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Givens DI. Animal board invited review: Dietary transition from animal to plant-derived foods: Are there risks to health? Animal 2024; 18:101263. [PMID: 39121724 DOI: 10.1016/j.animal.2024.101263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 07/09/2024] [Accepted: 07/12/2024] [Indexed: 08/12/2024] Open
Abstract
Animal-derived foods (ADFs) are a very varied group of foods, but many are nutrient rich and contain higher quality protein than provided by plant-derived foods such that a simple replacement of ADF protein is likely to lead to a reduction in overall protein quality. In addition, many ADFs are richer in some nutrients than plant-based foods (e.g. Fe, Ca) and these often have a higher bioavailability. ADFs also provide nutrients that plants cannot supply (e.g. vitamin B12) and some provide beneficial health functionality (e.g. hypotensive) which is not explained by traditional nutrition. However, there remains a good health reason to increase the proportion of plant-derived food in many diets to increase the intake of dietary fibre which is often consumed at very sub-optimal levels. It seems logical that the increased plant-derived foods should replace the ADFs that have the least benefit, the greatest risk to health and the highest environmental impact. Processed meat fits these characteristics and should be an initial target for replacement with plant-based based protein-rich foods that additionally provide the necessary nutrients and have high-quality dietary fibre. Processed meat covers a wide range of products including several traditional foods (e.g. sausages) which will make decisions on food replacement challenging. There is therefore an urgent need for research to better define the relative health risks associated with the range of processed meat-based foods. The aim of this review is to examine the evidence on the benefits and risks of this dietary transition including the absolute necessity to consider initial nutrient status before the replacement of ADFs is considered.
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Affiliation(s)
- D I Givens
- Institute for Food, Nutrition and Health, University of Reading, Earley Gate, Reading RG6 6EU, United Kingdom.
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Del Carmen Fernández-Fígares Jiménez M. Plant foods, healthy plant-based diets, and type 2 diabetes: a review of the evidence. Nutr Rev 2024; 82:929-948. [PMID: 37550262 DOI: 10.1093/nutrit/nuad099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
Type 2 diabetes (T2D) is a metabolic chronic disease in which insulin resistance and insufficient insulin production lead to elevated blood glucose levels. The prevalence of T2D is growing worldwide, mainly due to obesity and the adoption of Western diets. Replacing animal foods with healthy plant foods is associated with a lower risk of T2D in prospective studies. In randomized controlled trials, the consumption of healthy plant foods in place of animal foods led to cardiometabolic improvements in patients with T2D or who were at high risk of the disease. Dietary patterns that limit or exclude animal foods and focus on healthy plant foods (eg, fruits, vegetables, whole grains, nuts, legumes), known as healthy, plant-based diets, are consistently associated with a lower risk of T2D in cohort studies. The aim of this review is to examine the differential effects of plant foods and animal foods on T2D risk and to describe the existing literature about the role of healthy, plant-based diets, particularly healthy vegan diets, in T2D prevention and management. The evidence from cohort studies and randomized controlled trials will be reported, in addition to the potential biological mechanisms that seem to be involved.
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Shi S, Dong Y, Wang S, Du X, Feng N, Xu L, Zhong VW. Associations of Dietary Cholesterol Consumption With Incident Diabetes and Cardiovascular Disease: The Role of Genetic Variability in Cholesterol Absorption and Disease Predisposition. Diabetes Care 2024; 47:1092-1098. [PMID: 38593324 DOI: 10.2337/dc23-2336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 03/29/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVE Whether genetic susceptibility to disease and dietary cholesterol (DC) absorption contribute to inconsistent associations of DC consumption with diabetes and cardiovascular disease (CVD) remains unclear. RESEARCH DESIGN AND METHODS DC consumption was assessed by repeated 24-h dietary recalls in the UK Biobank. A polygenetic risk score (PRS) for DC absorption was constructed using genetic variants in the Niemann-Pick C1-Like 1 and ATP Binding Cassettes G5 and G8 genes. PRSs for diabetes, coronary artery disease, and stroke were also created. The associations of DC consumption with incident diabetes (n = 96,826) and CVD (n = 94,536) in the overall sample and by PRS subgroups were evaluated using adjusted Cox models. RESULTS Each additional 300 mg/day of DC consumption was associated with incident diabetes (hazard ratio [HR], 1.17 [95% CI, 1.07-1.27]) and CVD (HR, 1.09 [95% CI, 1.03-1.17]), but further adjusting for BMI nullified these associations (HR for diabetes, 0.99 [95% CI, 0.90-1.09]; HR for CVD, 1.04 [95% CI, 0.98-1.12]). Genetic susceptibility to the diseases did not modify these associations (P for interaction ≥0.06). The DC-CVD association appeared to be stronger in people with greater genetic susceptibility to cholesterol absorption assessed by the non-high-density lipoprotein cholesterol-related PRS (P for interaction = 0.04), but the stratum-level association estimates were not statistically significant. CONCLUSIONS DC consumption was not associated with incident diabetes and CVD, after adjusting for BMI, in the overall sample and in subgroups stratified by genetic predisposition to cholesterol absorption and the diseases. Nevertheless, whether genetic predisposition to cholesterol absorption modifies the DC-CVD association requires further investigation.
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Affiliation(s)
- Shuxiao Shi
- Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Dong
- Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sujing Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xihao Du
- Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Nannan Feng
- Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lan Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Victor W Zhong
- Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Virtanen JK, Larsson SC. Eggs - a scoping review for Nordic Nutrition Recommendations 2023. Food Nutr Res 2024; 68:10507. [PMID: 38370115 PMCID: PMC10870976 DOI: 10.29219/fnr.v68.10507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 06/07/2022] [Accepted: 01/08/2024] [Indexed: 02/20/2024] Open
Abstract
Cardiovascular diseases (CVD), type 2 diabetes (T2D), and cancer are a significant public health burden in the Nordic and Baltic countries. High intake of eggs, mainly due to its high cholesterol content, has been suggested to have adverse health effects. The purpose of this scoping review is to describe the evidence related to the impact of egg intake on health. A literature search identified 38 systematic reviews and meta-analyses on egg consumption in relation to health outcomes published between 2011 and 30 April 2022. Overall, current evidence from systematic reviews of randomized clinical trials indicates that higher egg intake may increase serum total cholesterol concentration and the ratio of low-density lipoprotein to high-density lipoprotein cholesterol, but with substantial heterogeneity in the response. However, recent evidence from observational studies does not provide strong support for a detrimental role of moderate egg consumption (up to one egg/day) on the risk of CVD, especially in the European studies. The overall evidence from observational studies indicates that egg consumption is not associated with increased risk of mortality or T2D in European study populations. There is also little support for a role of egg consumption in cancer development, although a weak association with higher risk of certain cancers has been found in some studies, mainly case-control studies. Again, no associations with cancer risk have been observed in European studies. Systematic reviews and meta-analyses of egg consumption in relation to other health-related outcomes are scarce. There are also limited data available on the associations between the consumption of more than one egg/day and risk of diseases. Based on the available evidence, one egg/day is unlikely to adversely affect overall disease risk.
