Eggs good for diabetes

Did you know that over 30 million Americans have diabetes? A whopping 1.5 million of those got a diagnosis only three years ago, in 2015.

Worse yet, 84 million people have prediabetes. Combine that sad statistic with the fact that most of them don’t even know they have it.

Diabetes’ number one symptom is high blood sugar levels. Because the body cannot produce enough or any insulin, the sugar isn’t taken out of the blood. Instead of entering the cells, the sugar stays there.

90 to 95% of diabetes cases are type 2. Which, believe it or not, is a good thing. Type 1 diabetes is permanent.

But type 2?

The factors thought to contribute to type 2 diabetes are anything from being overweight to lack of exercise. That means a well-rounded, healthy diet can reduce diabetes symptoms in amazing ways.

Here are the top 10 foods that lower blood sugar. Put them on the menu tonight!

1. All the Greens

When we say all the greens, we mean it:

  • Kale
  • Spinach
  • Sprouts
  • Chards
  • Arugula
  • Collard greens
  • Bok choy
  • Watercress

The options are plentiful.

Don’t like kale as your salad base? Try spinach instead. You’ll get much more nutritional value out of these greens than you would iceberg lettuce.

2. Pasture-Raised Eggs

Eggs are an amazing source of protein for diabetics. About 7 grams per large egg, in fact.

Not only that, they contain about a half a gram of carbs per large egg. Because carbohydrates increase blood sugar levels, it’s safe to say that an egg won’t harm them.

Like everything, diabetics should take care to eat eggs in moderation. A surplus of eggs could mean an increase in cholesterol levels. Although it doesn’t have quite the negative impact it was once thought to have, cholesterol should be monitored by diabetics.

3. Fatty Foods

More good news here. There are many fatty food options:

  • Avocados
  • Coconut oil (you can cook your eggs with this!)
  • Non-salted butter
  • Cheese (also protein-rich)
  • Eggs
  • Dark chocolate (you’ll see this later)
  • Certain fish; salmon is a big one
  • Nuts
  • Chia seeds (pro tip: add seeds to shakes)
  • Greek yogurt

And believe it or not, that’s not all.

These food items mean one large thing: a healthy diet doesn’t have to be boring or tasteless. It can be eclectic, multi-faceted, and scrumptious.

4. Beans and Lentils

The American Diabetes Association said that diabetics should add no-sodium or dried beans to their meals several times a week.

What’s the reason behind that?

Not only do they contain the necessary proteins and fibers, they are very low on the glycemic index.

5. Berries and Other Fruit

We recommend eating your berries and fruits whole. Blending them in shakes takes away the nutritional fibers, but leaves the fructose. Drinking fruity drinks tends to result in a high sugar intake.

Eating them whole allows your body to receive the necessary fiber and vitamins. The more fiber you take in, the longer you’ll feel full and stave off bad cravings later.

Steer clear of anything syrupy or processed. Whole is healthy!

6. Vegetables

Before eating certain veggies, take a moment to find out their GI levels. The glycemic index needs to be low in order for it to help lower your blood sugar. Some veggies, like potatoes, have a much higher GI level.

What are some that sit on the lower end of the scale?

  • Asparagus
  • Broccoli
  • Cauliflower
  • Peppers
  • Spinach
  • Celery
  • Snow peas
  • Artichoke

And beyond!

These veggies don’t have to be boring, either. Doctor them up with olive oil (great for diabetics) and some seasoning. Or toss your cauliflower in a light buffalo sauce.

Raw, steamed, cooked, seasoned. The options are as endless as you are creative!

7. Whole Grains

Whole grains are grains that include the bran, germ, and endosperm. What’s so good about those in comparison to refined grains?

Because refined grains remove the fiber. What happens then?

The body digests the remaining carbohydrates in a way that raises the glycemic response. Consuming a lot of refined grains increases odds of obesity and type 2 diabetes. It’s recommended for all Americans – diabetic or not – to make the switch to whole grain.

Some examples of healthy whole grains include quinoa, oats, and brown rice.

8. Lemons and Limes

The body doesn’t make enough of some of our most essential vitamins. One of those is Vitamin C, which we get in such an easy way: lemons and limes!

