Spotlight on Eggs

With spring upon us, the opportunity presents itself to examine a food that has been under scrutiny over the last four decades. Spotlight is on - the egg.

The nutritional benefit versus bodily detriment of the esoteric egg is even disputed among professionals. Eggs have been said to increase one’s risk for a heart attack and stroke, yet in the same breath potentially lower their risk for type 2 diabetes, help increase muscle building after a work out, and are a good source of 11 essential nutrients. So, what is it? Do we welcome them on our plates or toss them aside. Let’s get crackin’.

Few foods are versatile enough to make their way into any dish of the day. Whether as the focal point of a meal or the gel that holds it together, the adaptable egg always gets an invite. To other foods, the egg is that friend who is down for anything.

For breakfast it shines- scrambled, poached, fried, etc. Eggs hit a high note before most of the population jumps out of bed. They bake and sizzle their way onto our plates, holding the weighty role of being the first food your body may greet as it prepares to start the day. For lunch and dinner they are surreptitious, often making their way into cream sauces, pastas and baked goods. They can do double duty, plopping themselves on top of a burger, then deftly blending into the mayonnaise that covers the bun.

Today, consumers are fortunate to have eggs available year round. However, throughout antiquity chickens began to produce eggs come springtime. Conditions were fitting this time of year, when there was plenty of daylight and the temperature was moderate. It is not coincidental that eggs make their way into Seder and Easter plates, since these celebrations take place during a time when eggs are abundant.

Technically, eggs can be laid by numerous female species, including birds, reptiles, amphibians, and fish. For the sake of simplicity, I’m focusing on the prevalent chicken egg. Considering the chicken was one of the first domesticated animals, estimated to go back as far as 5400 BC in China and India, eggs have been incorporated into the human diet for literally thousands of years. Once domesticated, chickens would make the trek across the globe, thus, eggs for everyone!

For most, the savory flavor of an egg has never been questioned. However, the same cannot be said for its impact on human health.  First, the nutritional breakdown: per one large chicken egg, you will find 80 calories, 5 grams fat (1.6 saturated, 0.7 polyunsaturated, 2.0 monounsaturated), between 180 to 200 milligrams cholesterol, less than 1 gram carbohydrate, and 6 grams protein.

The amount of cholesterol found in eggs has been of concern due to the prior thought that excessive consumption from it in food would result in an increase of our very own serum cholesterol levels. However, in 2015, the Dietary Guidelines Advisory Committee (DGAC) released a statement that rocked the nutrition world to its core (or in this case, its yolk?). Since the 1970’s, the medical field advised the public to eat less than 300 mg of cholesterol a day. Considering the average large egg at the time was thought to contain around 270 mg, a person could surpass their daily allotment with a morning Western Omelet. This year, the tables have turned, and the shadow that hovered over the humble egg has lightened. When referring to the 300 mg per day recommendation, they wrote, “The 2015 DGAC will not bring forward this recommendation because available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum (blood) cholesterol, consistent with the AHA/ACC (American Heart Association/American College of Cardiology) report. Cholesterol is not a nutrient of concern for overconsumption.” 

Bold statement, especially given that the previous recommendation was to limit egg-yolk intake to 3-4 per week. How is the panel of 14 experts in the fields of nutrition, public health, and medicine coming to this conclusion?

A meta-analysis published in 2013, reviewed research studies looking at the connection between egg consumption with coronary heart disease and stroke. After identifying 17 studies that fit their criteria, their work suggests that higher egg consumption (defined as eating up to one egg per day) is not associated with increased risk of coronary heart disease or stroke. However, when taking a closer at just diabetic patients (who are at higher risk for heart disease) the results were not as clear-cut. Oddly enough, they found an increased risk of coronary heart disease among diabetic patients who had high egg consumption, yet a reduced risk of hemorrhagic stroke. Ultimately, they concluded further studies are needed on the diabetic subgroup. 

