PDF
ePub
Citation
Print
Abstract
ABSTRACT Purpose: The aim of this study is to examine the effects of egg consumption and suggest proper guidelines for consumption of eggs by determining the relationship between eggs and cholesterol. Methods: Literature review was conducted on the relationship between nutritional, functional properties of eggs and serum cholesterol, as well as cardiovascular disease. Results: Eggs, which are a good protein food with complete amino acid composition, contain vitamin A, riboflavin, vitamin B12, folic acid, vitamin D, vitamin E, vitamin K, calcium, iron, choline, selenium, β-carotene, lutein, zeaxanthin, etc. However the egg yolk has a high cholesterol content, which is associated with chronic diseases, including heart disease and hypertension. As a result, its intake is subject to regulation. Outbreak of heart disease by yolk intake can show different results depending on the characteristics of the subjects, amount of egg intake, and the implications of other foods eaten. It is difficult to determine whether eggs are beneficial, as they are the main supplying source for other major nutritive elements as well. Several research studies insist that when cholesterol intake increases by 100 mg, the level of serum cholesterol increases by 2.2∼4.5 mg/dL and when serum cholesterol increases by 1%, the risk of heart disease increases by 2%. This indicates that a large intake of eggs can increase the risk of heart disease. Although the cholesterol of egg yolk and serum cholesterol are correlated, it is insufficient to conclude that only cholesterol and not other components are related to heart disease. In fact, other components in egg such as various unsaturated fatty acids and phospholipids could be related as well. Rather than concluding egg as a ‘good' or ‘bad' food according to its cholesterol content, it is important to define egg as a part of dietary patterns. Conclusion: Generalizing an indiscriminate and uniform amount of egg intake for all seems inadequate. However, patients with diabetes or heart disease should pay particular attention to the amount of egg intake. As for the norm, eating egg with vegetables as a substitute for other animal products seems beneficial.
References
1. Herron KL, Fernandez ML. Are the current dietary guidelines regarding egg consumption appropriate? J Nutr. 2004; 134(1):187–190.
2. Applegate E. Introduction: nutritional and functional roles of eggs in the diet. J Am Coll Nutr. 2000; 19(5 Suppl):495S–498S.
3. Hopkins PN. Effects of dietary cholesterol on serum cholesterol: a metaanalysis and review. Am J Clin Nutr. 1992; 55(6):1060–1070.
4. Spence JD, Jenkins DJ, Davignon J. Dietary cholesterol and egg yolks: not for patients at risk of vascular disease. Can J Cardiol. 2010; 26(9):e336–e339.
5. Kritchevsky SB, Kritchevsky D. Egg consumption and coronary heart disease: an epidemiologic overview. J Am Coll Nutr. 2000; 19(5 Suppl):549S–555S.
6. Hu FB, Stampfer MJ, Rimm EB, Manson JE, Ascherio A, Colditz GA, Rosner BA, Spiegelman D, Speizer FE, Sacks FM, Hennekens CH, Willett WC. A prospective study of egg consumption and risk of cardiovascular disease in men and women. JAMA. 1999; 281(15):1387–1394.
7. Burke V, Zhao Y, Lee AH, Hunter E, Spargo RM, Gracey M, Smith RM, Beilin LJ, Puddey IB. Health-related behaviours as predictors of mortality and morbidity in Australian Aborigines. Prev Med. 2007; 44(2):135–142.
8. Mann JI, Appleby PN, Key TJ, Thorogood M. Dietary determinants of ischaemic heart disease in health conscious individuals. Heart. 1997; 78(5):450–455.
9. Dawber TR, Nickerson RJ, Brand FN, Pool J. Eggs, serum cholesterol, and coronary heart disease. Am J Clin Nutr. 1982; 36(4):617–625.
10. Gramenzi A, Gentile A, Fasoli M, Negri E, Parazzini F, La Vecchia C. Association between certain foods and risk of acute myocardial infarction in women. BMJ. 1990; 300(6727):771–773.
