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Egg-Rich Diet Not Harmful in Type 2 Diabetes
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VIENNA — Eggs do not have an adverse effect on lipid levels in patients with type 2 diabetes, a new study indicates. Researchers also found that an egg-rich diet for 3 months was associated with better appetite control and may provide greater satiety."These findings suggest that a high egg diet can be included safely as part of the dietary management of patients with type 2 diabetes," remarked Nicholas Fuller, PhD, from the Boden Institute Clinical Trials Unit, University of Sydney, Australia.
He presented his findings as a poster at the European Association for the Study of Diabetes 2014 Meeting last month and explained that the study was motivated by the negative perception widely held toward egg consumption by patients with type 2 diabetes.Epidemiological studies have also indicated "that high egg consumption, though not associated with adverse cardiovascular outcomes in the general population, may be associated with worse cardiovascular outcomes in people with type 2 diabetes," he said.
National guidelines on egg consumption and total dietary cholesterol intake are inconclusive and also vary widely between different countries, he added.
For example, in Australia, the National Heart Foundation recommends a maximum of 6 eggs per week as part of a diet low in saturated fatty acids for healthy people and in those with type 2 diabetes. However, in the US, guidelines recommend dietary cholesterol be limited to less than 300 mg/day (1 egg has approximately 200 mg of cholesterol) for healthy individuals and suggest that those with type 2 diabetes stick to less than 4 eggs per week.
Dr. Fuller added that, "there is a lack of good-quality prospective data on the effects of high egg consumption in this group [type 2 diabetes patients]."
Trend Toward Increase in HDL in High Egg GroupThe prospective, randomized controlled study led by Dr. Fuller explored health outcomes in people on a high egg diet who had either prediabetes or type 2 diabetes.
The trial was also a weight-maintenance study: subjects attended the clinic monthly and were given a written guide as to the specific types of foods and quantities that could be consumed, with particular emphasis on improving management of diabetes and replacing foods containing saturated fats with foods containing monounsaturated fats and polyunsaturated fats.
The trial lasted for 3 months, a duration in which a change in cholesterol levels can become evident.
A total of 140 participants with a body mass index (BMI) of at least 25 mg/m2 were recruited to either a low egg group (less than 2 eggs per week and protein intake to match that of the high egg group) or 2 eggs per day at breakfast for 6 days per week (high egg group). Lipids were assessed in each group.
The findings showed no significant difference between the 2 groups in levels of HDL cholesterol over the study period. But in the high egg group, there was a within-group trend toward an improvement in HDL of 0.034 mmol/L (P = .07).There were no differences found between the 2 groups with respect to low-density lipoprotein, triglycerides, or glycemic control.
Commenting on the hint at an improvement in HDL in the high egg group, Dr. Fuller suggested that this might be a possible area of future research to confirm whether a high egg diet in those with type 2 diabetes does in fact raise HDL cholesterol.
"Interventions that are associated with increases in HDL cholesterol have been shown to reduce cardiovascular events in people with type 2 diabetes. A further improvement in HDL cholesterol may have been found if the study was of longer duration, if it had been a crossover design, or if a larger sample size had been used," he speculated.
Less Boredom, More Satisfaction, With Egg DietAnd despite both groups being matched for protein intake, the high egg group reported less hunger and greater satiety after meals, Dr. Fuller reported.
"Eggs may also help with greater weight loss and less weight regain than a conventional diet, due to the greater satiety and less hunger reported with a high egg diet," he told Medscape Medical News.Both diets were well accepted, but the high egg group reported a significantly greater enjoyment of foods, less boredom, and more satisfaction with the diet.
The work is expected to be published later this month.
The study was supported by a research grant from the Australian Egg Corporation.
European Association for the Study of Diabetes; September 17, 2014; Vienna, Austria. Abstract 777