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Affiliation(s)
- Jyrki K. Virtanen
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Susanna C. Larsson
- Unit of Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Rondanelli M, Barrile GC, Cavioni A, Donati P, Genovese E, Mansueto F, Mazzola G, Patelli Z, Pirola M, Razza C, Russano S, Sivieri C, Tartara A, Valentini EM, Perna S. A Narrative Review on Strategies for the Reversion of Prediabetes to Normoglycemia: Food Pyramid, Physical Activity, and Self-Monitoring Innovative Glucose Devices. Nutrients 2023; 15:4943. [PMID: 38068801 PMCID: PMC10707766 DOI: 10.3390/nu15234943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/16/2023] [Accepted: 11/21/2023] [Indexed: 12/18/2023] Open
Abstract
In 2019, "Nutrition Therapy for Adults with Diabetes or Prediabetes: A Consensus Report" was published. This consensus report, however, did not provide an easy way to illustrate to subjects with prediabetes (SwPs) how to follow a correct dietary approach. The purpose of this review is to evaluate current evidence on optimum dietary treatment of SwPs and to provide a food pyramid for this population. The pyramid built shows that everyday consumption should consist of: whole-grain bread or potatoes eaten with their skins (for fiber and magnesium) and low glycemic index carbohydrates (GI < 55%) (three portions); fruit and vegetables (5 portions), in particular, green leafy vegetables (for fiber, magnesium, and polyphenols); EVO oil (almost 8 g); nuts (30 g, in particular, pistachios and almonds); three portions of dairy products (milk/yogurt: 300-400 g/day); mineral water (almost 1, 5 L/day for calcium intake); one glass of wine (125 mL); and three cups of coffee. Weekly portions should include fish (four portions), white meat (two portions), protein plant-based food (four portions), eggs (egg portions), and red/processed meats (once/week). At the top of the pyramid, there are two pennants: a green one means that SwPs need some personalized supplementation (if daily requirements cannot be satisfied through diet, vitamin D, omega-3, and vitamin B supplements), and a red one means there are some foods and factors that are banned (simple sugar, refined carbohydrates, and a sedentary lifestyle). Three to four times a week of aerobic and resistance exercises must be performed for 30-40 min. Finally, self-monitoring innovative salivary glucose devices could contribute to the reversion of prediabetes to normoglycemia.
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Affiliation(s)
- Mariangela Rondanelli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Gaetan Claude Barrile
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Alessandro Cavioni
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Paolo Donati
- AICUBE srl, 20090 Trezzano sul Naviglio, Italy; (P.D.); (S.R.)
| | - Elisa Genovese
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Francesca Mansueto
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Giuseppe Mazzola
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Zaira Patelli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Martina Pirola
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Claudia Razza
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Stefano Russano
- AICUBE srl, 20090 Trezzano sul Naviglio, Italy; (P.D.); (S.R.)
| | - Claudia Sivieri
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Alice Tartara
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Eugenio Marzio Valentini
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Simone Perna
- Department of Food, Environmental and Nutritional Sciences, Division of Human Nutrition, University of Milan, 20133 Milan, Italy;
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Antoni R. Dietary saturated fat and cholesterol: cracking the myths around eggs and cardiovascular disease. J Nutr Sci 2023; 12:e97. [PMID: 37706071 PMCID: PMC10495817 DOI: 10.1017/jns.2023.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/27/2023] [Accepted: 08/11/2023] [Indexed: 09/15/2023] Open
Abstract
Whilst dietary cholesterol guidelines have waivered through the years with historic restrictions lifted for the majority of the general population, recommendations to reduce saturated fat intake have been the mainstay of dietary guidelines since the 1980s and were recently reinforced by the Scientific Advisory Committee on Nutrition (SACN). Cholesterol metabolism is complex, with saturated fat known to have a more significant contribution at raising levels of low-density lipoprotein (LDL) cholesterol, a well-established risk factor for cardiovascular disease (CVD). However, it is clear from metabolic research that hyper-responsiveness to both dietary cholesterol and saturated fat exists; hence, for specific subsets of the population, reductions in both nutrients may be indicated. With this in mind, the current article aims to provide an overview of the mechanisms underlying biological variation in responsiveness and introduces research currently underway which will hopefully identify simple biomarkers that can be used to predict responsiveness and permit tailored, personalised, dietary advice. Eggs are a well-known source of dietary cholesterol whilst being low in saturated fat. A common question encountered in clinical practice is must individuals limit intake to manage blood cholesterol levels. This article summarises key recent papers which confirm that eggs can be enjoyed as part of a healthy balanced diet, whilst highlighting the need for further research in certain population groups, e.g. in individuals with diabetes.
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Affiliation(s)
- Rona Antoni
- Department of Nutrition, Food and Exercise Sciences at University of Surrey, Guildford GU2 7WG, UK
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Andersen CJ, Huang L, Zhai F, Esposito CP, Greco JM, Zhang R, Woodruff R, Sloan A, Van Dyke AR. Consumption of Different Egg-Based Diets Alters Clinical Metabolic and Hematological Parameters in Young, Healthy Men and Women. Nutrients 2023; 15:3747. [PMID: 37686779 PMCID: PMC10490185 DOI: 10.3390/nu15173747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/17/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
Eggs-particularly egg yolks-are a rich source of bioactive nutrients and dietary compounds that influence metabolic health, lipid metabolism, immune function, and hematopoiesis. We investigated the effects of consuming an egg-free diet, three egg whites per day, and three whole eggs per day for 4 weeks on comprehensive clinical metabolic, immune, and hematologic profiles in young, healthy adults (18-35 y, BMI < 30 kg/m2 or <30% body fat for men and <40% body fat for women, n = 26) in a 16-week randomized, crossover intervention trial. We observed that average daily macro- and micronutrient intake significantly differed across egg diet periods, including greater intake of choline during the whole egg diet period, which corresponded to increased serum choline and betaine without altering trimethylamine N-oxide. Egg white and whole egg intake increased serum isoleucine while whole egg intake reduced serum glycine-markers of increased and decreased risk of insulin resistance, respectively-without altering other markers of glucose sensitivity or inflammation. Whole egg intake increased a subset of large HDL particles (H6P, 10.8 nm) and decreased the total cholesterol:HDL-cholesterol ratio and % monocytes in female participants using combined oral contraceptive (COC) medication (n = 11) as compared to female non-users (n = 10). Whole egg intake further increased blood hematocrit whereas egg white and whole egg intake reduced blood platelet counts. Changes in clinical immune cell counts between egg white and whole egg diet periods were negatively correlated with several HDL parameters yet positively correlated with measures of triglyceride-rich lipoproteins and insulin sensitivity. Overall, the intake of whole eggs led to greater overall improvements in micronutrient diet quality, choline status, and HDL and hematologic profiles while minimally-yet potentially less adversely-affecting markers of insulin resistance as compared to egg whites.