When I read this, I was left perplexed. On the side of caution, I would assume one would still want to be weary of egg consumption, especially since diabetes can go undetected for years. But wait. Just this week the University of Eastern Finland submitted research to the American Journal of Clinical Nutrition that found egg consumption may actually benefit someone at risk for developing type 2 diabetes.  Researchers followed 2,332 men (ages 42-60) for 19.3 years, and during that time recorded that 432 of those men developed type 2 diabetes. The kicker? They concluded that egg consumption was associated with a reduced risk of type 2 diabetes. In fact, men who ate on average four eggs per week had a 37% decreased chance of developing the disease as opposed to the men who only ate one egg per week. However, eating more than four eggs per week showed no additional benefit.

The mixed messages can be mind boggling, and to be honest we are still getting more research to review. However, some undeniable facts have emerged. According to Dr. Steven Nissen, the Cardiovascular Medicine chairman at the Cleveland Clinic, only 15% of your very own circulating serum cholesterol comes from your diet, and the remaining 85% comes from what your liver makes and sends out. Therefore, keeping your liver healthy is priority number one.

As a whole, there is lack of evidence to support that eggs alone should be limited for improved health. Of course we have to be realistic. Now that I have officially scrambled both yours and my own brain, it is time to assess the big picture.     

      

Don’t judge a food by a single nutrient

      Regardless of the controversy surrounding dietary cholesterol, eggs are still loaded with beneficial nutrients known to support and improve health. They contain high quality protein, caretonoids like lutein and zeaxanthin, choline, B vitamins, and oh so much more. Arguably one of the most important attributes is its Vitamin D content. With 40 international units per large egg, it is one of the few dietary sources where Vitamin D can be found. Given the high prevalence of Vitamin D deficiency among those living in northern climates with little sunlight, this is a crucial fact to make known.

Shift your focus: what else are you eating with your eggs?

      Although dietary cholesterol may be out of the limelight, there is still concern regarding saturated and trans fat’s potential to increase risk of heart disease. It is important to keep in mind what typically is served with your eggs in the morning. If you are choosing bacon and cheese then placing it over a croissant, I hate to burst your bubble but the egg is not the concern in this meal. However, if you added sautéed vegetables to your egg scramble, well you just used it as an avenue to load even more nutrients into your body. Also, think of what else you choose throughout the entire day, not just in combination with the egg. Unless you are deathly allergic to a specific ingredient, the odds of a single food being the cause of your health’s demise are very slim. Reassess all of your choices. It should be noted that when research only collects food recalls, this is a difficult factor to adjust for, and should be kept in mind when reviewing results.

What are you eating in place of your eggs?

      This final point is coming from personal experience. In clinic, I may hear a patient proudly report that they have renounced eggs in their diet, yet as a substitute are now eating cinnamon sugar bagels with light cream cheese. Now, I’m not saying this delicious breakfast isn’t okay occasionally. However, the shift to a food with a high sugar content makes this concerning if consumed on a daily basis.


Rather than fat-shaming eggs, let's learn to embrace them as a convenient, inexpensive way to boost our nutrition intake. No need to go to the "eggs-treme." While more research continues to roll out, I advise keeping moderation in mind. When considering the information available at this time, I personally recommend staying between 4 to 7 per week (which could equate to one egg per day) to get the benefits without over doing it. Enjoy, and toss the guilt aside.





Works Cited:

1) Tinker, Ben. "Cholesterol in food not a concer, new report says." CNN online. http://www.cnn.com/2015/02/19/health/dietary-guidelines/index.ht

2) Ying Rong, Li Chen, Tingting Zhu, et al. Egg consumption and risk of coronary heart disease and stroke: dose-response meta-analysis of prospective cohort studies. BMJ 2013; 346:e8539. doi: http://dx.doi.org/10.1136/bmj.e8539 (Published 07 January 2013)

3) Jryki K Virtanen, Jaakko Mursu, Tomi-Pekka Tuomainen. Egg consumption and risk of incident type 2 diabetes in men: the Kuopio Ischaemic Heart Disease Risk Factor Study. The Am J Clin Nutr April 2015. doi: 10.3945/ajcn.114.104109  

4) Herron, Kristin L; Fernandez, Maria Luz. Are the current dietary guidelines regarding egg consumption appropriate? J Nutr. Jan 1, 2004 vol 134 no. 1 187-190. http://www.jn.nutrition.org/content/134/1/187.short

5) Welland, Diane. "Sunny Side Up - Eggs can be part of a healthy diet." Today'sDietitian. Vol. 12 No. 7 P. 22