Recently, a reader asked me to peel back the latest nutrition advice on eggs. In particular, he requested some clarity on conflicting advice for people with diabetes. Let’s get crackin’!
Dietary Cholesterol vs. Blood Cholesterol
Following years of research and input from scientific studies, health expert’s advice has changed from limiting eggs to liberalizing them. As reported in the Harvard T.H. Chan School of Public Health, previous advice was “based on guesswork.” They write, “Given that the artery-clogging plaques that cause heart disease are made mostly from cholesterol, and since eggs contain cholesterol” it was commonly believed that eating eggs posed a risk for heart attacks.
The current 2015-2020 USDA Guidelines state that, rather than contributing to high cholesterol and risk for heart disease, “dietary cholesterol is not considered a nutrient of concern for over-consumption… available evidence shows no appreciable relationship” between heart disease and how much dietary cholesterol you eat.
Which means — you can eat more eggs? Maybe!
Eggs pack a bunch of good nutrition in a very small package.
Eggs, a rich source of dietary cholesterol, are also a potent source of a variety of healthful nutrients, including vitamins and minerals.
A chicken egg has only about 80 calories each, and packs 7 grams of high-quality protein, all in the white. The yolk contains a significant amount of brain-nutrient choline, plus vitamin B12, and iron. One of the few food sources of vitamin D, eggs are also good sources of vitamin A and carotenoids lutein and zeaxanthin, helpful in reducing the risk of age-related macular degeneration, the leading cause of blindness in older adults.
Cholesterol plays a number of vital roles in body chemistry. It is a component of all major sex hormones, including estrogen, progesterone and testosterone. It’s part of our immune system, and it’s needed for brain function. Cholesterol is necessary for formation of cell membranes, vitamin D, and bile acids, which aid in digestion and vitamin absorption. We make most of our body’s cholesterol in our liver from dietary fat, carbohydrates and proteins.
Cholesterol is found only in animal foods, and in some more than others. For example, one egg yolk contains about 184 mg, an ounce of chicken liver contains 158 mg, and an ounce of wild sockeye salmon only 24 mg.
Very early in the 20th century the “lipid hypothesis” linked consumption of cholesterol-rich foods and saturated fat to clogged arteries. Read more here. Subsequent research has helped consumers separate fat from facts.
For most people, eating foods high in dietary cholesterol doesn’t mean a higher risk for heart disease — the body typically self-regulates and produces less blood cholesterol in response to more dietary cholesterol.
What About Eggs and Diabetes?
Since people with diabetes have a higher risk for heart disease, it may be prudent to limit to about one whole egg daily, or less, without a limit on egg whites. Nancy T. Smith, Lead Dietitian for Tallahassee Memorial Hospital Metabolic Health Center in Tallahassee, Florida and a diplomate of the Accreditation Council for Clinical Lipidology/Clinical Lipid Specialist since 2013, notes that in 2015, the National Lipid Association, based on research, published recommendations that advises limiting dietary cholesterol to less than 200 mg daily (one whole egg has 184 mg) for people who need to lower atherogenic lipids, as people with diabetes do. In an email to me she said, “I generally recommend that my patients with diabetes limit egg yolks to 3 or less per week.” Read the recommendations from the Journal of Clinical Lipidology here.
A recent 2017 study published in the Canadian Journal of Diabetes looked at the relationship between egg consumption and risk for heart disease in people with type 2 diabetes and concluded, “Results from randomized controlled trials suggest that consumption of 6 to 12 eggs per week, in the context of a diet that is consistent with guidelines on cardiovascular health promotion, has no adverse effect on major CVD risk factors in individuals at risk for developing diabetes or with type 2 diabetes.” It is still conflicting advice for people with diabetes, but…
In the Context of a Heart-Healthy Diet!
One thing’s for sure: it’s your total diet — what you eat day-by-day — that contributes to health or is harmful.
The “best” diet pattern is a whole-foods, plant-based diet. Ditch refined carbs, greasy animal fats, white flour, juices and sugary drinks — linked to inflammation and increased risk for heart disease. Benefit from healthy fats, whole fruits and vegetables, whole grains and legumes. And… eggs.
All of an egg’s 7 grams of protein is found in the white, and the yolk contains about 5 grams of mostly monounsaturated fat, plus iron, vitamins, minerals, and carotenoids… and dietary cholesterol. Eggs are also inexpensive, easy to cook, and easily digestible.