Think about all the times you go out to eat and order a water. Does the waitress sometimes add a lemon slice without you having to ask for it? That’s how easy it is to get lemons into your diet.

When they’re in your body, they do many wonderful things:

  • Improve digestion
  • Improve the immune system, which takes a hit in diabetics
  • Elevate energy levels
  • Keep you fuller longer

That lemon water at the start of your meal helps you digest fats during it, and even stave off your dessert craving.

9. Turmeric

Turmeric is an intervention food all diabetics should consider adding into their diets.

An active polyphenol, called curcumin, mitigates both high blood sugar and insulin resistance.

Cook your salmon with turmeric seasoning. Add it to a shake. Whatever you do, get this amazing anti-diabetic miracle into your system.

10. Raw Chocolate

Because you deserve to treat yourself sometimes. And it doesn’t have to mean sacrificing your health.

Raw chocolate contains the antioxidant chromium. This helps to lower your blood sugar levels by improving insulin function.

It’s important to choose raw, dark chocolates. The moment you buy a milk chocolate bar, these beneficial things become negated by the high sugar levels.

Get These Foods That Lower Blood Sugar into Your Diet

Chances are that on your mission to become healthier, your mental state will improve, as well. Diet is as important to mental health as it is to physical health.

If you have diabetes or suspect you have prediabetes, get these foods in your stomach. These life-changing foods should be eaten by everyone, diabetic or not. The sooner we raise humans to adopt this healthy lifestyle, the sooner we put a dent in this epidemic.

Whatever it takes, stay strong in your diet goals. Because soon enough they will be habits. And one cheat day you’ll have a piece of sugary pie to find that your sweet teeth is gone.

If you do suffer from diabetes or need items such as blood glucose test strips then we have a large range of diabetic supplies available.

Have you tried any of these foods that lower blood sugar levels? Let us know how it turned out!

Sources

Dietary and nutritional approaches for prevention and management of type 2 diabetes

Diet, nutrition and the prevention of type 2 diabetes

Prevention and management of type 2 diabetes: dietary components and nutritional strategies

On to you

What questions do you have? Let us know in the comments below and we’ll be happy to help!

-Marc Kaplan

CEO, Save Rite Medical

Created with a vision of helping customers in anyway possible, Save Rite Medical CEO, Marc Kaplan, created the company and has grown it to become the leading internet provider of medical supplies. Through valuable products to educational information, Save Rite Medical is your #1 resource for medical supplies.

Are Eggs Safe for People With Diabetes to Eat?

In the past, whole eggs got a bad rap for their cholesterol and fat content. But thanks to new studies and a fresh perspective in the medical community, this budget-friendly protein source has reemerged as a dietitian favorite — even for people with diabetes.

“We’re getting away from limiting eggs in the diet of people with diabetes, as their benefits are quite extensive,” says Elizabeth Ebner, a registered dietitian and a certified diabetes educator with Hackensack Meridian Health in Fair Haven, New Jersey. “They’re considered a high biological value protein, which means they provide all the amino acids required in the body.” When a protein source contains the essential amino acids in the right proportion required by humans, it is considered to have a high biological value.

But before an egg could be seen as a protein-and-healthy-fat powerhouse, it had to shed its negative reputation.

Eggs for Diabetes: What Changed?

The cholesterol found in egg yolks was once cause for alarm among people with diabetes. The disease puts you at an increased risk of heart issues, and cholesterol was seen as a contributing factor to heart disease.

The message was: Stay away from cholesterol to protect your ticker. According to a study published in September 2015 in Nutrients, the American Diabetes Association (ADA) used to recommend that people with type 2 diabetes limit their dietary cholesterol to 300 milligrams (mg). For reference, one egg has 200 mg — and so the egg-white craze began.

Subsequent research began suggesting that the relationship between how much cholesterol a person consumes and his or her blood cholesterol levels wasn’t as strong as once thought, according to a study published in March 2016 in The American Journal of Clinical Nutrition. Within the past few years, the ADA and the American Heart Association removed their cholesterol guidelines, and there’s no longer a limit placed on cholesterol, according to 2015 study in Nutrients cited above.

