovascular health. ACTA ACUST UNITED AC 2014; 67:738-47. [PMID: 25172070 DOI: 10.1016/j.rec.2014.05.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 05/26/2014] [Indexed: 11/25/2022]
Abstract
A multitude of studies have been published on the relationship between cardiovascular disease risk and a variety of nutrients, foods, and dietary patterns. Despite the well-accepted notion that diet has a significant influence on the development and prevention of cardiovascular disease, the foods considered healthy and harmful have varied over the years. This review aims to summarize the current scientific evidence on the cardioprotective effect of those foods and nutrients that have been considered healthy as well as those that have been deemed unhealthy at any given time in history. For this purpose, we reviewed the most recent literature using as keywords foods and nutrients (ie, meat, omega-3) and cardiovascular disease-related terms (ie, cardiovascular diseases, stroke). Emphasis has been placed on meta-analyses and Cochrane reviews. In general, there is a paucity of intervention studies with a high level of evidence supporting the benefits of healthy foods (ie, fruits and vegetables), whereas the evidence supporting the case against those foods considered less healthy (ie, saturated fat) seems to be weakened by most recent evidence. In summary, most of the evidence supporting the benefits and harms of specific foods and nutrients is based on observational epidemiological studies. The outcome of randomized clinical trials reveals a more confusing picture with most studies providing very small effects in one direction or another; the strongest evidence comes from dietary patterns. The current status of the relationship between diet and cardiovascular disease risk calls for more tailored recommendations based on genomic technologies.
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Affiliation(s)
| | - José M Ordovás
- IMDEA Alimentación, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; United States Department of Agriculture Jean Mayer Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, United States.
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Jeong HJ, Sun H, Chogsom C, Kwak HS. Cholesterol Removal from Whole Egg by Crosslinked β-Cyclodextrin. ASIAN-AUSTRALASIAN JOURNAL OF ANIMAL SCIENCES 2014; 27:537-42. [PMID: 25049985 PMCID: PMC4093521 DOI: 10.5713/ajas.2013.13706] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Revised: 01/21/2014] [Accepted: 01/14/2014] [Indexed: 11/27/2022]
Abstract
This study was carried out to optimize cholesterol removal in whole egg using crosslinked β-cyclodextrin (β-CD) and to recycle the β-CD. Various factors for optimizing conditions were concentration of the β-CD, mixing temperature, mixing time, mixing speed and centrifugal speed. In the result of this study, the optimum conditions of cholesterol removal were 25% crosslinked β-CD, 40°C mixing temperature, 30 min mixing time, 1,200 rpm mixing speed and 2,810×g centrifugal speed. The recycling was repeated five times. The cholesterol removal was 92.76% when treated with the optimum conditions. After determining the optimum conditions, the recyclable yields of the crosslinked β-CD ranged from 86.66% to 87.60% in the recycling and the percentage of cholesterol removal was over 80% until third recycling. However, the cholesterol removal efficiency was decreased when the number of repeated recycling was increased. Based on the result of this study, it was concluded that the crosslinked β-CD was efficient for cholesterol removal in whole egg, and recycling is possible for only limited repeating times due to the interaction of the β-CD and egg protein.
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196
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Michas G, Micha R, Zampelas A. Dietary fats and cardiovascular disease: Putting together the pieces of a complicated puzzle. Atherosclerosis 2014; 234:320-8. [DOI: 10.1016/j.atherosclerosis.2014.03.013] [Citation(s) in RCA: 127] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Revised: 03/11/2014] [Accepted: 03/16/2014] [Indexed: 12/28/2022]
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Goldberg S, Gardener H, Tiozzo E, Ying Kuen C, Elkind MSV, Sacco RL, Rundek T. Egg consumption and carotid atherosclerosis in the Northern Manhattan study. Atherosclerosis 2014; 235:273-80. [PMID: 24887016 DOI: 10.1016/j.atherosclerosis.2014.04.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 04/04/2014] [Accepted: 04/14/2014] [Indexed: 01/12/2023]
Abstract
BACKGROUND The evidence supporting recommendations to limit intake of cholesterol rich foods is inconclusive. We aimed to examine the association between egg consumption and carotid atherosclerosis phenotypes, and the association with clinical vascular events in a prospective, urban, multi-ethnic population. METHODS AND RESULTS The Northern Manhattan Study is a population based cohort to determine stroke incidence, risk factors and prognosis. A sub-cohort of 1429 NOMAS participants with both carotid ultrasounds and comprehensive dietary information was evaluated (mean ± SD age of participants 65.80 ± 8.80, 40% male, 18% white, 20% black, 60% Hispanic). The association between egg consumption and carotid intima media thickness (cIMT) was assessed with linear regression. Logistic and quantile regression was used to examine the association between egg consumption and carotid plaque presence, thickness, and area. The relation between egg consumption and clinical vascular events (N = 2669) was examined with Cox models. The mean total cIMT was 0.91 ± 0.08 mm and 58% had carotid plaque present. Increasing egg consumption was inversely associated with cIMT, plaque presence, thickness, and area, in models adjusted for demographics, vascular risk factors and diet. For every additional egg consumed per week, the risk of plaque decreased by 11% (95% CI 3%-18%). No association was detected between egg consumption and risk of clinical vascular outcomes, over a mean follow up of 11 years and after adjustment for covariates. CONCLUSIONS Frequency of egg consumption in the low to moderate range was inversely related to several markers of carotid atherosclerosis. No association with clinical vascular events, including stroke, was detected. Our findings do not support current vascular health guidelines suggesting the extreme limitation or avoidance of egg consumption due to its cholesterol content.
