Background: Previously published research that examined the effects of high egg consumption in people with type 2 diabetes (T2D) produced conflicting

The guidelines for dietary cholesterol and/or egg intake for both the general population and those at higher risk of cardiovascular disease (for example, people with type 2 diabetes mellitus (T2DM)) differ between countries, and even for different specialist societies in a country. The disparity between these guidelines is at least in part related to the conflicting evidence as to the effects of eggs in the general population and in those with T2DM. This review addresses the effect of eggs on cardiovascular disease (CVD) risk from both epidemiological research and controlled prospective studies, in people with and without cardio-metabolic disease. It also examines the nutritional qualities of eggs and whether they may offer protection against chronic disease. The evidence suggests that a diet including more eggs than is recommended (at least in some countries) may be used safely as part of a healthy diet in both the general population and for those at high risk of cardiovascular disease, those with established coronary heart disease, and those with T2DM. In conclusion, an approach focused on a person’s entire dietary intake as opposed to specific foods or nutrients should be the heart of population nutrition guidelines.

Some country guidelines recommend that people with type 2 diabetes (T2D) limit their consumption of eggs and cholesterol. Our previously published 3-mo weight-maintenance study showed that a high-egg (≥12 eggs/wk) diet compared with a low-egg diet (<2 eggs/wk) did not have adverse effects on cardiometabolic risk factors in adults with T2D. The current study follows the previously published 3-mo weight-maintenance study and assessed the effects of the high-egg compared with the low-egg diets as part of a 3-mo weight-loss period, followed by a 6-mo follow-up period for a total duration of 12 mo. Participants with prediabetes or T2D (n = 128) were prescribed a 3-mo daily energy restriction of 2.1 MJ and a macronutrient-matched diet and instructed on specific types and quantities of foods to be consumed, with an emphasis on replacing saturated fats with monounsaturated and polyunsaturated fats. Participants were followed up at the 9- and 12-mo visits. From 3 to 12 mo, the weight loss was similar (high-egg compared with low-egg diets: −3.1 ± 6.3 compared with −3.1 ± 5.2 kg; P = 0.48). There were no differences between groups in glycemia (plasma glucose, glycated hemoglobin, 1,5-anhydroglucitol), traditional serum lipids, markers of inflammation (high-sensitivity C-reactive protein, interleukin 6, soluble E-selectin), oxidative stress (F2-isoprostanes), or adiponectin from 3 to 12 mo or from 0 to 12 mo. People with prediabetes or T2D who consumed a 3-mo high-egg weight-loss diet with a 6-mo follow-up exhibited no adverse changes in cardiometabolic markers compared with those who consumed a low-egg weight-loss diet. A healthy diet based on population guidelines and including more eggs than currently recommended by some countries may be safely consumed. This trial is registered at http://www.anzctr.org.au/ as ACTRN12612001266853.