Abstract
Metabolic syndrome (MetS) is characterized by low-grade inflammation and insulin resistance, which increase the risk of heart disease. Eggs have numerous nutrients including choline, carotenoids, and fat-soluble vitamins that may protect against these conditions. Egg phosphatidylcholine (PC) is a major contributor of dietary choline in the American diet. However, uncertainty remains regarding eggs due to their high concentration of cholesterol. In this study, we evaluated the effect of two sources of choline, whole eggs (a source of PC) and a choline supplement (choline bitartrate, CB), on plasma lipids, glucose, insulin resistance, and inflammatory biomarkers. We recruited 23 subjects with MetS to participate in this randomized cross-over intervention. After a 2-week washout, with no choline intake, participants were randomly allocated to consume three eggs/day or CB (~400 mg choline/d for both) for 4 weeks. After a 3-week washout period, they were allocated to the alternate treatment. Dietary records indicated higher concentrations of vitamin E and selenium during the egg period (p < 0.01). Interestingly, there were no changes in plasma total, low density lipoprotein (LDL)- or high density lipoprotein (HDL)-cholesterol, triglycerides, or glucose, compared either to baseline or between treatments. In contrast, interleukin-6 was reduced, with both sources of choline compared to baseline, while eggs also had an effect on lowering C-reactive protein, insulin, and insulin resistance compared to baseline. This study demonstrates that in a MetS population, intake of three eggs per day does not increase plasma LDL cholesterol, and has additional benefits on biomarkers of disease compared to a choline supplement, possibly due to the presence of other antioxidants in eggs.
Highlights
Metabolic syndrome (MetS) is characterized by dyslipidemia, hypertension, insulin resistance, and large waist circumference, which further increases risk for development of cardiovascular disease (CVD) and type 2 diabetes [1]
Several clinical trials have demonstrated that egg consumption favorably increases plasma high density lipoprotein cholesterol (HDL-C), and improves plasma ratios of low density lipoprotein cholesterol (LDL)-C/HDL-C [8,9]
We demonstrated that, contrary to what we hypothesized based on previous research [25], there were no differences in plasma choline concentrations when we compared intake of egg versus supplement in this group of subjects with MetS
Summary
Metabolic syndrome (MetS) is characterized by dyslipidemia, hypertension, insulin resistance, and large waist circumference, which further increases risk for development of cardiovascular disease (CVD) and type 2 diabetes [1]. While some research reports that dietary cholesterol or egg consumption may increase the risk of CVD [6,7], the majority of current research does not support this claim. Several clinical trials have demonstrated that egg consumption favorably increases plasma high density lipoprotein cholesterol (HDL-C), and improves plasma ratios of low density lipoprotein cholesterol (LDL)-C/HDL-C [8,9]. Studies report that dietary cholesterol in general does not negatively impact plasma cholesterol concentrations or LDL-C/HDL-C ratio [4,8,9,10,11,12]. According to the American heart association, eggs are not significantly associated with risk of CVD, some meta-analysis have reported that in some cases excess dietary cholesterol has been associated with elevations in LDL-C [13]. The low saturated fat content and high concentrations of other beneficial nutrients in eggs may account for the lack of association between eggs and heart disease, despite their high cholesterol content [11,14]
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