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Affiliation(s)
- Catherine J. Andersen
- Department of Biology, Fairfield University, Fairfield, CT 06824, USA; (J.M.G.); (A.S.)
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA; (L.H.); (F.Z.); (R.Z.); (R.W.)
| | - Lindsey Huang
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA; (L.H.); (F.Z.); (R.Z.); (R.W.)
| | - Fangyi Zhai
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA; (L.H.); (F.Z.); (R.Z.); (R.W.)
| | - Christa Palancia Esposito
- Marion Peckham Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT 06824, USA;
| | - Julia M. Greco
- Department of Biology, Fairfield University, Fairfield, CT 06824, USA; (J.M.G.); (A.S.)
| | - Ruijie Zhang
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA; (L.H.); (F.Z.); (R.Z.); (R.W.)
| | - Rachael Woodruff
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA; (L.H.); (F.Z.); (R.Z.); (R.W.)
| | - Allison Sloan
- Department of Biology, Fairfield University, Fairfield, CT 06824, USA; (J.M.G.); (A.S.)
| | - Aaron R. Van Dyke
- Department of Chemistry and Biochemistry, Fairfield University, Fairfield, CT 06824, USA;
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Myers M, Ruxton CHS. Eggs: Healthy or Risky? A Review of Evidence from High Quality Studies on Hen's Eggs. Nutrients 2023; 15:2657. [PMID: 37375561 DOI: 10.3390/nu15122657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/21/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
Hen's eggs (from Gallus gallus domesticus) provide choline, folate, vitamin D, iodine, B vitamins and high-quality protein and are no longer viewed by national bodies as a risk factor for hypercholesterolaemia and cardiovascular disease (CVD). Yet, questions remain about the benefits and risks of eating eggs regularly. This review evaluates recent high-quality evidence from randomised controlled trials (RCT) and meta-analyses of observational studies and considers new areas of interest, such as weight management, protein metabolism, allergy risk and sustainability. In several RCT, eggs increased muscle protein synthesis and lowered fat mass, which could support optimal body composition. Eggs within a meal improved satiety, which could translate into lower energy intakes, although more RCT are needed. In observational studies, higher egg consumption was associated with a null effect or a modest reduced risk of CVD. For type 2 diabetes (T2D) incidence and risk of CVD in people with T2D, there were inconsistencies between observational and RCT data, with the former noting positive associations and the latter seeing no effect of higher egg intake on markers of T2D and CVD. Sustainability metrics suggest that eggs have the lowest planetary impact amongst animal proteins. To lower allergy risk, earlier introduction of eggs into weaning diets is warranted. In conclusion, the balance of evidence points to eggs being a nutritious food suggesting there are broad health benefits from including eggs in the diet at intakes higher than that currently consumed by European populations.
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Egg Intake Is Associated with Lower Risks of Impaired Fasting Glucose and High Blood Pressure in Framingham Offspring Study Adults. Nutrients 2023; 15:nu15030507. [PMID: 36771213 PMCID: PMC9920838 DOI: 10.3390/nu15030507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/09/2023] [Accepted: 01/13/2023] [Indexed: 01/21/2023] Open
Abstract
The association between egg consumption and cardiometabolic risk factors such as high blood pressure (HBP) and impaired fasting glucose (IFG) or type 2 diabetes (T2D) is still under debate. This study examines the association between egg consumption and these outcomes among 2349 30-64 year-old adults in the prospective Framingham Offspring Study. Diet was assessed using three-day dietary records. Potential confounders retained in the final models included age, sex, body mass index, and other dietary factors. The analysis of covariance and Cox proportional hazard's models were used to assess the relevant continuous (i.e., FG, SBP, DBP) and categorical (i.e., T2D, HBP) outcomes. Consuming ≥5 eggs per week was associated with lower mean FG (p = 0.0004) and SBP (p = 0.0284) after four years of follow-up. Higher egg intakes led to lower risks of developing IFG or T2D (HR: 0.72; 95% CI: 0.51-1.03) and high blood pressure (HBP) (HR: 0.68; 0.50-0.93). The beneficial effects of egg consumption were stronger in combination with other healthy dietary patterns. This study found that regular egg consumption as part of a healthy diet had long-term beneficial effects on blood pressure and glucose metabolism and lowered the long-term risks of high blood pressure and diabetes.
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Kouvari M, Damigou E, Florentin M, Kosti RI, Chrysohoou C, Pitsavos CS, Panagiotakos DB. Egg Consumption, Cardiovascular Disease and Cardiometabolic Risk Factors: The Interaction with Saturated Fatty Acids. Results from the ATTICA Cohort Study (2002-2012). Nutrients 2022; 14:nu14245291. [PMID: 36558450 PMCID: PMC9783240 DOI: 10.3390/nu14245291] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022] Open
Abstract
Purpose: To examine the association of egg intake with 10-year risk of cardiovascular disease (CVD) and other cardiometabolic risk factors in a sample of individuals of Mediterranean origin. Methods: In 2001−2002, n = 1514 men and n = 1528 women (>18 years old) from the greater Athens area, Greece, were enrolled. Information on any egg intake, eaten as a whole, partly or in recipes was assessed via a validated semi-quantitative food frequency questionnaire. Follow-up for CVD evaluation (2011−2012) was achieved in n = 2020 participants (n = 317 CVD cases). Results: Ranking from lowest (<1 serving/week) to intermediate (1−4 servings/week) and high (4−7 servings/week) egg consumption tertiles, lower CVD incidence was observed (18%, 9% and 8%, respectively, p-for-trend = 0.004). Unadjusted analysis revealed that 1−3 eggs/week and 4−7 eggs/week were associated with a 60% and 75%, respectively, lower risk of developing CVD compared with the reference group (<1 egg/week). When adjusting for sociodemographic, lifestyle and clinical factors, significance was retained only for 1−3 eggs/week (hazard ratio (HR) = 0.53, 95% confidence interval (95% CI) = 0.28, 1.00). When total saturated fatty acid (SFA) intake was taken into account, this inverse association was non-significant. Multi-adjusted analysis revealed that in participants of low SFA intake, 1 serving/day increase in egg intake resulted in 45% lower risk of developing CVD. In the case of higher SFA consumption, only 1−3 eggs/week seemed to protect against CVD (HR = 0.25, 95% CI = 0.07, 0.86). In the case of intermediate cardiometabolic disorders, no significant trend was observed. Conclusions: Overall dietary habits principally in terms of SFA intake may be detrimental to define the role of eggs in cardiac health.
