Eggs and Health Special Issue.

In 1968, the American Heart Association recommended the consumption of no more than 300 mg/day of dietary cholesterol and emphasized that no more than 3 eggs should be eaten per week, resulting in substantial reductions in egg consumption, not just by diseased populations but alsobyhealthyindividuals,andmoreimportantlybypoorcommunitiesinundevelopedcountieswho were advised against consuming a highly nutritious food.[...].

Egg Consumption and Human Cardio-Metabolic Health in People with and without Diabetes.

The guidelines for dietary cholesterol and/or egg intake for both the general population and those at higher risk of cardiovascular disease (for example, people with type 2 diabetes mellitus (T2DM)) differ between countries, and even for different specialist societies in a country. The disparity between these guidelines is at least in part related to the conflicting evidence as to the effects of eggs in the general population and in those with T2DM. This review addresses the effect of eggs on cardiovascular disease (CVD) risk from both epidemiological research and controlled prospective studies, in people with and without cardio-metabolic disease. It also examines the nutritional qualities of eggs and whether they may offer protection against chronic disease. The evidence suggests that a diet including more eggs than is recommended (at least in some countries) may be used safely as part of a healthy diet in both the general population and for those at high risk of cardiovascular disease, those with established coronary heart disease, and those with T2DM. In conclusion, an approach focused on a person's entire dietary intake as opposed to specific foods or nutrients should be the heart of population nutrition guidelines.

Cholesterol guidelines update: more aggressive therapy for higher-risk patients.

The 2004 update to the National Cholesterol Education Program guidelines goes farther than the 2001 version in suggesting an optional low-density lipoprotein cholesterol (LDL-C) goal of less than 70 mg/dL for patients at "very high risk." It recommends starting both diet and drug therapy in all patients at high or very high risk whose LDL-C level is above the goal level, with the goal of reducing LDL-C by 30% to 40%. These more aggressive guidelines are based on results of five clinical studies published since 2001.

Influence of the number of meals taken per day on cardiovascular risk factors and the energy and nutrient intakes of a group of elderly people.

The aim of this investigation was to analyse the influence of the number of meals per day on a range of cardiovascular risk factors and on the energy and nutrient intakes of a group of elderly people. The participants in this study were 150 elderly people (64 men and 86 women) from Madrid. Food intake was followed over a period of 5 days. "Precise individual weighing" was used to determine the intake of institutionalized subjects (n = 58) whilst "food intake records" were used to register the same for independent subjects (n = 92). The nutrient and energy intake of the studied population was then determined from these data. The number of meals taken was also recorded. Serum cholesterol and triacylglycerol levels were determined using enzymatic methods. In this population, the meal most frequently omitted was breakfast. No subject took only one meal per day, though 7.4% took only two. 56.6% took three meals and 36% took four. No subject took more than four meals per day. As the number of meals taken increased, so too the covering of theoretical energy expenditure, and the intakes of a range of nutrients became closer to those recommended e.g. proteins, fibre, vitamin C, thiamin, riboflavin, calcium, magnesium and iodine. As the number of meals taken per day increased, carbohydrate intake (in g/1000 Kcal and as % of energy) also increased, and approached recommended levels more closely. As observed in other studies, blood cholesterol levels were seen to be negatively correlated with increasing number of meals (r = -0.2297, p < 0.05). Further, those subjects who distributed their food intake more evenly throughout the day showed lower serum cholesterol (p < 0.05). VLDL-cholesterol (p < 0.05) and triacylglycerol levels (p < 0.05). The results favour the distribution of energy intake over the day as a method of improving nutritional status and as a factor that might improve blood lipid profiles.

Cholesterol intake and plasma cholesterol: an update.

The misperception that dietary cholesterol determines blood cholesterol is held by many consumers in spite of evidence to the contrary. Many studies reported over the past 2 years have shown that dietary cholesterol is not a significant factor in an individual's plasma cholesterol level or cardiovascular disease (CVD) risk. Reports from the Lipid Research Clinics Research Prevalence Study and the Framingham Heart Study have shown that dietary cholesterol is not related to either blood cholesterol or heart disease deaths. In a similar manner, 10 clinical trials (1994 to 1996) of the effects of dietary cholesterol on blood lipids and lipoproteins indicate that addition of an egg or two a day to a low-fat diet has little if any effect on blood cholesterol levels. This observation was noted in young men and women with normal cholesterol levels as well as older subjects with elevated plasms cholesterol concentrations. The consistency of the clinical and the epidemiological data demonstrating that dietary cholesterol has little effect on plasma cholesterol in most individuals raises a number of questions regarding the justification of population wide restrictions on dietary cholesterol intake and egg consumption.

Review of human studies evaluating individual dietary responsiveness in patients with hypercholesterolemia.

Individual variation in the low-density-lipoprotein (LDL)-cholesterol response to a cholesterol-lowering diet has been well documented in inpatient and outpatient diet studies. This variation could be due to both clinical and biological factors. Clinical factors include adherence to dietary changes and changes in body weight. Biological factors include specific changes in dietary composition, initial serum cholesterol concentrations, presence of excess body weight, the fractional catabolic rate of LDL with a diet high in saturated fatty acid, the presence of specific isoforms of apoprotein E and apoprotein A-IV, changes in the gene encoding apoprotein B or the apoprotein A-I promoter region, and the ultracentrifugation pattern of LDL lipoproteins. Work exploring the metabolic basis for individual variation in responsiveness to a cholesterol-lowering diet is in its infancy. Careful studies controlling for the clinical influences of responsiveness are needed so that true biological determinants of response can be uncovered.

Level of knowledge and misconceptions about cholesterol: gender and race differences.

This study highlights the differences in knowledge and misconceptions about cholesterol according to gender and race in the United States. Data were obtained from a randomly selected national sample of 1,068 adults. Respondents were asked a series of true-false questions covering such topics as recommended cholesterol levels, how cholesterol is reduced, the effect of diet, smoking habits, and exercise on cholesterol levels, etc. The results indicated that the knowledge level differed according to gender and race.

School lunch: a comparison of the fat and cholesterol content with dietary guidelines.

OBJECTIVE: To compare the fat and cholesterol content of the foods offered and selected in an elementary school lunch program with current dietary guidelines. DESIGN: For 105 school days we recorded the food items selected by elementary school students in an entire school district (262,851 meals) who were given a choice between two entrees. The nutrient content of foods was assessed with a computerized nutrient data base supplemented by the food manufacturers' data. SETTING: Sixteen elementary schools in the Bellevue (Washington) School District. PARTICIPANTS: The number of students eating school lunch averaged 2500 per day, of whom 25% were from households with incomes less than 185% of poverty. INTERVENTION: None. MAIN OUTCOME MEASURES: We determined the nutritional content of the average meal selected; the proportion of days when one of the two offered entrees met fat and cholesterol guidelines; and the proportion of children selecting the entrees that met the guidelines. RESULTS: The average lunch selected had 35.9% of calories from total fat and 12.6% from saturated fat, exceeding the guidelines of 30% and 10%, respectively. Lunch contained an average of 57 mg cholesterol (106 mg/1000 kcal) and met guidelines. One of the two daily entree choices met guidelines for both total fat and saturated fat on 20% of days, and met both fat and cholesterol guidelines on 14% of days. When available, entrees meeting the fat guidelines were chosen by 37% of students, and entrees meeting both fat and cholesterol guidelines were chosen by 34% of students. CONCLUSIONS: In this school district the average lunch selected did not meet the current guidelines for dietary fat; when given the choice, more than one third of students selected the entrees that met these guidelines.