In addition to cholesterol, each large egg has about 5 grams (g) of fat. According to the Harvard T.H. Chan School of Public Health, most of the fat is polyunsaturated and monounsaturated, which are two examples of healthy fats. But there’s also 1.6 g of saturated fat — or nearly 10 percent of your daily allowance for the bad kind of fat — in each egg. Saturated fat has been linked to diabetes and puts you at a higher risk for heart disease, according to the American Heart Association (AHA), so it’s still best not to go overboard in the yolk department.

If your cholesterol is normal, the AHA recommends that your saturated fat intake be no more than 5 to 6 percent of your total daily caloric intake (or a maximum of 20 g for someone on a 2,000 calorie-per-day diet). If you’re trying to lower your LDL, or “bad,” cholesterol, that recommendation is a maximum of 11 to 13 g of daily saturated fat when you’re consuming 2,000 calories per day.

The New Reputation of the Egg

Today, many nutritionists recommend eating eggs because they’re satiating and can help with weight loss and management; healthy weight is beneficial for people with diabetes because it reduces insulin resistance.

Now the message has shifted to focus on protein. Each egg contains 6 g, which is why Ebner considers eggs a good, inexpensive source of the nutrient. Protein is satiating, meaning eggs may help curb unhealthy cravings and promote a healthy weight in people with diabetes — further aiding diabetes management. Plus, eating protein and carbohydrates together may delay the impact of carbohydrates on blood sugar, Ebner says.

“I always use the analogy that the protein is like the seat belt to the carbohydrate — it kind of holds it back and slows it down a bit from spiking the sugar.” That said, it’s still important to monitor your carbohydrate intake and observe how what you eat impacts your blood sugar reading. No matter what nutrients you combine them with, carbs are digested as glucose, which raises blood sugar levels.

How Eating Eggs May Affect Diabetes Risk

According to a study published in April 2015 in The American Journal of Clinical Nutrition, middle-aged and older men who ate about four eggs each week had a 37 percent lower risk of type 2 diabetes than their peers who ate one egg per week. That study is an outlier, though. Most research has found eating eggs in moderation isn’t linked to diabetes one way or the other, but you still have to be careful not to overdo it.

A study published in January 2016 in The American Journal of Clinical Nutrition suggests there’s no link between occasionally eating eggs and developing type 2 diabetes, but people who eat three or more eggs per week are at a slightly higher risk of developing the disease. An earlier study, published in 2009 in Diabetes Care, found that eating seven or more eggs each week increased the risk of type 2 diabetes among men by 58 percent and among women by 77 percent.

However, these studies were observational, meaning they didn’t prove a cause-and-effect relationship. Experts agree you don’t need to ban eggs from your diet, but you should eat them in moderation. “I usually incorporate an egg every other day when I’m writing a meal plan ,” Ebner says, adding that there’s no need to limit the amount of egg whites you eat, since they’re predominantly made up of protein and are low in fat. Ebner recommends sticking to egg whites and avoiding yolks altogether if you take large doses of statins or have a strong family history of heart disease, which she estimates affects about 1 in 10 people with diabetes. According to the AHA, about 68 percent of people age 65 or older with diabetes die from heart disease.

The Best Ways to Prepare or Order Eggs

How you prepare your eggs can affect how diabetes-friendly they are, too. When you’re cooking at home, stick to an olive oil spray instead of butter and make them in whatever style you like — scrambled, over easy, or sunny-side up.

When you’re out for breakfast, Ebner recommends ordering a poached egg “because it’s cooked in water and no additional fat,” she says, or ordering egg whites. “At diners, eggs are often mixed with pancake batter to make them fluffy,” Ebner says. “I tell patients to ask for egg whites when they’re at a diner so they aren’t adding carbohydrates.”

Feel free to load up your eggs with vegetables — leafy greens, onions, and mushrooms are all good choices, Ebner says. And when it comes to adding cheese, the sharper, the better. “I recommend you get the strongest cheese you can tolerate — a really hard sharp cheddar or maybe a parmesan — and fine-grate it to add to the egg,” Ebner says. “It’s so strong you don’t need much of it, so a tablespoon would probably be plenty.”

It’s okay to add a pinch of salt if it makes the eggs taste better to you. Just don’t load up on both cheese and salt, since cheese is already salty enough, Ebner says.

The bottom line? Eggs are an excellent source of protein. You can certainly add eggs to your meal plan, but be careful not to eat too many egg yolks. Ebner recommends limiting them to no more than four yolks per week.