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Affiliation(s)
- Matina Kouvari
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17272 Athens, Greece
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, ACT 2617, Australia
| | - Evangelia Damigou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17272 Athens, Greece
| | - Matilda Florentin
- Department of Internal Medicine, School of Medicine, University of Ioannina, 45221 Ioannina, Greece
- Correspondence: (M.F.); (D.B.P.)
| | - Rena I. Kosti
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 38221 Trikala, Greece
| | - Christina Chrysohoou
- First Cardiology Clinic, School of Medicine, University of Athens, 11527 Athens, Greece
| | - Christos S. Pitsavos
- First Cardiology Clinic, School of Medicine, University of Athens, 11527 Athens, Greece
| | - Demosthenes B. Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17272 Athens, Greece
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Canberra, ACT 2601, Australia
- Correspondence: (M.F.); (D.B.P.)
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Jiao Y, Li W, Jiang H, Wang L, Wang S, Hao L, Jia X, Wang Z, Wang H, Zhang B, Ding G. Association of egg intake with risks of cardiometabolic factors among adults in China. Front Public Health 2022; 10:1010539. [PMID: 36388381 PMCID: PMC9645429 DOI: 10.3389/fpubh.2022.1010539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 09/30/2022] [Indexed: 01/27/2023] Open
Abstract
Objective To explore the association between egg intake and cardiometabolic factors (CMFs) in Chinese adults. Method The subjects were 6,182 adults aged 18-64 who had complete survey data and had no CMFs at baseline. Egg intake was assessed with 3 days-24 h dietary recalls in all waves of the China Health and Nutrition Survey (CHNS). Multivariate Cox proportional risk regression model and restricted cubic spline (RCS) model were used to analyze the association and dose-response relationship between egg intake and CMFs. Results Of the 6,182 participants who did not have metabolic syndrome (MetS) at baseline, 1,921 developed this disease during an average follow-up of 5.71 years, with an incidence of 31.07%. Central obesity, elevated TG, decreased HDL-C, elevated blood pressure and elevated plasma glucose were 38.65, 26.74, 30.21, 40.64, and 30.64%, respectively. After adjusting for demographic characteristics, lifestyle, energy and BMI, using the lowest quintile (Q1) as a reference, the risk of central obesity, elevated TG, decreased HDL-C, and elevated plasma glucose in the highest quintile (Q5) were reduced by 15% (HR = 0.85, 95% CI = 0.73-0.98, P = 0.16), 33% (HR = 0.67, 95% CI = 0.57-0.78), 25% (HR = 0.75, 95% CI = 0.63 0.90, p = 0.05), and 28% (HR = 0.72, 95% CI = 0.63-0.83, p < 0.05), respectively. The risk of elevated blood pressure was reduced by 26% in the fourth quintile (HR = 0.74, 95% CI = 0.64-0.85, P = 0.85). RCS analysis show that the overall correlation and nonlinear relationship between egg intake and CMFs were statistically significant (P < 0.05). When the intake was lower than 20 g/days, the risk of MetS, central obesity, elevated blood pressure and elevated plasma glucose were negatively correlated with egg intake, while elevated TG was negatively correlated with eggs when the intake was lower than 60 g/days. There was no statistically significant association between egg intake and CMFs at higher egg intake. Conclusion There was a U-shaped association between egg intake and CMFs in Chinese adults.
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Affiliation(s)
- Yingying Jiao
- National Institute for Nutrition and Health, Chinese Center for Diseases Control and Prevention, Beijing, China
| | - Weiyi Li
- National Institute for Nutrition and Health, Chinese Center for Diseases Control and Prevention, Beijing, China,Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing, China,Dietary Reference Intakes (DRIs) Expert Committee on Macroelements, Chinese Nutrition Society, Beijing, China
| | - Hongru Jiang
- National Institute for Nutrition and Health, Chinese Center for Diseases Control and Prevention, Beijing, China,Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing, China,Dietary Reference Intakes (DRIs) Expert Committee on Macroelements, Chinese Nutrition Society, Beijing, China
| | - Liusen Wang
- National Institute for Nutrition and Health, Chinese Center for Diseases Control and Prevention, Beijing, China,Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing, China,Dietary Reference Intakes (DRIs) Expert Committee on Macroelements, Chinese Nutrition Society, Beijing, China
| | - Shaoshunzi Wang
- National Institute for Nutrition and Health, Chinese Center for Diseases Control and Prevention, Beijing, China,Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing, China
| | - Lixin Hao
- National Institute for Nutrition and Health, Chinese Center for Diseases Control and Prevention, Beijing, China,Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing, China
| | - Xiaofang Jia
- National Institute for Nutrition and Health, Chinese Center for Diseases Control and Prevention, Beijing, China,Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing, China
| | - Zhihong Wang
- National Institute for Nutrition and Health, Chinese Center for Diseases Control and Prevention, Beijing, China,Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing, China,Dietary Reference Intakes (DRIs) Expert Committee on Macroelements, Chinese Nutrition Society, Beijing, China
| | - Huijun Wang
- National Institute for Nutrition and Health, Chinese Center for Diseases Control and Prevention, Beijing, China,Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing, China
| | - Bing Zhang
- National Institute for Nutrition and Health, Chinese Center for Diseases Control and Prevention, Beijing, China,Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing, China
| | - Gangqiang Ding
- National Institute for Nutrition and Health, Chinese Center for Diseases Control and Prevention, Beijing, China,Key Laboratory of Trace Elements and Nutrition, National Health Commission, Beijing, China,Dietary Reference Intakes (DRIs) Expert Committee on Macroelements, Chinese Nutrition Society, Beijing, China,*Correspondence: Gangqiang Ding
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12
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Giosuè A, Calabrese I, Riccardi G, Vaccaro O, Vitale M. Consumption of different animal-based foods and risk of type 2 diabetes: An umbrella review of meta-analyses of prospective studies. Diabetes Res Clin Pract 2022; 191:110071. [PMID: 36067917 DOI: 10.1016/j.diabres.2022.110071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/29/2022] [Accepted: 08/31/2022] [Indexed: 12/27/2022]
Abstract
We performed an umbrella review of dose-response meta-analyses of prospective studies reporting the incidence of type 2 diabetes associated with the consumption of animal-based foods. A systematic search was conducted in PubMed, Web of Science, Scopus, and Embase according to PRISMA. Thirteen meta-analyses are included in the study providing 175 summary risk ratio estimates. The consumption of 100 g/day of total or red meat, or 50 g/day of processed meat, were associated with an increased risk; RR and 95 % CI were respectively 1.20, 1.13-1.27; 1.22, 1.14-1.30 and 1.30, 1.22-1.39. White meat (50 g/day) was associated with an increased risk, but of lesser magnitude (RR 1.04, 95 % CI 1.00-1.08). A risk reduction was reported for 200 g/day of total dairy (RR 0.95, 95 % CI 0.92-0.98) or low-fat dairy (RR 0.96, 95 % CI 0.92-1.00) or milk (RR 0.90, 95 % CI 0.83-0.98), or 100 g/day of yogurt (RR 0.94, 95 % CI 0.90-0.98). No association with diabetes risk was reported for fish or eggs. In conclusions animal-based foods have a different association with diabetes risk. To reduce diabetes risk the consumption of red and processed meat should be restricted; a moderate consumption of dairy foods, milk and yogurt, can be encouraged; moderate amounts of fish and eggs are allowed.
