Table 3.
Clinical studies on CHD risk factors and egg consumption among diabetics
| Study | Design, aim, and sample size | Treatment and duration | Outcome measures | Findings |
|---|---|---|---|---|
| Arora et al47 | Single dietary challenge to study lipoprotein profile following egg cholesterol challenge. n=13 controls, n=10 diabetic patients | One feeding of 800 mg of cholesterol derived from egg and 150 mL sweetened milk | Serum TC, HDL, LDL, and TAG | No SS changes detected within groups or across study groups |
| Taggart et al58 | Dietary intervention to study relationship between fasting and postprandial intestine-derived atherogenic Apo B48 in T2DM subjects. n=10 cases, n=10 controls | Test meal with 1 g added cholesterol. Egg yolk was not used as a source of cholesterol. Two single meals given 1 week apart | Serum VLDL, LDL, chylomicron, blood glucose, HbA1C, and insulin | A tenfold increase in VLDL Apo B48 in diabetics compared with a threefold increase in controls (P<0.001) postchallenge. VLDL Apo B100 similar between groups following challenge. Accounting for E3/E3 genotype did not change results |
| Romano et al48 | Double-blind, randomized placebo control, sequential crossover study of the effects of cholesterol supplementation on plasma lipid lipoprotein subclasses in normolipidemic type 1 diabetics. N=10 patients, n=11 controls | Cholesterol supplementation (800 mg/day) from egg yolk or placebo | VLDL (subtypes 1, 2, and 3) and composition, LDL (subtypes 1, 2, and 3) and composition, HDL (subtypes 2b, 2a, 3a, and 3b) and composition | SS increase in total LDL in patients but not controls following cholesterol intake. No effect on HDL in patients after cholesterol feeding, and increased concentration of HDL2a subtype (but not other subtypes) in controls. In patients’ LDL, the particle mass increased with cholesterol feeding, but not in controls. No changes in VLDL in either group following cholesterol feeding |
| Lindeberg et al51 | Randomized, controlled intervention; male patients with ischemic heart disease, either glucose intolerance or T2DM. n=15 on Mediterranean-like diet, n=14 on Paleolithic diet | 12-week controlled diet | Plasma glucose; body weight changes | Plasma glucose decreased in the Paleolithic group by 26%, whereas in the Mediterranean group, it only decreased by 7%, independent of changes in WC |
| Jönsson et al50 | Randomized crossover pilot study comparing the effects of a Paleolithic diet and a diabetes diet in T2DM patients. n=10 men, 3 women | Paleolithic diet; egg limited to 1 egg/day; diabetes diet: 3 months per diet then crossover; total duration 6 months | HbA1C, TAG, DBP, weight, BMI, WC, and HDL-C | Paleolithic diet (as compared with the diabetes diet) resulted in lower mean HbA1C, TAG, DBP, weight, BMI, WC, and higher mean HDL-C |
| Pearce et al49 | Parallel, randomized, matched dietary intervention to study the effect of a hypoenergetic HPHchol compared with a hypoenergetic HPLchol on plasma lipids, glycemic control, and cardiovascular risk factors in T2DM subjects. N=31 on HPHchol, n=34 on HPLchol | HPHchol: 590 mg cholesterol; HPLchol: 213 mg cholesterol by egg supplementation; 12 weeks of hypoenergetic high protein diet with either low or high cholesterol | TC, TAG, LDL, HDL, apo-B, CRP, FPG, 2-hour glucose, serum insulin, homocysteine, HbA1C, SBP, DBP, lutein, folate, vitamin B12, alpha carotene | SS decreases in weight, total cholesterol, TAG, non-HDL-C Apo B, HbA1C, FPG, and insulin, and SBP and DBP in both groups. LDL-C and homocysteine unchanged in both groups following the hypoenergetic high-protein diet. HDL-C, plasma folate, and lutein increased in the high cholesterol but not the low-cholesterol group following the intervention |
Abbreviations: Apo, apolipoprotein; BMI, body mass index; HbA1C, hemoglobin A1C; CHD, coronary heart disease; CRP, C-reactive protein; DBP, diastolic blood pressure; FPG, fasting blood glucose; HDL, high-density lipoprotein; HDL-C, high-density lipoprotein cholesterol; HPHchol, high-protein high-cholesterol diet; HPLchol, high-protein low-cholesterol diet; LDL, low-density lipoprotein; LDL-C, low-density lipoprotein cholesterol; n = sample size; SBP, systolic blood pressure; SS, statistically significant; T2DM, Type 2 diabetes mellitus; TAG, triglycerides or triacylglycerols; TC, total cholesterol; VLDL, very low-density lipoprotein; WC, waist circumference.