Dietary cholesterol, eggs and coronary heart disease risk in perspective

A General Review of Methodologies Used in the Determination of Cholesterol (C27H46O) Levels in Foods

Cholesterol (C27H46O) is a lipid-derived substance found in lipoproteins and cell membranes. It is also one of the main sources for the production of bile acids, vitamin D, and steroid hormones. Today, foods are evaluated by consumers not only according to their taste and nutritional content but also according to their effects on consumer health. For example, many consumers choose foods according to their cholesterol level. The cholesterol in the food can directly affect the blood cholesterol level when consumed, which can lead to cardiovascular diseases. High levels of cholesterol can lead to diet-related human diseases such as cardiac arrest, paralysis, type II diabetes, and cerebral hemorrhage. In societies with high living standards, interest in and consumption of foods that lower or have low cholesterol levels have increased recently. Accordingly, efforts to increase the variety of foods with reduced cholesterol levels are on the rise. This has indirectly led to the accurate measurement of cholesterol levels in blood and food being of great importance. Classical chemical, enzymatic, colorimetric, polarographic, chromatographic, and spectrophotometric methods; enzymatic, nonenzymatic, and electrochemical sensors; and biosensors are used for the determination of cholesterol in foods. The purpose of this review is to reveal and explore current and future trends in cholesterol detection methods in foods. This review will summarize the most appropriate and standard methods for measuring cholesterol in biological components and foods.

Effect of Sodium Selenite, Selenium Yeast, and Bacterial Enriched Protein on Chicken Egg Yolk Color, Antioxidant Profiles, and Oxidative Stability

The chicken egg is one of nature's flawlessly preserved biological products, recognized as an excellent source of nutrients for humans. Selenium (Se) is an essential micro-element that plays a key role in biological processes. Organic selenium can be produced biologically by the microbial reduction of inorganic Se (sodium selenite). Therefore, the possibility of integrating Se enriched bacteria as a supplement in poultry feed can provide an interesting source of organic Se, thereby offering health-related advantages to humans. In this study, bacterial selenoproteins from Stenotrophomonas maltophilia was used as a dietary supplement with other Se sources in Lohman brown Classic laying hens to study the egg yolk color, egg yolk and breast antioxidant profile, oxidative stability, and storage effect for fresh and stored egg yolk at 4 ± 2 °C for 14-days. The results showed that dietary Se supplementation significantly (p < 0.05) improved egg yolk color, the antioxidant profile of egg yolk, and breast meat (total carotenoid and phenol content). When the Se treated groups were compared to control groups, there was a significant (p < 0.05) decrease in total cholesterol in fresh and stored egg yolk and breast muscle. In hens that were fed ADS18-Se, the primary oxidation products (MDA) concentrations in the eggs, breast, and thigh muscle, and plasma were significantly (p < 0.05) lower. However, the MDA content increased (p < 0.05) with an extended storage time in egg yolk. In comparison to inorganic Se and basal diets, egg yolk from hens fed organic Se remained fresh for two weeks. The egg yolk color, antioxidant profile, and oxidative status of egg yolk and tissue improve with dietary Se organic supplementation (ADS18 > Se-Yeast). The source of supplemented organic Se is critical for egg enrichment and antioxidant properties. As a result, ''functional eggs'' enriched with organic Se becomes possible to produce.

Egg Quality from Siciliana and Livorno Italian Autochthonous Chicken Breeds Reared in Organic System

In poultry production, the intensive use of high-performing hybrid animals led to loss of genetic variability and a consequent lower response to climatic change and disease. Poultry biodiversity is seriously threatened, and its safeguard is a strong objective in developed countries. According to the FAO, which emphasized the importance of native breeds for its country of origin, the aim of this study was to present the first contribution on eggs quality for endangered the Siciliana chicken breed and deepen knowledge on the local Livorno breed. At 20 weeks of age, 108 laying hens (54 Siciliana breed and 54 Livorno breed) were divided into six homogeneous groups of 18 hens each and reared according to requirements imposed by the EC Regulation 889/08 for organic production. The production cycle was controlled over one year, and egg production was recorded daily by group. Eggs were collected, weighted, and measured. Physico-chemical parameter and fatty acids profile were analyzed and nutritional indexes calculated. The statistical model included the effects of breed (Siciliana, Livorno). Egg production was 190 egg/head for Siciliana and 180 for Livorno group. The results showed similar values for Siciliana and Livorno egg quality, highlighting several valuable quality traits from these breeds which might be taken into account for conservation programs.