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Affiliation(s)
- Annalisa Giosuè
- Dept. of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
| | - Ilaria Calabrese
- Dept. of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
| | - Gabriele Riccardi
- Dept. of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
| | - Olga Vaccaro
- Dept. of Pharmacy, Federico II University, Naples, Italy.
| | - Marilena Vitale
- Dept. of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
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13
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Li J, Glenn AJ, Yang Q, Ding D, Zheng L, Bao W, Beasley J, LeBlanc E, Lo K, Manson JE, Philips L, Tinker L, Liu S. Dietary Protein Sources, Mediating Biomarkers, and Incidence of Type 2 Diabetes: Findings From the Women's Health Initiative and the UK Biobank. Diabetes Care 2022; 45:1742-1753. [PMID: 35713602 PMCID: PMC9346982 DOI: 10.2337/dc22-0368] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/03/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Whether and how dietary protein intake is linked to type 2 diabetes (T2D) remains unclear. The aim of this study was to investigate the associations of protein intake with development of T2D and the potential mediating roles of T2D biomarkers. RESEARCH DESIGN AND METHODS We included 108,681 postmenopausal women without T2D at baseline from the Women's Health Initiative (WHI) (primary cohort) and 34,616 adults without T2D from the U.K. Biobank (UKB) (replication cohort). Cox proportional hazard models were used for estimation of protein-T2D associations. Mediation analysis was performed to assess the mediating roles of biomarkers in case-control studies nested in the WHI. RESULTS In the WHI, 15,842 incident T2D cases were identified during a median follow-up of 15.8 years. Intake of animal protein was associated with increased T2D risk (hazard ratio in comparing the highest to the lowest quintile = 1.31 [95% CI 1.24-1.37]) and plant protein with decreased risk (0.82 [0.78-0.86]). Intakes of red meat, processed meat, poultry, and eggs were associated with increased T2D risk and whole grains with decreased risk. Findings from the UKB were similar. These findings were materially attenuated after additional adjustment for BMI. Substituting 5% energy from plant protein for animal protein was associated with 21% decreased T2D risk (0.79 [0.74-0.84]), which was mediated by levels of hs-CRP, interleukin-6, leptin, and SHBG. CONCLUSIONS Findings from these two large prospective cohorts support the notion that substituting plant protein for animal protein may decrease T2D risk mainly by reducing obesity-related inflammation.
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Affiliation(s)
- Jie Li
- Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Department of Epidemiology and Center for Global Cardiometabolic Health, School of Public Health, Brown University, Providence, RI
| | - Andrea J Glenn
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Qingling Yang
- Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ding Ding
- Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Lingling Zheng
- Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Wei Bao
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Jeannette Beasley
- Division of General Internal Medicine and Clinical Innovation, New York University Langone Health, New York, NY
| | - Erin LeBlanc
- Kaiser Permanente Center for Health Research, Portland, OR
| | - Kenneth Lo
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong Special Administrative Region, China
| | - JoAnn E Manson
- Brigham and Women's Hospital, Harvard Medical School, and Harvard T.H. Chan School of Public Health, Boston, MA
| | | | - Lesley Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Simin Liu
- Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Department of Epidemiology and Center for Global Cardiometabolic Health, School of Public Health, Brown University, Providence, RI.,Departments of Surgery and Medicine, The Warren Alpert Medical School, Brown University, Providence, RI
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14
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Cea-Soriano L, Pulido J, Franch-Nadal J, Santos JM, Mata-Cases M, Díez-Espino J, Ruiz-García A, Regidor E. Mediterranean diet and diabetes risk in a cohort study of individuals with prediabetes: propensity score analyses. Diabet Med 2022; 39:e14768. [PMID: 34897805 DOI: 10.1111/dme.14768] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 11/29/2021] [Accepted: 12/10/2021] [Indexed: 11/30/2022]
Abstract
AIMS Randomized controlled trials have demonstrated the efficacy of several dietary patterns plus physical activity to reduce diabetes onset in people with prediabetes. However, there is no evidence on the effect from the Mediterranean diet on the progression from prediabetes to diabetes. We aimed to evaluate the effect from high adherence to Mediterranean diet on the risk of diabetes in individuals with prediabetes. METHODS Prospective cohort study in Spanish Primary Care setting. A total of 1184 participants with prediabetes based on levels of fasting plasma glucose and/or glycated hemoglobin were followed up for a mean of 4.2 years. A total of 210 participants developed diabetes type 2 during the follow up. Hazard ratios of diabetes onset were estimated by Cox proportional regression models associated to high versus low/medium adherence to Mediterranean diet. Different propensity score methods were used to control for potential confounders. RESULTS Incidence rate of diabetes in participants with high versus low/medium adherence to Mediterranean diet was 2.9 versus 4.8 per 100 persons-years. The hazard ratios adjusted for propensity score and by inverse probability weighting (IPW) had identical magnitude: 0.63 (95% confidence interval, 0.43-0.93). The hazard ratio in the adjusted model using propensity score matching 1:2 was 0.56 (95% confidence interval, 0.37-0.84). CONCLUSIONS These propensity score analyses suggest that high adherence to Mediterranean diet reduces diabetes risk in people with prediabetes.
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Affiliation(s)
- Lucía Cea-Soriano
- Department of Public Health and Maternal and Child Health, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
- redGDPS Foundation, Madrid, Spain
- Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - José Pulido
- Department of Public Health and Maternal and Child Health, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Josep Franch-Nadal
- redGDPS Foundation, Madrid, Spain
- Barcelona City Research Support Unit/University Institute for Research in Primary Care Jordi Gol, Barcelona, Spain
- CIBER Diabetes and Associated Metabolic Diseases (CIBERDEM), Madrid, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Juana M Santos
- Department of Public Health and Maternal and Child Health, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
- Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Manel Mata-Cases
- redGDPS Foundation, Madrid, Spain
- Barcelona City Research Support Unit/University Institute for Research in Primary Care Jordi Gol, Barcelona, Spain
- CIBER Diabetes and Associated Metabolic Diseases (CIBERDEM), Madrid, Spain
- La Mina Primary Care Center, Barcelona, Spain
| | - Javier Díez-Espino
- redGDPS Foundation, Madrid, Spain
- Tafalla Health Center, Navarra, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Madrid, Spain
- Navarra Institute for Health Research (IDiSNA), Pamplona, Spain
| | - Antonio Ruiz-García
- redGDPS Foundation, Madrid, Spain
- Centro de Salud Universitario Pinto, Madrid, Spain
- Universidad Europea de Madrid, Madrid, Spain
| | - Enrique Regidor
- Department of Public Health and Maternal and Child Health, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
- redGDPS Foundation, Madrid, Spain
- Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
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15
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Fernandez ML, Murillo AG. Is There a Correlation between Dietary and Blood Cholesterol? Evidence from Epidemiological Data and Clinical Interventions. Nutrients 2022; 14:2168. [PMID: 35631308 PMCID: PMC9143438 DOI: 10.3390/nu14102168] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 05/18/2022] [Accepted: 05/20/2022] [Indexed: 11/25/2022] Open
Abstract
Dietary cholesterol has been a topic of debate since the 1960s when the first dietary guidelines that limited cholesterol intake to no more than 300 mg/day were set. These recommendations were followed for several years, and it was not until the late 1990s when they were finally challenged by the newer information derived from epidemiological studies and meta-analysis, which confirmed the lack of correlation between dietary and blood cholesterol. Further, dietary interventions in which challenges of cholesterol intake were evaluated in diverse populations not only confirmed these findings but also reported beneficial effects on plasma lipoprotein subfractions and size as well as increases in HDL cholesterol and in the functionality of HDL. In this review, we evaluate the evidence from recent epidemiological analysis and meta-analysis as well as clinical trials to have a better understanding of the lack of correlation between dietary and blood cholesterol.