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Affiliation(s)
- Sharon Goldberg
- Division of Hospital Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA.
| | - Hannah Gardener
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Eduard Tiozzo
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Cheung Ying Kuen
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Mitchell S V Elkind
- Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Ralph L Sacco
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Tatjana Rundek
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
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Micha R, Khatibzadeh S, Shi P, Fahimi S, Lim S, Andrews KG, Engell RE, Powles J, Ezzati M, Mozaffarian D. Global, regional, and national consumption levels of dietary fats and oils in 1990 and 2010: a systematic analysis including 266 country-specific nutrition surveys. BMJ 2014; 348:g2272. [PMID: 24736206 PMCID: PMC3987052 DOI: 10.1136/bmj.g2272] [Citation(s) in RCA: 375] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/11/2014] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To quantify global consumption of key dietary fats and oils by country, age, and sex in 1990 and 2010. DESIGN Data were identified, obtained, and assessed among adults in 16 age- and sex-specific groups from dietary surveys worldwide on saturated, omega 6, seafood omega 3, plant omega 3, and trans fats, and dietary cholesterol. We included 266 surveys in adults (83% nationally representative) comprising 1,630,069 unique individuals, representing 113 of 187 countries and 82% of the global population. A multilevel hierarchical Bayesian model accounted for differences in national and regional levels of missing data, measurement incomparability, study representativeness, and sampling and modelling uncertainty. SETTING AND POPULATION Global adult population, by age, sex, country, and time. RESULTS In 2010, global saturated fat consumption was 9.4%E (95%UI=9.2 to 9.5); country-specific intakes varied dramatically from 2.3 to 27.5%E; in 75 of 187 countries representing 61.8% of the world's adult population, the mean intake was <10%E. Country-specific omega 6 consumption ranged from 1.2 to 12.5%E (global mean=5.9%E); corresponding range was 0.2 to 6.5%E (1.4%E) for trans fat; 97 to 440 mg/day (228 mg/day) for dietary cholesterol; 5 to 3,886 mg/day (163 mg/day) for seafood omega 3; and <100 to 5,542 mg/day (1,371 mg/day) for plant omega 3. Countries representing 52.4% of the global population had national mean intakes for omega 6 fat ≥ 5%E; corresponding proportions meeting optimal intakes were 0.6% for trans fat (≤ 0.5%E); 87.6% for dietary cholesterol (<300 mg/day); 18.9% for seafood omega 3 fat (≥ 250 mg/day); and 43.9% for plant omega 3 fat (≥ 1,100 mg/day). Trans fat intakes were generally higher at younger ages; and dietary cholesterol and seafood omega 3 fats generally higher at older ages. Intakes were similar by sex. Between 1990 and 2010, global saturated fat, dietary cholesterol, and trans fat intakes remained stable, while omega 6, seafood omega 3, and plant omega 3 fat intakes each increased. CONCLUSIONS These novel global data on dietary fats and oils identify dramatic diversity across nations and inform policies and priorities for improving global health.
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Affiliation(s)
- Renata Micha
- Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA
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Tran NL, Barraj LM, Heilman JM, Scrafford CG. Egg consumption and cardiovascular disease among diabetic individuals: a systematic review of the literature. Diabetes Metab Syndr Obes 2014; 7:121-37. [PMID: 24711708 PMCID: PMC3969252 DOI: 10.2147/dmso.s58668] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND 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. RESULTS 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. CONCLUSION 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.
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Affiliation(s)
- Nga L Tran
- Exponent Center for Chemical Regulation and Food Safety, Washington, DC, USA
| | - Leila M Barraj
- Exponent Center for Chemical Regulation and Food Safety, Washington, DC, USA
| | | | - Carolyn G Scrafford
- Exponent Center for Chemical Regulation and Food Safety, Washington, DC, USA
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Eggs Can Make Your Day. Am J Lifestyle Med 2014. [DOI: 10.1177/1559827613514519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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