11. Nakamura Y, Okamura T, Tamaki S, Kadowaki T, Hayakawa T, Kita Y, Okayama A, Ueshima H. NIPPON DATA80 Research Group. Egg consumption, serum cholesterol, and cause-specific and all-cause mortality: the National Integrated Project for Prospective Observation of Noncommunicable Disease and Its Trends in the Aged, 1980 (NIPPON DATA80). Am J Clin Nutr. 2004; 80(1):58–63.
12. International Egg Commission (GB). Internationalegg.com [Internet]. London: International Egg Commission Online Resources, Inc.;2014. [cited 2014 Aug 1]. Available from:. https://www.inter-nationalegg.com/corporate/downloads/index.asp.
13. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2007: Korea National Health and Nutrition Examination Survey (KNHANES IV-1). Cheongwon: Korea Centers for Disease Control and Prevention;2008.
14. The Korean Nutrition Society. 2009 food values. Seoul: The Korean Nutrition Society;2009.
15. The Korean Nutrition Society. Dietary reference intakes of Koreans, 1st revision. Seoul: The Korean Nutrition Society;2010.
17. The Korea Professors Association of Food and Nutrition. Food. 3rd edition.Seoul: Munwundang;2008.
18. Abeyrathne ED, Lee HY, Ahn DU. Egg white proteins and their potential use in food processing or as nutraceutical and pharmaceutical agents–a review. Poult Sci. 2013; 92(12):3292–3299.
19. Ginsberg HN, Karmally W, Siddiqui M, Holleran S, Tall AR, Rumsey SC, Deckelbaum RJ, Blaner WS, Ramakrishnan R. A dose-response study of the effects of dietary cholesterol on fasting and postprandial lipid and lipoprotein metabolism in healthy young men. Arterioscler Thromb. 1994; 14(4):576–586.
20. Yang SY, Hong S, Sung MK, Kang MH, Kim MK. Effect of lecithin intake on lipid metabolism and antioxidative capacity in rats fed high fat diet. Korean J Nutr. 2007; 40(4):312–319.
21. Groff JL, Gropper SA. Advanced nutrition and human metabolism. 3rd edition.Belmont (CA): Wadsworth;2000.
22. Detopoulou P, Panagiotakos DB, Antonopoulou S, Pitsavos C, Stefanadis C. Dietary choline and betaine intakes in relation to concentrations of inflammatory markers in healthy adults: the ATTICA study. Am J Clin Nutr. 2008; 87(2):424–430.
23. Cho H, Na J, Jeong H, Chung Y. Choline contents of Korean common foods. Korean J Nutr. 2008; 41(5):428–438.
24. Goodrow EF, Wilson TA, Houde SC, Vishwanathan R, Scollin PA, Handelman G, Nicolosi RJ. Consumption of one egg per day increases serum lutein and zeaxanthin concentrations in older adults without altering serum lipid and lipoprotein cholesterol concentrations. J Nutr. 2006; 136(10):2519–2524.
25. Wenzel AJ, Gerweck C, Barbato D, Nicolosi RJ, Handelman GJ, Curran-Celentano J. A 12-wk egg intervention increases serum zeaxanthin and macular pigment optical density in women. J Nutr. 2006; 136(10):2568–2573.
26. Handelman GJ, Nightingale ZD, Lichtenstein AH, Schaefer EJ, Blumberg JB. Lutein and zeaxanthin concentrations in plasma after dietary supplementation with egg yolk. Am J Clin Nutr. 1999; 70(2):247–251.
27. Kritchevsky SB. A review of scientific research and recommendations regarding eggs. J Am Coll Nutr. 2004; 23(6 Suppl):596S–600S.
28. Choi HM. Chapter 3. Lipid. In: Nutrition, 4th revision. Paju: Kyo-munsa;2011. p. 84–105.
29. Kim MK, Kwon OR, Chon HS, Won HS, Kim JY, Kang BC, Che JH, Han JK, Hong SH, Bok HS, Kim WS, Pee JH, Park HY, Kim HJ. Cholesterol-holding. Health Functional Foods. Revised edition. Paju: Kyomunsa;2010. p. 135–140.
30. McNamara DJ. The impact of egg limitations on coronary heart disease risk: do the numbers add up? J Am Coll Nutr. 2000; 19(5 Suppl):540S–548S.