For more on what to eat for breakfast when managing diabetes, check out Diabetes Daily’s article “Recipe Roundup: Low-Carb Sunday Brunch”!

New research denies a link between higher intakes of eggs, cholesterol imbalance and elevated risks of cardiovascular disease (CVD) events or type 2 diabetes.
Since the 1970s, due to a one-sided focus on the effects of cholesterol in CVD, dietary guidelines have recommended limiting egg intake to between two and four per week or even less for people with type 2 diabetes or history of CVD.
However, a growing body of research now suggests that dietary cholesterol is not of concern based on the fact that there aren’t any appreciable relationships between cholesterol in the diet and blood cholesterol or CVD.
Many of these earlier studies about the diet-heart hypothesis and cholesterol also formed the basis for meta-analysis on the associations of egg consumption and incidence of type 2 diabetes.
In those, it was highlighted that consuming seven or more eggs per week was tied to a higher prevalence of type 2 diabetes and that, among people with type 2 diabetes, frequent consumers of eggs may experience more CVD events.
All of this outdated and possibly incorrect evidence sparked calls for further scrutiny, which is why Dutch researchers from the University of Copenhagen set out to analyse more recent (
Their findings are severalfold. First, they found that there is little or no consistency between egg consumption and the risk of type 2 diabetes in studies with follow-ups as long as seven years.
It was also shown that, in healthy people and people with type 2 diabetes, no direct associations exist between egg consumption and coronary artery calcium, a marker for the development of atherosclerosis.
Among people at higher risk for CVD, egg consumption was generally inversely associated with dyslipidemia and, in some cases, those who consumed them had less visible atherosclerotic plaque when they underwent a coronary angiography.
In terms of the impact of eggs on cholesterol levels, a few well-designed studies found no adverse effects of a high (one to three eggs daily) versus low egg consumption for up to one year among healthy adults and those with type 2 diabetes or metabolic syndrome.
There is sometimes a higher increase of total and LDL cholesterol, but this is almost always accompanied by an increase in protective HDL cholesterol which tends to persist over time while triglycerides stay low and total and LDL cholesterol stop rising.
Overall, recent evidence seems to suggest that up to two eggs per day can be safely consumed in the context of a healthy lifestyle as they have either neutral or slightly positive effects on various risk markers of CVD or type 2 diabetes.
In addition to their health benefits, eggs can increase satiety and constitute healthful alternatives to harmful foods in our modern diet such as processed meat, refined grains and sugars.

Mmmm, cheese – a food as nutritious as it is delicious. Or is it?

On the one hand, cheese is an excellent source of minerals like calcium and magnesium, vitamins A, B2 and B12, not to mention being a complete protein.

On the other hand, cheese is also a significant source of saturated fat and sodium in our diets. To lower saturated fat intake, consuming reduced-fat cheese is sometimes recommended to lower cardiovascular disease risk.

Paradoxically, however, there is now a growing body of evidence that people who eat lots of cheese do not have a higher risk of cardiovascular diseases, including Type 2 diabetes.

Our research team at the University of Alberta examined the impact of both reduced- and regular-fat cheese on insulin resistance in the bodies of pre-diabetic rats. We found that both types of cheese reduced insulin resistance, which is important to maintain normal blood sugars.

Why we used rats

Many of the studies previously conducted into the impact of cheese on cardiovascular disease (CVD) have been observational. In other words, researchers have studied the usual eating behaviour of large numbers of people, usually for years, and then correlated the amount of cheese (and other dairy foods) eaten with the development of CVD risks, such as high cholesterol or coronary artery disease.

Observational studies of human eating patterns cannot be used to determine causation. ()

A 2016 survey of published observational studies found that cheese had either a neutral or beneficial effect on several CVD risk factors

These studies are very useful to establish trends associated with usual eating patterns but they can’t definitively say that a particular food causes or prevents a particular disease.

To understand causation better, studies that examine the effects of foods in a controlled setting are useful. These studies can be conducted in humans but there are limitations. Thus, studies in laboratory animals can also be useful, particularly in understanding biochemical mechanisms.