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Affiliation(s)
- Maria Luz Fernandez
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06268, USA
| | - Ana Gabriela Murillo
- Department of Biochemistry, University of Costa Rica, San Jose 11501-2060, Costa Rica;
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16
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Thomas MS, Puglisi M, Malysheva O, Caudill MA, Sholola M, Cooperstone JL, Fernandez ML. Eggs Improve Plasma Biomarkers in Patients with Metabolic Syndrome Following a Plant-Based Diet-A Randomized Crossover Study. Nutrients 2022; 14:nu14102138. [PMID: 35631279 PMCID: PMC9147178 DOI: 10.3390/nu14102138] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/16/2022] [Accepted: 05/18/2022] [Indexed: 12/12/2022] Open
Abstract
Plant-based (PB) diets are considered a healthy dietary pattern; however, eggs are not always included in this dietary regime. We hypothesized that the addition of two eggs per day would increase HDL cholesterol as well as plasma lutein, zeaxanthin and choline in individuals with metabolic syndrome (MetS). In this randomized controlled crossover intervention, we recruited 30 participants (49.3 ± 8 y) with MetS who followed a PB diet for 13 weeks. A registered dietitian advised all subjects on food selection and followed them through the intervention to ensure compliance. Participants underwent a 2-week washout with no eggs or spinach (a source of dietary lutein and zeaxanthin) and were randomly allocated to consume spinach (70 g) with either two eggs (EGG) or the equivalent amount of egg substitute (SUB) for breakfast for 4 weeks. After a 3-week washout, they were allocated the alternate breakfast. A total of 24 participants (13 women/11 men) finished the intervention. Plasma lipids, glucose, insulin, anthropometrics, plasma lutein, zeaxanthin, choline and trimethylamine oxide (TMAO) were assessed at baseline and the end of each intervention. When we compared individuals consuming the EGG versus the SUB breakfast, we observed a lower body weight (p < 0.02) and a higher HDL cholesterol (p < 0.025) after the EGG diet. There were no differences in plasma LDL cholesterol, triglycerides, glucose, insulin, or blood pressure. The number of large HDL particles measured by NMR was higher after EGG (p < 0.01) as compared to SUB. Plasma choline was higher in both treatments (p < 0.01) compared to baseline (8.3 ± 2.1 μmol/L). However, plasma choline values were higher in EGG (10.54 ± 2.8 μmol/L) compared to SUB (9.47 ± 2.7 μmol/L) p < 0.025. Both breakfasts increased plasma lutein compared to baseline (p < 0.01), while plasma zeaxanthin was only increased in the egg intervention (p < 0.01). These results indicate that consuming a plant-based diet in combination with whole eggs increases plasma HDL cholesterol, choline and zeaxanthin, important biomarkers in subjects with MetS.
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Affiliation(s)
- Minu S. Thomas
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA; (M.S.T.); (M.P.)
| | - Michael Puglisi
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA; (M.S.T.); (M.P.)
| | - Olga Malysheva
- Department of Human Nutrition, Division of Nutritional Science, Cornell University, Ithaca, NY 14860, USA; (O.M.); (M.A.C.)
| | - Marie A. Caudill
- Department of Human Nutrition, Division of Nutritional Science, Cornell University, Ithaca, NY 14860, USA; (O.M.); (M.A.C.)
| | - Maria Sholola
- Department of Food Science and Technology, The Ohio State University, Columbus, OH 43210, USA; (M.S.); (J.L.C.)
| | - Jessica L. Cooperstone
- Department of Food Science and Technology, The Ohio State University, Columbus, OH 43210, USA; (M.S.); (J.L.C.)
- Department of Horticulture and Crop Science, The Ohio State University, Columbus, OH 43210, USA
| | - Maria Luz Fernandez
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT 06269, USA; (M.S.T.); (M.P.)
- Correspondence:
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17
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Greenberg JA, Jiang X, Tinker LF, Snetselaar LG, Saquib N, Shadyab AH. Eggs, dietary cholesterol, choline, betaine, and diabetes risk in the Women's Health Initiative: a prospective analysis. Am J Clin Nutr 2021; 114:368-377. [PMID: 33829251 PMCID: PMC8246612 DOI: 10.1093/ajcn/nqab036] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/29/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Epidemiological studies have been inconsistent regarding the relations between diabetes risk and the consumption of eggs and nutrients in eggs, such as choline, betaine, and cholesterol. There have been few studies among elderly women. OBJECTIVES The objective of this study was to examine associations between consumption of eggs, cholesterol, choline, and betaine and the risk of diabetes among elderly US women. METHODS Multivariable Cox regression was used with data from the prospective Women's Health Initiative. Population attributable risks were calculated. Consumption of eggs alone (not mixed in foods) and nutrients were assessed with an FFQ. Diabetes incidence was defined as the first incidence of self-reported diabetes treated with oral diabetes medication or insulin injections. RESULTS There were 46,263 women at follow-up baseline. During 13.3 y and 592,984 person-years of follow-up, there were 5480 incident diabetes cases. Higher egg, cholesterol, and choline consumption were each significantly associated with increases in diabetes risk. The associations for eggs and choline were not significant after adjustment for cholesterol consumption. The association for eggs was attenuated after adjustment for non-egg cholesterol consumption, with 1 significant HR in the top consumption quintile (≥3 eggs/wk) of 1.15 (95% CI: 1.05, 1.27; P for linear trend = 0.0001). The population attributable risks for obesity, overweight, consumption of ≥3 eggs/wk, inadequate exercise, and poor diet were 25.0 (95% CI: 22.3, 27.6), 12.8 (95% CI: 11.1, 14.5), 4.2 (95% CI: 2.3, 6.1), 3.5 (95% CI: 1.2, 5.8), and 3.1 (95% CI: 0.5, 5.7), respectively. CONCLUSIONS As egg consumption increased to ≥3 eggs/wk, there was a steady increase in diabetes risk that may have been due to the cholesterol in the eggs. The population attributable risk for ≥3 eggs/wk was far lower than that for being obese or overweight.