Could Eggs Help Increase Dietary Protein Intake in Older Adults? - Exploring Reasons for the Consumption and Non-Consumption of Eggs in People over 55 years old

Compared to other protein-rich foods, eggs are of soft texture, easy to cook, and low cost, and may be useful in increasing protein intakes in older adults. Focus groups and interviews were used to explore all reasons for consuming and not consuming eggs in older adults. Forty-two individuals (20 males, 22 females, aged 56-96 years) took part in one of eight focus groups or two individual interviews. Thematic analyses revealed 69 different reasons for eating or not eating eggs in this population. Reasons were related to: hedonics, properties of the food, preparation style, convenience, physical environment, variety, physical health/abilities, nutrition and health knowledge, food safety, social environment, morality, emotion, and habit. Some of these reasons are likely to be specific to egg consumption in older adults, e.g. properties of the food and convenience combined with physical health/abilities. Some reasons are also likely to be more relevant to older than younger individuals, e.g. medical factors. Investigation of the reasons most related to intake on a population-wide scale would aid the development of interventions.

Intake of up to 3 Eggs/Day Increases HDL Cholesterol and Plasma Choline While Plasma Trimethylamine-N-oxide is Unchanged in a Healthy Population

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.

Dietary Factors in Reducing Risk of Cardiovascular Diseases

Diet influences many modifiable risk factors for cardiovascular diseases (CVDs). Considering this, moderation of total dietary fat, particularly trans and saturated fats, as well as cholesterol is recommended. Dietary fats should come mainly from plants and fatty fish, providing monounsaturated and polyunsaturated (including omega-3) fatty acids. Carbohydrate sources to emphasize include whole grains, legumes, vegetables, fruits, and other fiber-rich sources, rather than sugars. Although vitamins such as E, C, and some B vitamins are associated with reduced CVD risk, data do not support the use of supplements, but foods rich in these nutrients are advocated. Dietary minerals such as potassium, magnesium, and calcium may be beneficial to heart health, while reduction of dietary sodium decreases risk of hypertension. A large variety of phytonutrients are also associated with reduced CVD risk. Other dietary factors receiving research attention regarding CVD risk. Other dietary factors receiving research attention regarding CVD risk include caffeine, alcobol, and meal frequency, although more work is needed in these areas. In contrast, data are quite robust to support the importance of healthy body weight management in cardiovascular health. In general, diets based on a variety of less processed foods, mainly of plant origin, in the context of an active lifestyle, are conducive to heart health.

Fatty acid and cholesterol profiles and hypocholesterolemic, atherogenic, and thrombogenic indices of table eggs in the retail market

Background

Eggs are an important source of food due to its favorable effects on human health derived from the protein, fats, minerals, vitamins and bioactive components. We studied the effects of source of eggs in the retail market on fatty acids, lipid profiles and antioxidant status in eggs.

Methods

Eggs from four sources named A, B, C, and D in the retail market were collected to determine fatty acid, total lipid, and cholesterol profiles; hypocholesterolemic, atherogenic and thrombotic indices; antioxidant status (e.g., of malondialdehyde); and total antioxidant capacity in the whole edible parts of eggs (albumen + yolk) and egg yolk. Samples were collected four times and pooled over times to represent 5 and 10 samples per source for determinations of fatty acids and determinations of lipid profiles and antioxidant status, respectively.

Results

Fatty acid, total lipid, and cholesterol profiles; hypocholesterolemic, atherogenic and thrombotic indices; presence of malondialdehyde; and total antioxidant capacity in the whole edible parts of eggs and egg yolk showed significant differences (P ≥ 0.05) among different sources of eggs in retail market. Source D showed higher levels of saturated fatty acids (SFA) and linoleic and monounsaturated fatty acid (MUFA)/polyunsaturated fatty acid (PUFA) ratio but lower levels of MUFA and linolenic, arachidonic, eicosapentaeonic (EPA), decohexaenoic (DHA), and total ω9 fatty acids and lower unsaturated fatty acids (UFA)/SFA ratio. Similar trend was shown in fatty acids profiles of the whole edible parts of eggs. On the other hand, total cholesterol, low density lipoprotein (LDL), LDL/high density lipoprotein (HDL) ratio, and atherogenic and thrombogenic indices and total antioxidant capacity of source D were significantly higher than those of other source, but levels of hypocholesterolemic index, and malondialdehyde levels were lower for source D.