Cheese and insulin resistance

Insulin resistance is a condition that commonly develops with ageing and obesity, leading to high blood glucose, and risk factor of CVD and Type 2 diabetes.

Our objective was to compare how consuming reduced- versus regular-fat cheese affected insulin resistance, and to explore biochemical mechanisms that might explain any observed effects.

We used a rat model of insulin resistance that shares many characteristics with humans. We created the model by feeding the rats high amounts of lard. After four weeks, the rats were divided into three groups: 1) lard diet, 2) lard diet and reduced-fat cheddar cheese, 3) lard diet and regular fat cheddar cheese.

All the diets had the same total amount of fat, only the source of it varied (lard versus cheese). The rats ate these diets for eight more weeks.

The most interesting finding in our research was that both reduced- and regular-fat cheddar cheese reduced insulin resistance in the rats. This suggests that the beneficial effects of cheese might not be related to the amount of fat but to some other component, such as the protein or the calcium.

Butter versus cheese

A few new studies in humans have appeared in the literature since we began our study. A group from Laval University and the University of Manitoba compared the effects of eating fats from different sources in men and women with abdominal obesity.

Another study tested butter, cheese, olive oil and corn oil diets and found no impact on insulin levels. ()

The diet duration was four weeks and each diet was assessed in all the participants. Butter, cheese, olive oil and corn oil diets (32 per cent calories from fat) were compared with a higher carbohydrate diet (25 per cent calories from fat).

The researchers examined blood glucose and insulin levels (which are indirect indicators of insulin resistance) and found no effect from any of the fats. However, the blood samples were collected after fasting, so the information about blood sugar was incomplete.

Another study that compared reduced- to regular-fat cheese found no overall differences on LDL-cholesterol characteristics in people with cardiovascular disease risk factors, but did not examine blood sugar-related outcomes.

Changing blood metabolites

In our study, we also examined how metabolites in the blood changed after cheese feeding and found similar effects in reduced- and regular-fat cheese.

The changes are related to a specific type of molecule called phospholipids, which have many functions in the body. Interestingly, low-circulating phospholipids are linked with diabetes and insulin resistance in humans.

The rats fed on a lard diet had lower phospholipid levels. These were normalized in the rats that ate cheese.

We are pursuing this line of research now — to understand how cheese regulates phospholipid metabolism and how this relates to insulin resistance.

Oct. 9, 2014 — Eggs don’t have a bad effect on cholesterol levels in people with type 2 diabetes, a new study suggests. Researchers also found that eating an egg-rich diet for 3 months was linked to better appetite control, and may also provide a greater sense of feeling full.

The findings suggest that eating two eggs per day, 6 days a week can be a safe part of a healthy diet for people with type 2, according to Nicholas Fuller, PhD, from the Boden Institute Clinical Trials Unit, University of Sydney, Australia.

Fuller presented his findings at the European Association for the Study of Diabetes 2014 Meeting last month.

He said the study was motivated by the negative perception widely held toward eggs in the diets of people with type 2 diabetes. Studies have also suggested that, although eating high amounts of eggs is not linked to heart problems in people without diabetes, it may be tied to heart problems in people with type 2, he said.

National guidelines on eating eggs and total cholesterol limits are inconclusive, though, and guidelines vary between different countries, he said.

For example, in Australia, the National Heart Foundation recommends a maximum of six eggs per week as part of a diet low in saturated fats for healthy people and in those with type 2 diabetes. But in the U.S., guidelines recommend cholesterol be limited to less than 300 milligrams per day for healthy people — and one egg has about 200 milligrams of cholesterol. Those guidelines also suggest that people with type 2 stick to less than four eggs per week.

There’s a lack of research into the effects of eating high amounts of eggs in people with type 2 diabetes, Fuller said.