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Affiliation(s)
- James A Greenberg
- Department of Health and Nutrition Sciences, Brooklyn College of the City University of New York, Brooklyn, NY, USA
| | - Xinyin Jiang
- Department of Health and Nutrition Sciences, Brooklyn College of the City University of New York, Brooklyn, NY, USA
| | - Lesley F Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Linda G Snetselaar
- Department of Epidemiology, School of Public Health, University of Iowa, Iowa City, IA, USA
| | - Nazmus Saquib
- Research Unit, College of Medicine, Sulaiman Al-Rajhi Colleges, Al Bukairiyah, Saudi Arabia
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA
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18
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Xu K, Shi L, Zhang B, Mi B, Yang J, Sun X, Liao X, Dai X, Zeng L, Liu X, Yan H. Distinct metabolite profiles of adiposity indices and their relationships with habitual diet in young adults. Nutr Metab Cardiovasc Dis 2021; 31:2122-2130. [PMID: 34053831 DOI: 10.1016/j.numecd.2021.03.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/13/2021] [Accepted: 03/25/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND AIMS Obesity is characterized as overall or regional adiposity accumulation. However, the metabolic status underlying fat accumulation was not well understood. We sought to identify metabolite profiles based on their correlations with body mass index (BMI), body fat percentage (BFP), waist circumference (WC), and visceral adiposity index (VAI) in young Chinese adults (19-37 years old), and their associations with dietary consumption were also explored. METHODS AND RESULTS A total of 86 plasma samples were analyzed using untargeted lipidomics and metabolomics approaches. Metabolite profiles of adiposity indices were identified using random forest modelling. Ridge regression was used to generate metabolite scores. Overall, 30, 46, 30, and 20 metabolites correlated with BMI, BFP, WC, and VAI, respectively, which resulted in metabolite scores for each index. Top three enriched categories of the identified metabolites were glycerophospholipids, glycerolipids, and sphingolipids, with some specific metabolites (such as phosphatidylserine (37:2), phatidylethanolamine (42:4), and ceramide (40:0)) exclusively associated with overall adiposity, and some other metabolites exclusively associated with abdominal adiposity indices, e.g., triradylglycerol (45:0, 52:4, and 35:0) and diacylglycerol (38:4, 36:3, and 36:5). Moreover, metabolite scores were negatively associated with the intake of food rich in protein or fiber, while they were positively associated with food rich in carbohydrate, with similar results for adiposity indices. CONCLUSION We observed unique metabolite profiles of regional or overall fat deposition in young adults. Glycerophospholipids, glycerolipids, or sphingolipids may be involved in the regulation of adiposity accumulation, affected by dietary exposures.
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Affiliation(s)
- Kun Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, 710061, Xi'an, Shaanxi, China
| | - Lin Shi
- School of Food Engineering and Nutritional Science, Shaanxi Normal University, Xi' an, 710062, China; Xi'an Key Laboratory of Characteristic Fruit Storage and Fresh-keeping, Xi'an, Shaanxi, China
| | - Baoming Zhang
- Hospital of Stomatology, Xi'an Jiaotong University, Xi'an, 710004, China; School of Public Health, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, 710061, Xi'an, Shaanxi, China
| | - Baibing Mi
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, 710061, Xi'an, Shaanxi, China
| | - Jiaomei Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, 710061, Xi'an, Shaanxi, China
| | - Xiaomin Sun
- Global Health Institute, Department of Nutrition and Food Safety, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China
| | - Xia Liao
- Department of Nutrition, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xiaoshuang Dai
- BGI Institute of Applied Agriculture, BGI-Agro, Shenzhen, 518083, China
| | - Lingxia Zeng
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, 710061, Xi'an, Shaanxi, China
| | - Xin Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, 710061, Xi'an, Shaanxi, China.
| | - Hong Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, 710061, Xi'an, Shaanxi, China; Nutrition and Food Safety Engineering Research Center of Shaanxi Province, Key Laboratory of Environment and Genes Related to Diseases, Xi'an Jiaotong University, 76 West Yanta Road, 710061, Xi'an, Shaanxi, China.
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Djoussé L, Zhou G, McClelland RL, Ma N, Zhou X, Kabagambe EK, Talegawkar SA, Judd SE, Biggs ML, Fitzpatrick AL, Clark CR, Gagnon DR, Steffen LM, Gaziano JM, Lee IM, Buring JE, Manson JE. Egg consumption, overall diet quality, and risk of type 2 diabetes and coronary heart disease: A pooling project of US prospective cohorts. Clin Nutr 2021; 40:2475-2482. [PMID: 33932789 PMCID: PMC8564713 DOI: 10.1016/j.clnu.2021.03.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 01/25/2021] [Accepted: 03/02/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND AIMS Data on the relation of egg consumption with risk of type 2 diabetes (T2D) and coronary heart disease (CHD) are limited and inconsistent. Few studies have controlled for overall dietary patterns in egg-T2D or egg-CHD analyses, and it is unclear whether any observed elevated risks of T2D and CHD with frequent egg consumption is real or due to confounding by dietary habits. We tested the hypothesis that frequent egg consumption is associated with a higher risk of T2D and CHD risk after adjustment for overall dietary patterns among adults. DESIGN We used prospective cohort design to complete time-to-event analyses. METHODS We pooled de novo, harmonized, individual-level analyses from nine US cohorts (n = 103,811). Cox regression was used to estimate hazard ratios separately in each cohort adjusting for age, ethnicity, body mass index (BMI), exercise, smoking, alcohol intake, and dietary patterns. We pooled cohort-specific results using an inverse-variance weighted method to estimate summary relative risks. RESULTS Median age ranged from 25 to 72 years. Median egg consumption was 1 egg per week in most of the cohorts. While egg consumption up to one per week was not associated with T2D risk, consumption of ≥2 eggs per week was associated with elevated risk [27% elevated risk of T2D comparing 7+ eggs/week with none (95% CI: 16%-37%)]. There was little evidence for heterogeneity across cohorts and we observed similar conclusions when stratified by BMI. Overall, egg consumption was not associated with the risk of CHD. However, in a sensitivity analysis, there was a 30% higher risk of CHD (95% CI: 3%-56%) restricted to older adults consuming 5-6 eggs/week. CONCLUSIONS Our data showed an elevated risk of T2D with egg consumption of ≥2 eggs per week but not with <2 eggs/week. While there was no overall association of egg consumption with CHD risk, the elevated CHD observed with consumption of 5-6 eggs/week in older cohorts merits further investigation.