Conclusion

Eggs in the retail market in Jeddah city, Saudi Arabia, from May to August 2015 showed a different pattern of fatty acid and cholesterol profiles; hypocholesterolemic, atherogenic, and thrombogenic indices; and antioxidant status, which might reflect the nutritional and husbandry practice of laying hens. This can affect the nutritional values of eggs, and hence, customer benefits, suggesting the need for standardization and quality control based on nutrient index values.

Dietary cholesterol, heart disease risk and cognitive dissonance

In the 1960s, the thesis that dietary cholesterol contributes to blood cholesterol and heart disease risk was a rational conclusion based on the available science at that time. Fifty years later the research evidence no longer supports this hypothesis yet changing the dietary recommendation to limit dietary cholesterol has been a slow and at times contentious process. The preponderance of the clinical and epidemiological data accumulated since the original dietary cholesterol restrictions were formulated indicate that: (1) dietary cholesterol has a small effect on the plasma cholesterol levels with an increase in the cholesterol content of the LDL particle and an increase in HDL cholesterol, with little effect on the LDL:HDL ratio, a significant indicator of heart disease risk, and (2) the lack of a significant relationship between cholesterol intake and heart disease incidence reported from numerous epidemiological surveys. Over the last decade, many countries and health promotion groups have modified their dietary recommendations to reflect the current evidence and to address a now recognised negative consequence of ineffective dietary cholesterol restrictions (such as inadequate choline intake). In contrast, health promotion groups in some countries appear to suffer from cognitive dissonance and continue to promote an outdated and potentially hazardous dietary recommendation based on an invalidated hypothesis. This review evaluates the evidence for and against dietary cholesterol restrictions and the potential consequences of such restrictions.

The effects of biopolymer encapsulation on total lipids and cholesterol in egg yolk during in vitro human digestion

The purpose of this study was to examine the effect of biopolymer encapsulation on the digestion of total lipids and cholesterol in egg yolk using an in vitro human digestion model. Egg yolks were encapsulated with 1% cellulose, pectin, or chitosan. The samples were then passed through an in vitro human digestion model that simulated the composition of mouth saliva, stomach acid, and the intestinal juice of the small intestine by using a dialysis tubing system. The change in digestion of total lipids was monitored by confocal fluorescence microscopy. The digestion rate of total lipids and cholesterol in all egg yolk samples dramatically increased after in vitro human digestion. The digestion rate of total lipids and cholesterol in egg yolks encapsulated with chitosan or pectin was reduced compared to the digestion rate of total lipids and cholesterol in other egg yolk samples. Egg yolks encapsulated with pectin or chitosan had lower free fatty acid content, and lipid oxidation values than samples without biopolymer encapsulation. Moreover, the lipase activity decreased, after in vitro digestion, in egg yolks encapsulated with biopolymers. These results improve our understanding of the effects of digestion on total lipids and cholesterol in egg yolk within the gastrointestinal tract.

Vitamin D content of food and its contribution to vitamin D status: a brief overview and Australian focus

There are only a few natural foods that contain nutritionally significant quantities of vitamin D. These include egg yolk, some fatty fish, and in much lower concentrations, meat. The published values of the vitamin D content of food are summarised here and their contribution to dietary vitamin D intake is discussed, with particular reference to Australia. Dietary vitamin D is unlikely to reach the level recommended by the US Institute of Medicine. It is therefore concluded that dietary vitamin D will only be a component of vitamin D supply, with UV exposure and/or oral supplements continuing to be the main sources of vitamin D to maintain adequate status.

The good and the bad: what researchers have learned about dietary cholesterol, lipid management and cardiovascular disease risk since the Harvard Egg Study

BACKGROUND

The prevalence of cardiovascular diseases, while lower than it once was, remains a significant health consideration.

AIMS AND METHODS

To review the evolving evidence with respect to what role various factors play in the aetiology of coronary heart disease (CHD).

