Cholesterol

Nutritional Pearls: Are Eggs Okay For Patients With Diabetes?

Ryan is a 32-year-old man with diabetes who is curious about how he can shift his diet in a way that benefits his cholesterol levels. He is especially unsure about the amount of eggs that he should be eating. He tells you that if it were up to him, he would be eating eggs every day, but he knows that they are “bad for him.”

How would you advise your patient?
(Answer and discussion on next page)



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Answer: In the context of an overall healthy diet, you can eat eggs even if you are diabetic or pre-diabetic.

Sometimes it still seems to be an uphill battle to let people know that for the vast majority of people, dietary cholesterol (the cholesterol in your food) has virtually no effect on your cholesterol scores. Every now and then I still get questions about the cholesterol in a recipe, but the good news is that the word does seem to be getting out that eggs are good for you. That said, there's been lingering concern about eggs increasing the risk of heart disease or stroke in individuals with diabetes, and so they are often told to limit their egg consumption.1

The Research

A team in Australia recruited 121 overweight or obese men and women who had been diagnosed with diabetes or pre-diabetes to participate in a 3-month dietary study known as DIABEGG (Diabetes and Egg).2 Half were assigned to a "high egg group" and half were assigned to a "low egg group." Those in the high egg group were instructed to eat 2 eggs per day at breakfast, while those in the low egg group were told to eat no more than 2 eggs per week, while having 10 grams of lean animal protein (beef, chicken, or fish) at breakfast.
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Both groups were counseled by a dietitian on replacing foods high in saturated fats with foods high in poly- and mono-unsaturated fats (for example, replacing butter with olive oil). Both groups' diets were designed to maintain the individual's body weight and both groups were told to maintain their usual level of physical activity.

The Results

After 3 months the researchers compared the participants' cholesterol scores, glucose levels, and HbA1C (hemoglobin A1C) scores from the start and end of the study and found that there were no changes in HDL cholesterol (the good cholesterol), LDL cholesterol (the bad cholesterol), or triglycerides, regardless of whether the participant ate 12 eggs per week or less than 2. Nor were there any changes in glucose levels or HbA1C scores.

Even better, those in the high egg group reported being happier with the variety of food choices in their diet as well as feeling more satisfied after meals.

What’s the Take-Home?

It's pretty clear that in the context of an overall healthy diet, you can eat eggs even if you are diabetic or pre-diabetic. Don't douse them in butter, but by all means scramble or fry them for breakfast using a spray of olive oil instead. That may even help you lose more weight, if that is your goal.

References:

  1. Hu FB, Stampfer MJ, Rimm EB, Manson JE, et al. A prospective study of egg consumption and risk of cardiovascular disease in men and women. JAMA. 1999;281(15):1387-1394
  2. Clifton PM. Does dietary cholesterol influence cardiovascular disease risk in people with type 2 diabetes? Am J Clin Nutr .2015;101:705-13