People with type 2 diabetes typically need to watch their weight, since overweight and obesity is a proven risk factor for this disease. And although eggs can be safely incorporated into any heart-healthy diet, it’s not the eggs, it’s the additions that make them healthy or …
Jill Weisenberger, a registered dietitian and certified diabetes educator, wrote to me that based on the most current research, she’s comfortable recommending whole eggs to her clients with diabetes. She says, “I truly believe this has to do with the company eggs keep. If you eat eggs with bacon and biscuits, you’re likely to have a different outcome than if you eat eggs with veggies, whole wheat toast, avocado and fresh fruit.”
My favorite egg-inspired dish is an open-faced omelet, a frittata: eggs whipped and cooked in a nonstick skillet with a little olive oil, with plenty of chopped vegetables (my favorites are garlic, onions, bell peppers, and spinach), and topped with crumbled feta or shaved Parmesan cheese (both naturally low in saturated fat). Email me for the recipe.
Rob Gray, Gran Roca farm founder and food guru, knows his chickens! He told me the best eggs are from pastured chickens, which he’s raising on his sustainable farm in beautiful Yunguilla. Pastured chickens are happier when not cooped up with thousands of other birds! Where they’re ranging and scratching and gobbling organic greens and nutrient-rich insects. Their eggs are naturally richer in omega-3 fatty acids compared to eggs from chickens fed corn or soybeans. Rob estimates by November 2017 he’ll be coming to his Cuenca market with fresh eggs from the farm, and I can’t wait! In the meanwhile, if you have a favorite source for pastured eggs, feel free to post below.
Bonus! Five Fun Egg Tips
- Having a hard time getting your hard-boiled eggs to cook properly? Bake them! I just experimented and I’m happy to report, it works! Preheat your oven to 325 F (163 C), put the eggs into a muffin tin (allow the eggs to reach room temp first if they’re refrigerated) and bake for 30 minutes. Then immediately place the eggs into big bowl of ice water until cool. They peeled just fine, no green ring, great texture. Click here for detailed instructions from Wikihow.com
- My friends on Food & Cooking in Ecuador’s Facebook page are in agreement about the most reliable way to cook hard-boiled eggs — in a pressure cooker! Pressure “steam” eggs, at low pressure. Learn more from HipPressureCooking.
- How to tell if the egg is fresh? Float it! Fill a bowl with water, gently drop the egg in, and if it sinks to the bottom and lies flat, it’s fresh. The older it is, the more likely it is to float. The air pocket in the fat portion of the egg increases in size the older an egg gets. The older the egg, the less nutrition it has.
- Wash your eggs only when you’re ready to use them, and crack on a flat surface as to not push any bacteria into them. Washing removes the “cuticle” that keeps them fresh. An unrefrigerated egg will stay fresh, unwashed, for at least two weeks, and unwashed and stored in the refrigerator, about two to three months.
- You can freeze eggs! Not in the shell, but blend the whites and eggs and store in the freezer, and thawed they’re great for scrambled eggs, quiches and any recipe calling for whole eggs. Learn more from CupCakeProject.com.
Have an egg-ceptional day!
American College of Allergy, Asthma & Immunology. Egg Allergy. http://acaai.org/allergies/types/food-allergies/types-food-allergy/egg-allergy
British Medical Journal. Egg consumption and risk of coronary heart disease and stroke: http://www.bmj.com/content/346/bmj.e8539
Canadian Journal of Diabetes. Impact of egg consumption on cardiovascular risk factors in individuals with type 2 diabetes and at risk for developing diabetes: a systematic review of randomized nutritional intervention studies. https://www.ncbi.nlm.nih.gov/pubmed/28359773
Harvard T.H. Chan School of Pubic Health. Eggs, fats, and the new dietary guidelines. https://www.hsph.harvard.edu/news/hsph-in-the-news/eggs-fats-and-the-new-dietary-guidelines/
Health.gov. Dietary Guidelines for Americans 2015-2020. Eighth Edition. https://health.gov/dietaryguidelines/2015/guidelines/
Journal of Clinical Lipidology. National Lipid Association Recommendations for Patient-Centered Management of Dyslipidemia: Part 2. http://www.lipidjournal.com/article/S1933-2874(15)00380-3/fulltext#sec2.5
Journal of Lipid Research. In celebration of the 100th anniversary of the lipid hypothesis of atherosclerosis. http://www.jlr.org/content/54/11/2946.full