RESULTS

While total cholesterol and low-density lipoprotein cholesterol (LDL-C) were previously believed to play central roles, it has now become clear that neither in isolation is highly significant. For example, some people with very high LDL-C levels do not develop CHD, while others with very low LDL-C levels do. Furthermore, there is a difference between dietary cholesterol and serum cholesterol. Dietary cholesterol, which is found in animal-based foods, raises blood cholesterol in only approximately one-third of people. Conversely, intake of saturated fatty acids and trans fatty acids can result in dyslipidaemia. Furthermore, obesity--particularly abdominal obesity--and metabolic syndrome both are strong independent risk factors for development of cardiovascular disease.

CONCLUSIONS

Statin therapy and a diet comprising a portfolio of plant sterols and viscous fibres can both significantly reduce LDL-C levels and C-reactive protein. The latter is a key marker of inflammation and of elevated risk for cardiovascular disease.

The role of meat fat in the human diet

Food fat plays an important role in the human diet. On the one hand, fats provide the body with energy, contribute to the absorption of fat-soluble vitamins, and act as structural elements of cell walls. On the other hand, a high fat intake is associated with obesity, type 2 diabetes, cancer, and coronary heart disease. Animal fats, which contain a high proportion of saturated fatty acids, are often the focus of attention when it comes to reducing the share of fat in the diet. The present overview of the literature describes the amount of total fat and the percentage of individual fatty acid groups in meat and meat products, documents the contribution of meat and meat products to fat intake, and investigates the connection between meat fat and various diseases. The information given is based mainly on data material from Switzerland; data from other countries have been included for comparison.

Egg consumption and CHD and stroke mortality: a prospective study of US adults

OBJECTIVE

To evaluate the relationship between egg consumption and CHD and stroke mortality using the Third National Health and Nutrition Examination Survey 1988-1994 (NHANES III) and follow-up survey.

DESIGN

A cross-sectional survey using a stratified, multi-stage probability sample was analysed, adjusting for survey design. Egg consumption was obtained from the FFQ and separated into categories of egg intake. Hazard ratios (HR) were calculated for CHD and stroke mortality using multivariate Cox regression models.

SETTING

A health and nutrition survey conducted in the USA from 1988 to 1994 with follow-up through 31 December 2000.

SUBJECTS

The study population included men and women who were free of CVD and had completed a FFQ at baseline.

RESULTS

Multivariate models adjusting for health, lifestyle and dietary factors indicated that 'high' egg consumption (≥ 7 times/week v. <1 time/week) was not associated with significantly increased CHD mortality (HR = 1·13, 95 % CI 0·61, 2·11 (men); HR = 0·92, 95 % CI 0·27, 3·11 (women)). There was a statistically significant inverse association between 'high' egg consumption and stroke mortality among men (HR = 0·27, 95 % CI 0·10, 0·73), but the estimate was imprecise because of sparse data. We did not observe a statistically significant positive association between 'high' egg consumption and CHD or stroke mortality in analyses restricted to individuals with diabetes, but these analyses may be limited due to the small number of diabetics.

CONCLUSIONS

We did not find a significant positive association between egg consumption and increased risk of mortality from CHD or stroke in the US population. These results corroborate the findings of previous studies.

A comparison of egg consumption with other modifiable coronary heart disease lifestyle risk factors: a relative risk apportionment study

Guidelines from the American Heart Association (AHA) recommend that healthy adults limit their intake of dietary cholesterol to less than 300 mg per day. Since a large egg contains about 71% of that amount, the AHA recommends restricting egg consumption unless dietary cholesterol intakes from other sources are limited. We applied a risk apportionment approach to estimate the contribution of egg consumption and other modifiable lifestyle risk factors (e.g., smoking, poor diet, minimal exercise, and alcohol intake) to coronary heart disease (CHD) risk at the population level. Specifically, we categorized the U.S. adult population ages 25+ into distinct risk groups based on the prevalence of modifiable lifestyle risk factors and applied an apportionment model, typically used to assess risk contribution at the individual level, to estimate the contribution of egg intake to CHD risk. Our analysis shows that the combination of modifiable lifestyle risk factors accounts for less than 40% of the population CHD mortality. For the majority of U.S. adults age 25+, consuming one egg a day accounts for <1% of CHD risk. Hence, focusing on decreasing egg intake as an approach to modify CHD risk would be expected to yield minimal results relative to changing other behaviors such as smoking and other dietary habits.