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Affiliation(s)
- Luc Djoussé
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Boston VA Healthcare System, Boston, MA, USA.
| | - Guohai Zhou
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Nanxun Ma
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Xia Zhou
- University of Minnesota School of Public Health Division of Epidemiology and Community, Health, Minneapolis, MN, USA
| | | | - Sameera A Talegawkar
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health at the George Washington University, Washington, DC, USA
| | | | - Mary L Biggs
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | | | - Cheryl R Clark
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - David R Gagnon
- Boston VA Healthcare System, Boston, MA, USA; Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Lyn M Steffen
- University of Minnesota School of Public Health Division of Epidemiology and Community, Health, Minneapolis, MN, USA
| | - J Michael Gaziano
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Boston VA Healthcare System, Boston, MA, USA
| | - I-Min Lee
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Julie E Buring
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
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Nestel PJ, Sullivan DR, Mori TA. Dietary management of cardiovascular risk including type 2 diabetes. Curr Opin Endocrinol Diabetes Obes 2021; 28:134-141. [PMID: 33186195 DOI: 10.1097/med.0000000000000589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Recent changes or confirmations linking patterns of eating and specific dietary interventions in the management of cardiovascular risk factors including associations with prevalent and incident type 2 diabetes. RECENT FINDINGS Recently published guidance for dietary management of cardiovascular risk and type 2 diabetes have mostly common features. Major findings include a trend to replace strict quantitative advice on nutrients with qualitative advice on food consumption with exceptions for diabetes, global advice to increase intake of plant foods, confirmation to substitute mono and polyunsaturated oils for saturated and trans fats, new advisory on supplemental omega-3 intake, less limitation on dairy foods and fermented dairy foods encouraged, reduced emphasis on specific cholesterol-rich foods allowing greater consumption of eggs except for people with diabetes, processed meat consumption limited allowing modest intake of lean red meat, distinguishing between 'healthy' and 'unhealthy' carbohydrates including sugars, and maintaining advice on healthy bodyweight, reducing salt intake and encouraging water as preferred beverage. SUMMARY The new guidance for healthier patterns of food consumption supported by evidence is more readily understood by health practitioners and translatable to consumers and patients.
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Affiliation(s)
| | - David R Sullivan
- Department of Chemical Pathology, Royal Prince Alfred Hospital, NSW Health Pathology, Camperdown
| | - Trevor A Mori
- Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
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21
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Hahn J, Dehghan M, Drouin-Chartier JP, Mentz RJ, Jneid H, Virani SS, Tang WHW, Krittanawong C. Egg Consumption and Risk of Cardiovascular Disease: a Critical Review. CURRENT EMERGENCY AND HOSPITAL MEDICINE REPORTS 2021. [DOI: 10.1007/s40138-021-00225-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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22
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Sugano M, Matsuoka R. Nutritional Viewpoints on Eggs and Cholesterol. Foods 2021; 10:494. [PMID: 33669005 PMCID: PMC7996514 DOI: 10.3390/foods10030494] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/20/2021] [Accepted: 02/22/2021] [Indexed: 12/17/2022] Open
Abstract
Although most current epidemiologic studies indicate no significant association between consuming one egg daily and blood cholesterol levels and cardiovascular risk, arguments still persist with a positive association. Since the diet is one of the most influential factors for this association, we illustrate characteristic features in Japanese people whose dietary pattern is distinct from that, for example, the US (United States) population. Available epidemiologic studies in healthy Japanese people show no association between consumption of one egg daily and blood cholesterol level, consistent with those observed in the US population. However, when consumption of major nutrients and food sources of cholesterol are compared to the US population, Japanese people may have an extra-reserve against the influence of eggs on cardiovascular risk markers, despite consuming relatively more eggs. Further discussion on the influence of nutrients contained in the egg and dietary pattern, including interaction with gut microbes, is necessary. In addition, special consideration at the personalized level is needed for judgment regarding dietary cholesterol not only for hypercholesterolemic patients but for hyper-responsive healthy persons. Although randomized controlled trials with long-term follow-up are required to evaluate the association between consumption of eggs and human health, available information, at least from the nutritional viewpoint, suggests that egg is a healthy and cost-efficient food worldwide.
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Affiliation(s)
- Michihiro Sugano
- Kyushu University, Fukuoka 819-0395, Japan;
- Prefectural University of Kumamoto, Kumamoto 862-8502, Japan
- Japan Egg Science Society, Tokyo 182-0002, Japan
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23
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Nestel PJ, Beilin LJ, Clifton PM, Watts GF, Mori TA. Practical Guidance for Food Consumption to Prevent Cardiovascular Disease. Heart Lung Circ 2020; 30:163-179. [PMID: 33158734 DOI: 10.1016/j.hlc.2020.08.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/28/2020] [Accepted: 08/28/2020] [Indexed: 02/07/2023]
Abstract
This dietary guidance, informed by best contemporary evidence, aims to assist medical practitioners and allied health professionals in advising patients for the primary and secondary prevention of cardiovascular disease (CVD). While differing in some details from other current guidelines, the core messages accord with those published in 2019 by the American College of Cardiology/American Heart Association and the European Society of Cardiology/European Atherosclerosis Society; the National Lipid Association in 2014 and the NH&MRC Australian Dietary Guidelines in 2013. These were assessed through the Appraisal of Guidelines for Research and Evaluation (AGREE II) and the levels of evidence and classes of a recommendation developed using the GRADE system. Recommendations with high levels of evidence include increased consumption of plant based foods comprising mainly complex, fibre enriched carbohydrates (wholegrains, fruits and vegetables) while limiting intake of refined starches; partial replacement of saturated fats with monounsaturated or polyunsaturated fats and oils; reduced salt intake; achievement and maintenance of healthy weight; and low-to-moderate consumption of alcohol. Additional guidance but with moderate levels of evidence includes increased consumption of fish (and fish oils where indicated); reduction in sugar-sweetened beverages and added sugars; avoidance of butter and cream especially in those at increased CVD risk but encouragement of yoghurt; allow moderate consumption of lean meat but limit intake of processed meats; and limit cholesterol-rich foods such as eggs and crustaceans for those at increased CVD risk. Guidance has been formulated qualitatively on food categories of commonly eaten foods while avoiding prescriptive quantitative measures that are less readily translatable. This approach accords with current guidelines such as the American College of Cardiology/American Heart Association 2019 guidelines and is understandable and readily implemented.
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Affiliation(s)
- Paul J Nestel
- Baker Heart and Diabetes Institute, Melbourne, Vic, Australia.
| | - Lawrence J Beilin
- Medical School, University of Western Australia, Perth, WA, Australia
| | - Peter M Clifton
- School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia
| | - Gerald F Watts
- Medical School, University of Western Australia, Perth, WA, Australia
| | - Trevor A Mori
- Medical School, University of Western Australia, Perth, WA, Australia
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Dehghan M, Mente A, Yusuf S. Eggs and diabetes: 1 daily egg a safe bet? Am J Clin Nutr 2020; 112:503-504. [PMID: 32869067 DOI: 10.1093/ajcn/nqaa183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Mahshid Dehghan
- Population Health Research Institute, Hamilton, Ontario, Canada
| | - Andrew Mente
- Population Health Research Institute, Hamilton, Ontario, Canada
| | - Salim Yusuf
- Population Health Research Institute, Hamilton, Ontario, Canada
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