31. Ginsberg HN, Karmally W, Siddiqui M, Holleran S, Tall AR, Blaner WS, Ramakrishnan R. Increases in dietary cholesterol are associated with modest increases in both LDL and HDL cholesterol in healthy young women. Arterioscler Thromb Vasc Biol. 1995; 15(2):169–178.
32. Clarke R, Frost C, Collins R, Appleby P, Peto R. Dietary lipids and blood cholesterol: quantitative metaanalysis of metabolic ward studies. BMJ. 1997; 314(7074):112–117.
33. Weggemans RM, Zock PL, Katan MB. Dietary cholesterol from eggs increases the ratio of total cholesterol to high-density lipoprotein cholesterol in humans: a metaanalysis. Am J Clin Nutr. 2001; 73(5):885–891.
34. Oh H, Shin E, Kim H, Lim Y, Park M, Kim K, Kim E, Lee M. Apo E4 genotype as the Alzheimer indictor in Korean senior subjects E4 genotype as the Alzheimer indictor in Korean senior subjects aged 50 to 64 years old. Korean J Nutr. 2007; 40(7):593–600.
35. Kushi LH, Lew RA, Stare FJ, Ellison CR, el Lozy M, Bourke G, Daly L, Graham I, Hickey N, Mulcahy R, Kevaney J. Diet and 20-year mortality from coronary heart disease. The Ireland-Boston Diet-Heart Study. N Engl J Med. 1985; 312(13):811–818.
36. Kromhout D, de Lezenne Coulander C. Diet, prevalence and 10-year mortality from coronary heart disease in 871 middle-aged men. The Zutphen Study. Am J Epidemiol. 1984; 119(5):733–741.
37. Posner BM, Cobb JL, Belanger AJ, Cupples LA, D'Agostino RB, Stokes J 3rd. Dietary lipid predictors of coronary heart disease in men. The Framingham Study. Arch Intern Med. 1991; 151(6):1181–1187.
38. Hu FB, Stampfer MJ, Manson JE, Rimm E, Colditz GA, Rosner BA, Hennekens CH, Willett WC. Dietary fat intake and the risk of coronary heart disease in women. N Engl J Med. 1997; 337(21):1491–1499.
39. McGee DL, Reed DM, Yano K, Kagan A, Tillotson J. Ten-year incidence of coronary heart disease in the Honolulu Heart Program. Relationship to nutrient intake. Am J Epidemiol. 1984; 119(5):667–676.
40. Shekelle RB, Shryock AM, Paul O, Lepper M, Stamler J, Liu S, Raynor WJ Jr. Diet, serum cholesterol, and death from coronary heart disease. The Western Electric study. N Engl J Med. 1981; 304(2):65–70.
41. Hu FB, Manson JE, Willett WC. Types of dietary fat and risk of coronary heart disease: a critical review. J Am Coll Nutr. 2001; 20(1):5–19.
42. Ahn Y, Park YJ, Park SJ, Min H, Kwak HK, Oh KS, Park C. Dietary patterns and prevalence odds ratio in middle-aged adults of rural and mid-size city in Korean genome epidemiology study. Korean J Nutr. 2007; 40(3):259–269.
43. Jones PJ. Dietary cholesterol and the risk of cardiovascular disease in patients: a review of the Harvard egg study and other data. Int J Clin Pract Suppl. 2009; 163:1–8,. 28–36.
44. Liebman M, Bazzarre TL. Plasma lipids of vegetarian and nonveg-etarian males: effects of egg consumption. Am J Clin Nutr. 1983; 38(4):612–619.
45. Djoussé L, Gaziano JM. Egg consumption in relation to cardiovascular disease and mortality: the Physicians' Health Study. Am J Clin Nutr. 2008; 87(4):964–969.
46. Djoussé L, Gaziano JM, Buring JE, Lee IM. Egg consumption and risk of type 2 diabetes in men and women. Diabetes Care. 2009; 32(2):295–300.
47. American Heart Association. Heart.org [Internet]. Dallas (TX): American Heart Association Online Resource, Inc.;2014. [cited 2014 Aug 1]. Available from:. http://www.heart.org/HEARTORG/GettingHealthy/GettingHealthy_UCM_001078_SubHomeP-age.jsp. age.jsp.
