Dropping that yogurt or cereal in the morning for eggs? You may want to reconsider it. A recent analysis, using data from six study cohorts, has raised a concern about dietary cholesterol intake and egg consumption. This is interesting work since the 2015 US Dietary Guidelines downplayed concerns about dietary cholesterol intake.
Data from nearly 30,000 US adults were included in the analysis and was collected over approximately 17 years. Consuming more dietary cholesterol or eggs (>300 mg/day; one egg has ~185 mg cholesterol) was associated with risk of cardiovascular disease (CVD) and mortality. The study findings show a ‘dose-response,’ meaning, as someone consumes more cholesterol, there is higher risk of CVD and death.
Previously published studies have shown conflicting results, and because of that, the 2015 Dietary Guidelines removed the recommendation to consume <300 mg/day of dietary cholesterol.
Some considerations about the analysis:
- This is observational study so:
- Cause (intake of cholesterol or eggs) and effect (CVD, death) cannot be proven.
- There could be other diet or lifestyle factors that contribute to this finding.
- Intake was assessed at one point
- This leads to an assumption that the one measure is representative of typical intake and unchanged over the study period.
- Self-reported intake can be inaccurate, but typically people underreport their intake of foods (eg, eggs, red meat) that they believe may not be desired by researchers.
- Overall intake scores, assessed by the Alternative Healthy Eating Index, were mean scores of 40-51, with possible scores of 2.5 (worst) to 87.5 (best).
Some suggestions about what to do with this information:
- The trend in nutrition research continues to support that eating more whole, minimally processed plant foods is healthier than consuming a larger amount of animal foods. Vegetarian and plant-based diets do have many merits.
- Processed animal foods (eg, sausages, bacon, deli meat) are, perhaps, even more of a concern.
- When eating meat, choose fish and chicken (without the skin) when possible over red meat.
- Keep animal protein servings to about the size of a smart phone (4-5 oz.).
- Eggs can be a healthy choice when balancing them among lots of other plant foods.
- If eggs are your typical daily
breakfast, consider mixing it up and eating other choices some days of the
week. Ideas include:
- Oatmeal—rolled or steel cut oats—flavored with fruit (eg, apples, berries, grapes) and nuts.
- Yogurt—Greek yogurt has a generous amount of protein. Again, use fruit and nuts to flavor. Not ready to go to plain yogurt without sugar? Mix one container of plain and one container of flavored yogurt and use ½ one day and the other ½ the next day.
- Whole grain bread (> 3 grams of fiber/slice) with peanut or other nut butter.
- Whole grain, low sugar cereal like Ezekiel and Uncle Sam’s cereals with low fat milk (cow, soy, oat, or others with 5 grams of protein or more/serving) or yogurt.
It can be frustrating that nutrition science can change over time, and I would fault no one for that frustration. It is the intent, though, of scientists to continue to study nutrition and unravel the best eating patterns for health and exercise performance. No doubt, this new analysis gives the experts, recently chosen for the 2020 Dietary Guidelines review, something to think about.
Happy and healthful eating,
Donna G. Pertel, MEd, RD, LDN
Ready to talk about nutrition? Contact me at firstname.lastname@example.org.
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