Abstract
Eggs are a major source of phospholipids (PL) in the Western diet. Dietary PL have emerged as a potential source of bioactive lipids that may have widespread effects on pathways related to inflammation, cholesterol metabolism, and high-density lipoprotein (HDL) function. Based on pre-clinical studies, egg phosphatidylcholine (PC) and sphingomyelin appear to regulate cholesterol absorption and inflammation. In clinical studies, egg PL intake is associated with beneficial changes in biomarkers related to HDL reverse cholesterol transport. Recently, egg PC was shown to be a substrate for the generation of trimethylamine N-oxide (TMAO), a gut microbe-dependent metabolite associated with increased cardiovascular disease (CVD) risk. More research is warranted to examine potential serum TMAO responses with chronic egg ingestion and in different populations, such as diabetics. In this review, the recent basic science, clinical, and epidemiological findings examining egg PL intake and risk of CVD are summarized.
Highlights
Cardiovascular disease (CVD) claims upwards of 17 million lives worldwide each year [1]
Atherosclerosis is a key contributor to CVD and is characterized by the hardening and thickening of the artery wall caused by accumulation of fatty plaque
Atherosclerosis is an inflammatory disease characterized by infiltration of immune cells, and a lipid disorder; subendothelial accumulation of lipids derived from plasma lipoproteins is a key initiator of plaque development [4]
Summary
Cardiovascular disease (CVD) claims upwards of 17 million lives worldwide each year [1]. Atherosclerosis is an inflammatory disease characterized by infiltration of immune cells, and a lipid disorder; subendothelial accumulation of lipids derived from plasma lipoproteins is a key initiator of plaque development [4]. High-density lipoprotein (HDL) improves CVD through its ability to remove excess lipid from the artery and transport it back to the liver for excretion from the body, a pathway termed “reverse cholesterol transport” (RCT) [7]. Numerous large-scale epidemiological studies have failed to find any association between the intake of eggs and CVD risk [11,12,13]. Dietary PL have emerged as a potential source of bioactive lipids that may have widespread effects on pathways related to inflammation, cholesterol metabolism, and HDL function. The aim of this review is to summarize the recent basic science, clinical, and epidemiological research examining egg PL intake and CVD risk
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