One Egg a Day Keeps Diabetes at Bay

Consumption of one egg every day seems to associate with a blood metabolite profile that is related to a lower risk of type 2 diabetes, a new study conducted in the University of Eastern Finland shows. The findings were published in Molecular Nutrition and Food Research
Eggs remain one of the most controversial food items. High intake of eggs has traditionally been discouraged, mainly due to their high cholesterol content. However, eggs are also a rich source of many bioactive compounds that can have beneficial effects on health. This means that the health effects of consuming eggs are difficult to determine based solely on their cholesterol content.
The investigators have previously shown that eating roughly one egg per day was associated with a lower risk of developing type 2 diabetes among middle-aged men participating in the Kuopio Ischaemic Heart Disease Risk Factor Study in eastern Finland.
“The purpose of the current study was to explore potential compounds that could explain this association using non-targeted metabolomics, a technique that enables a broad profiling of chemicals in a sample,” says Early Stage Researcher and lead author of the study Stefania Noerman from the University of Eastern Finland.
The study found that the blood samples of men who ate more eggs included certain lipid molecules that positively correlated with the blood profile of men who remained free of type 2 diabetes. In addition, the researchers identified several biochemical compounds in blood that predicted a higher risk of developing type 2 diabetes, including the amino acid tyrosine.
The study suggests some plausible mechanisms which could at least partly explain the inverse association between egg intake and the previously observed lower risk of developing type 2 diabetes.
“Although it is too early to draw any causal conclusions, we now have some hints about certain egg-related compounds that may have a role in type 2 diabetes development. Further detailed investigations with both cell models and intervention studies in humans that use modern techniques, such as metabolomics, are needed to understand the mechanisms behind physiological effects of egg intake,” Early Stage Researcher Noerman concludes.
This article has been republished from materials provided by the University of Eastern Finland. Note: material may have been edited for length and content. For further information, please contact the cited source.
Reference: Stefania Noerman, Olli Kärkkäinen, Anton Mattsson, Jussi Paananen, Marko Lehtonen, Tarja Nurmi, Tomi‐Pekka Tuomainen, Sari Voutilainen, Kati Hanhineva, Jyrki K Virtanen. Metabolic Profiling of High Egg Consumption and the Associated Lower Risk of Type 2 Diabetes in Middle‐Aged Finnish Men. 2018. Molecular Nutrition and Food Research. https://doi.org/10.1002/mnfr.201800605.

Eggs for breakfast benefits those with diabetes

Associate Professor Jonathan Little, who teaches in UBC Okanagan’s School of Health and Exercise Sciences, published a study this week demonstrating that a high-fat, low-carb breakfast (LCBF) can help those with T2D control blood sugar levels throughout the day.

“The large blood sugar spike that follows breakfast is due to the combination of pronounced insulin resistance in the morning in people with T2D and because typical Western breakfast foods — cereal, oatmeal, toast and fruit — are high in carbohydrates,” says Little.

Breakfast, he says, is consistently the “problem” meal that leads to the largest blood sugar spikes for people with T2D. His research shows that by eating a low-carb and high-fat meal first thing in the morning is a simple way to prevent this large spike, improve glycemic control throughout the day, and perhaps also reduce other diabetes complications.

Study participants, with well-controlled T2D, completed two experimental feeding days. On one day, they ate an omelette for breakfast and on another day, they ate oatmeal and some fruit. An identical lunch and dinner were provided on both days. A continuous glucose monitor — a small device that attaches to your abdomen and measures glucose every five minutes — was used to measure blood sugar spikes across the entire day. Participants also reported ratings of hunger, fullness and a desire to eat something sweet or savory.

Little’s study determined that consuming a very low-carbohydrate high-fat breakfast completely prevented the blood sugar spike after breakfast and this had enough of an effect to lower overall glucose exposure and improve the stability of glucose readings for the next 24 hours.

“We expected that limiting carbohydrates to less than 10 per cent at breakfast would help prevent the spike after this meal,” he says. “But we were a bit surprised that this had enough of an effect and that the overall glucose control and stability were improved. We know that large swings in blood sugar are damaging to our blood vessels, eyes, and kidneys. The inclusion of a very low-carbohydrate high-fat breakfast meal in T2D patients may be a practical and easy way to target the large morning glucose spike and reduce associated complications.”

He does note that there was no difference in blood sugar levels in both groups later in the day, suggesting that the effect for reducing overall post-meal glucose spikes can be attributed to the breakfast responses with no evidence that a low-carb breakfast worsened glucose responses to lunch or dinner.

“The results of our study suggest potential benefits of altering macronutrient distribution throughout the day so that carbohydrates are restricted at breakfast with a balanced lunch and dinner rather than consuming an even distribution and moderate amount of carbohydrates throughout the day.”