Angiotensin I converting enzyme inhibitory peptides from simulated in vitro gastrointestinal digestion of cooked eggs

Egg proteins are an excellent source of bioactive peptides. The purpose of this work was to study the effect of cooking methods on the production of angiotensin converting enzyme (ACE) inhibitory peptides. Boiled or fried eggs (in the forms of whites, yolks, and whole eggs) were digested by gastrointestinal tract proteases at simulated gut conditions. Fried egg digests showed more potent activity than those of boiled egg digests; the fried whole egg digest had an IC(50) value of 0.009 mg protein/mL. This hydrolysate was further purified by cation exchange chromatography and gel filtration chromatography. Seven peptides, Val-Asp-Phe (IC(50): 6.59 microM), Leu-Pro-Phe (10.59 microM), Met-Pro-Phe (17.98 microM), Tyr-Thr-Ala-Gly-Val (23.38 microM), Glu-Arg-Tyr-Pro-Ile (8.76 microM), Ile-Pro-Phe (8.78 microM), and Thr-Thr-Ile (24.94 microM), were identified by liquid chromatography-mass spectrometry (LC-MS/MS), and their IC(50) values were predicted by using our previously reported structure and activity models. The presence of several tripeptides from in vitro simulated gastrointestinal egg digest indicates that these peptides may be absorbed into the body and exert an in vivo antihypertensive activity, although in vivo study is needed to confirm this assumption. Our results showed that in vitro digestion of cooked eggs could generate a number of potent ACE inhibitory peptides which may have implications for cardiovascular disease prevention, including hypertension.

Increased dietary cholesterol does not increase plasma low density lipoprotein when accompanied by an energy-restricted diet and weight loss

BACKGROUND

Diets enriched with dietary cholesterol, frequently from eggs, have been shown to produce a small but variable increase in plasma low density lipoprotein (LDL) cholesterol. There is evidence to suggest that energy-restricted diets, that may contain a relatively high proportion of fat and cholesterol, can attenuate the cholesterol-raising effect of dietary cholesterol on plasma LDL.

AIM OF THE STUDY

To determine the combined effects of increased dietary cholesterol and weight loss produced by energy restriction on plasma LDL cholesterol and lipoproteins.

METHODS

A randomized, controlled, parallel study was performed in two groups of free-living volunteers on an energy-restricted diet for 12 weeks, one group was instructed to consume two eggs a day (n = 24), the other, to exclude eggs (n = 21). Dietary advice on energy restriction was based on the British Heart Foundation guidelines on how to lose weight for men and women.

RESULTS

Energy intake fell by 25 and 29% in the egg-fed and non-egg-fed groups, resulting in a moderate weight loss of 3.4 kg (P < 0.05) and 4.4 kg (P < 0.05), respectively. The daily intake of dietary cholesterol increased significantly in the egg-fed group from 278 to 582 mg after 6 weeks. The concentration of plasma LDL cholesterol decreased in the non-egg-fed groups after 6 weeks (P < 0.01) and in the egg-fed and non-egg-fed at 12 weeks relative to baseline. There were no other significant changes in plasma lipoproteins or LDL particle size.

CONCLUSIONS

An increased intake of dietary cholesterol from two eggs a day, does not increase total plasma or LDL cholesterol when accompanied by moderate weight loss. These findings suggest that cholesterol-rich foods should not be excluded from dietary advice to lose weight on account of an unfavorable influence on plasma LDL cholesterol.

Productive performance and meat quality of Mouflon×Sarda and Sarda×Sarda suckling lambs

The objective of this study was to compare slaughtering performance, carcass characteristics, and meat quality in lambs of two different genotypes. Sixteen crossbred Mouflon×Sarda (M×S) and sixteen pure Sarda breed (S×S) suckling lambs were analysed. Chemical and fatty acid composition were determined on semitendinosus and longissimus dorsi muscles and perirenal and pelvic fats. Dressing percentage was higher (P<0.01) in M×S group and after histological dissection M×S carcasses had more muscle tissue (P<0.01) and less separable fat (P<0.05). Muscles of M×S had less cholesterol than the S×S lambs (P<0.01). Polyunsaturated/saturated and n-6/n-3 fatty acids ratios of the intramuscular lipids were optimal in both groups. Indexes of atherogenicity and of thrombogenicity in muscles varied between 0.9 and 1.1. The results indicated several good qualities in both the genotypes, but M×S lambs have some traits which could provide a higher market price.