The Dietary Guidelines for Americans no longer provide a limit for dietary cholesterol for healthy people,1 however, some questions remain about the cardiovascular impact in people with diabetes or impaired fasting glucose. This Nutrition Research Update highlights new evidence that supports eggs can be included in a healthy dietary pattern without adverse cardiovascular effects linked to diabetes, and in some cases, can be linked to beneficial outcomes.
Data from the Framingham Offspring Study were used to evaluate the effects of dietary cholesterol alone and in combination with markers of a healthy diet. No statistically significant differences in glucose levels across different categories of dietary cholesterol intake were found over 20 years follow-up, and there was not an increased risk of type 2 diabetes mellitus or impaired fasting glucose associated with higher cholesterol intake.2 In a separate analysis, these prospective data showed “…no adverse association between dietary cholesterol and serum lipid levels or CVD risk amongst those with impaired fasting glucose or Type 2 diabetes.”3 Although eggs contribute cholesterol to the diet, confounding factors have been thought to impact the relationship between egg consumption and risk of diabetes. A recent study found egg consumption is not independently associated with type 2 diabetes risk.4
A 12-week randomized controlled trial in overweight and obese individuals with pre- and type 2 diabetes found that adding one large egg to the daily diet for 12 weeks did not have a negative impact on total cholesterol levels. In this trial, fasting blood glucose was significantly reduced by 4.4% at the final measurement for the egg group.5 Finally, participants with prediabetes or type 2 diabetes had no adverse changes in cardiometabolic markers when 12 eggs/week were incorporated into a 3-month weight loss diet.6
The American Diabetes Association7 and the American Heart Association8 encourage people with diabetes to consume a healthy dietary pattern that includes nutrient-rich foods. A large egg provides 13 essential vitamins and minerals, 6 grams of protein (12% DV), as well as 250 mcg of antioxidants lutein and zeaxanthin, and these new data continue to support that eggs are a beneficial part of healthy dietary patterns.
- U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015-2020 Dietary Guidelines for Americans. 8th Edition. December 2015. Available at http://health.gov/dietaryguidelines/2015/guidelines/.
- Baghdasarian S, Lin H-P, Pickering RT, et al. Dietary Cholesterol Intake Is Not Associated with Risk of Type 2 Diabetes in the Framingham Offspring Study. Nutrients 2018. doi: 10.3390/nu10060665.
- Lin H-P, Baghdasarian S, Singer MR, et al. Dietary Cholesterol, Lipid Levels, and Cardiovascular Risk among Adults with Diabetes or Impaired Fasting Glucose in the Framingham Offspring Study. Nutrients 2018. doi: 10.3390/nu10060770.
- Sabaté J, Burkholder-Cooley NM, Segovia-Siapco G et al. Unscrambling the relations of egg and meat consumption with type 2 diabetes risk. Am J Clin Nutr 2018;108:1-8.
- Pourafshar S, Akhavan NS, George KS, et al. Egg consumption may improve factors associated with glycemic control and insulin sensitivity in adults with pre- and type II diabetes. Royal Society of Chemistry 2018.
- Fuller NR, Sainsbury A, Caterson ID, et al. Effect of a high-egg diet on cardiometabolic risk factors in people with type 2 diabetes: the Diabetes and Egg (DIABEGG) Study – randomized weight-loss and follow-up phase. Am J Clin Nutr 2018;107:1-11.
- American Diabetes Association. Standards of Medical Care in Diabetes – 2017. Diabetes Care. 2017;40 (supplement 1): S33-43.
- Fox CS, Golden SH, Anderson C, et al. Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence: A Scientific Statement From the American Heart Association and the American Diabetes Association. Diabetes Care 2015;38:1777-1803.