As another interesting aspect of the research, participants noted that pre-meal hunger and their cravings for sweet foods later in the day tended to be lower if they ate the low-carb breakfast. Little suggests this change in diet maybe a healthy step for anybody, even those who are not living with diabetes.

Little’s study was published this week in the American Journal of Clinical Nutrition. His research is funded by the Canadian Institutes of Health Research and a Michael Smith Foundation for Health Research Scholar Award.

Eggs and Diabetes

The 2011-2012 Australian Health Survey reported 5.1% of adult Australians have diabetes and a further 3.1% are at high risk of developing diabetes1. The survey also found that for every 4 cases of diagnosed diabetes there was one case that goes undiagnosed.

For type 2 diabetes, the increased prevalence is likely driven by rising obesity, the ageing population, dietary changes, and sedentary lifestyles2. Body mass index (BMI), alcohol consumption and physical inactivity have been specifically identified as significant lifestyle risk factors impacting the development of type 2 diabetes in Australian adults3. Previously thought to only occur in adulthood, type 2 diabetes is now increasingly being identified in younger age groups.

EGG CONSUMPTION IN INDIVIDUALS WITH OR AT RISK OF DEVELOPING TYPE 2 DIABETES

It has been previously suggested that individuals with (or at risk of) type 2 diabetes may need to limit their intake of eggs (and/or dietary cholesterol intake) due to observational evidence of an association between higher egg intake ((>7 eggs/week (in most studies)) and an increased risk of cardiovascular disease (CVD)4-7. While some evidence indicates a link, two recent observational studies in US8 and UK9 adults found no evidence of an association between dietary cholesterol or higher egg intake and CVD in individuals with pre-diabetes or type 2 diabetes8,9. On the other hand, one recent longitudinal study in Korean adults indicated an increased risk of CVD amongst individuals with type 2 diabetes who consumed more than 4.2 eggs per week10. These mixed results are likely due to factors such as the inadequate control of confounders and, in some cases, small sample sizes. Authors have called for caution when interpreting these findings4.

Importantly, well-designed intervention studies do not indicate that higher egg intake has any adverse effects on CVD risk in individuals with or at risk of type 2 diabetes. A 2017 systematic review of six randomised controlled trials concluded that the consumption of 6 to 12 eggs per week, in the context of a diet that is consistent with guidelines on cardiovascular health promotion, has no adverse effect on major CVD risk factors in individuals at risk for developing diabetes or with type 2 diabetes11.

Furthermore, since the 2017 systematic review, the results of an Australian 12 month intervention study have been published which support the conclusion that eggs can be enjoyed by individuals with (or at risk of) type 2 diabetes. In the DIABEGG study, consuming ≥12 eggs per week produced no detrimental outcomes in CVD risk factors (including cholesterol, triglycerides, inflammatory markers, oxidative stress or measures of glycemia) for individuals with prediabetes or type 2 diabetes and overweight or obesity 12. These 12 month findings are an extension of the original 3-month DIABEGG study which showed that high egg (≥12 eggs per week) consumption vs low egg (<2 eggs per week) consumption, as part of a weight maintenance diet, had no detrimental effect on CVD risk factors13.

Overall, intervention studies in individuals with prediabetes, metabolic syndrome and type 2 diabetes indicate that eggs are an acceptable and convenient whole food option that can be consumed regularly as part of a healthy diet to manage these conditions.

BENEFITS OF EGG CONSUMPTION FOR INDIVIDUALS WITH OR AT RISK OF TYPE 2 DIABETES

Research in individuals with type 2 diabetes has also indicated that the inclusion of eggs daily may be beneficial as they may displace less healthful foods such as refined grains and boost levels of quality protein in the diet14.

As well as providing quality protein, eggs contain at least 11 vitamins and minerals, omega-3 fatty acids and antioxidants. Eggs can therefore make a valuable contribution to daily protein and nutrient requirements.

Further research has been carried out with the aim of determining if there is a relationship between egg consumption and risk of developing type 2 diabetes.