48. Ministry of Health, Labour and Welfare (JP). Reference intakes of lipid [Internet]. Tokyo: Ministry of Health, Labour and Welfare Online Resources, Inc.;2009. [cited 2014 Aug 1]. Available from:. http://www.mhlw.go.jp/shingi/2009/05/dl/s0529–4g.pdf.
Table 1.
Nutrition composition of representative animal foods (per 100g edible portion)1)
Table 2.
Contribution of eggs to the Korean diet (per one egg)1)
Table 3.
Comparison of protein quality of foods1)
| Foods | Eggs | Meat | Milk | Soybean |
|---|---|---|---|---|
| Amino acid score | 100 | 66–70 | 60 | 47 |
| Biological value | 94 | 74–76 | 85 | 71 |
| Protein efficiency ratio | 3.92 | 2.30–3.55 | 3.09 | 2.32 |
Table 4.
Protein digestibility of foods1)
| Foods | Eggs | Meat | Milk | Soybean |
|---|---|---|---|---|
| digestibility (%) | 97 | 85–99 | 81 | 90 |
Table 5.
Fat amount of representative animal foods (per 100g edible portion)1)
| Nutrient | Whole eggs | Egg whites | Egg yolks | Beef (chuck) | Pork | Chicken | Whole milk |
|---|---|---|---|---|---|---|---|
| Total fat (g) | 11.8 | – | 31.2 | 12.3 | 16.1 | 14.6 | 3.2 |
| Cholesterol (g) | 0.47 | – | 1.3 | 0.07 | 0.06 | 0.09 | 0.01 |
| Fatty acid (g) | 9.11 | – | 25.4 | – | 23.3 | 12.6 | 3.2 |
| SFA2 (g) | 3.1 | – | 8.7 | 4.7 | 9.9 | 3.9 | 2.2 |
| MUFA3 (g) | 4.4 | – | 12.2 | 6.0 | 10.8 | 6.5 | 0.9 |
| PUFA4 (g) | 1.6 | – | 4.5 | 0.3 | 2.5 | 2.3 | 0.1 |
| PUFA:MUPA:SFA | 1:3:2 | – | 1:3:2 | 1:20:16 | 1:4:4 | 1:3:2 | 1:9:2 |
| Palmitic acid (C16:0) | 5) 25.5 | 29.6 | 24.0 | 27.9 | 26.6 | 23.4 | 30.4 |
| Stearic acid (C18:0)5 | 5 8.6 | 15.9 | 8.1 | 9.8 | 12.3 | 5.7 | 14.9 |
| Oleic acid (C18:1)5 | 45.3 | 30.4 | 45.3 | 43.3 | 44.7 | 43.5 | 28.6 |
| Linoleic acid (C18:2) | 5 12.6 | 8.8 | 13.1 | 2.7 | 10.1 | 15.2 | 3.4 |
| Linolenic acid (C18:3 | 3)5 0.5 | 0.8 | 0.4 | 0.1 | 0.4 | 1.2 | 0.3 |
Table 6.
The effects of egg consumption to coronary heart disease risk
| Study, year (reference) | Egg consumption levels compared (per week) | Relative risk | Adjustment factors |
|---|---|---|---|
| Dawber et al., 19829 | men, <2.5 vs ≥7 | 1.3 | none |
| Hu et al., 19996 | men, <1 vs ≥7 | 1.08 | lifestyle variables |
| women, <1 vs ≥7 | 0.82 | lifestyle variables | |
| Gramenzi et al., 199010 | women, <1 vs >2 | 0.8 | age |
| Djousse et al., 200845 | men, 1< vs ≥7 | 0.92 | lifestyle variables |
| Jones, 200943 | men, 1< vs ≥7 | 1.08 | lifestyle variables |
| women, <1 vs ≥7 | 0.82 | lifestyle variables | |
| Burke et al., 20077 | <2 vs ≥2 | 2.59∗ | gender |
| Mann et al., 19978 | <1 vs ≥6 | 2.68∗∗ | gender, lifestyle variables |
XML Download