SUMMARY OF EPIDEMIOLOGICAL STUDIES INVOLVING EGG CONSUMPTION AND RISK OF DIABETES (T2DM)

A 2016 meta-analysis of twelve prospective cohort studies examined the risk of developing type 2 diabetes based on levels of egg consumption15 and found no overall association. In sub-analysis, egg consumption was positively associated with type 2 diabetes risk in US studies but no overall association was observed in non-US studies. This isolation to US populations suggests that egg consumption may be a marker of a broader dietary pattern in which the studies were conducted. For example in one of the US studies which found a significant association between egg consumption and type 2 diabetes 16 egg consumption was related to the Western dietary pattern characterised by a high intake of red or processed meat, French-fries, sweets and dessert, snacks and refined grains. Whereas, in the study conducted in Japan17 which found no association, egg consumption was strongly associated with prudent, traditional dietary patterns rather than a western dietary pattern.

Overall there is a lack of evidence relating egg consumption with incidence of type 2 diabetes. The current body of evidence highlights the importance of consuming eggs in the context of an overall healthy dietary pattern as recommended by the current Australian Dietary Guidelines18 as well as Diabetes Australia19 and the Heart Foundation20.

SUMMARY OF INTERVENTION STUDIES INVOLVING EGG CONSUMPTION AND INDIVIDUALS WITH/OR AT RISK OF TYPE 2 DIABETES

Clinical intervention trials have investigated the effect of egg consumption on glycaemic control in individuals with type 2 diabetes. This research includes the Australian DIABEGG study which found no difference in glycaemic control when individuals consumed 2 eggs per day or less than 2 eggs per week as part of a weight maintenance diet13 or weight loss diet and follow up period (12 months in total) 12. Furthermore a 2016 trial found no effect of the short term consumption of 2 eggs per day on glycaemic control in individuals with type 2 diabetes21. In the context of a 12 week weight loss diet, consumption of 2 eggs per day showed similar weight loss and improvements in glycaemic control as consuming 100g lean meat per day22. Another small study showed no significant differences on blood sugar levels or HbA1C when 1 egg per day for 5 weeks was consumed compared to an oatmeal and milk breakfast23. Overall clinical evidence to date shows a “lack of detrimental effects of eggs on lipoprotein or glucose metabolism” 24.

GESTATIONAL DIABETES

An analysis of two studies25 examined the effect of egg consumption before or during the first trimester of pregnancy on the risk of gestational diabetes. After adjusting for confounders, researchers in both studies found a 2.4-2.5 fold increased risk of developing gestational diabetes with the consumption of 10 or more eggs per week. However both studies found little to no effect on gestational diabetes risk for those who consumed less than seven eggs per week26. Including eggs in the diet of pregnant women can contribute a range of important nutrients to the diet.

CONCLUSIONS

Epidemiological evidence regarding egg consumption and its effect on people with diabetes is inconsistent and positive associations appear to be isolated to US based studies. Caution with interpretation is warranted particularly given evidence from clinical studies conducted to date do not support an association between egg consumption and risk of type 2 diabetes or CVD risk in individuals with (or at risk of) type 2 diabetes.

RECOMMENDATIONS

  • Further longer term studies would help further assess the effect of egg consumption in people with diabetes.
  • Overall dietary patterns, physical activity and genetics effect the development of type 2 diabetes more than a single food such as eggs27.
  • Prudent advice is that eggs may be included in the context of a diet low in saturated fat, containing known cardio-protective foods and meeting the guidelines for diabetes management. Eggs can contribute valuable nutrients including quality protein, vitamins and minerals in the diets of individuals with or at risk of type 2 diabetes.
  • Research supports the regular inclusion of eggs as part of a healthy diet. Furthermore, Diabetes Australia recommends individuals with diabetes follow the Australian Dietary Guidelines which support the consumption of eggs daily and conclude that “there do not appear to be any increased health risks associated with consumption of eggs”.18

This statement is for healthcare professionals only.

*One serve = 2x60g eggs (104g edible portion)

As diet-induced changes in plasma glucose levels, total cholesterol and lipoproteins vary considerably between individuals, the Egg Nutrition Council recommends individual discussion of the recommendations regarding egg intake with their health care professional.

To find out more about .

USEFUL LINKS

Australian Dietary Guidelines: www.eatforhealth.gov.au/guidelines

Diabetes Australia: http://www.diabetesaustralia.com.au

American Diabetes Association: http://www.diabetes.org/

Joslin Diabetes Center: http://www.joslin.org/

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