For decades, the humble egg was considered by many to be unsuitable for a heart-healthy diet. After all, the yolk of the egg is rich in cholesterol, which has historically been linked to heart disease. People living with type 1 or type 2 diabetes may have concerns because their risk of developing heart disease is higher than for individuals who do not have diabetes. (Read more about hypertension and diabetes.)
Dietary cholesterol versus blood cholesterol
Fortunately, today we have a greater understanding of the effect of dietary cholesterol on blood cholesterol and heart disease. And this means that you may be able to enjoy eggs once again. (Be sure to check with your care team if you have any questions about your diabetes meal plan.)
Blood cholesterol levels – typically measured after fasting for at least eight hours – are important indicators of heart disease risk. Elevated levels of total cholesterol and LDL (low-density lipoprotein) cholesterol levels are associated with increased risks of developing heart disease. Though it seems logical to eliminate dietary cholesterol, the cholesterol you eat may not have a large effect. In fact, the 2015 Dietary Guidelines Advisory Committee noted that dietary cholesterol is no longer a nutrient of concern. Instead, the 2015-2020 Dietary Guidelines for Americans (DGA) reinforced its previous recommendation and the recommendation of the American Heart Association to limit saturated fats in the diet as a means to control blood cholesterol levels. Foods rich in saturated fats include fatty meats, butter, whole and 2% milk, cheese and yogurt made from whole or 2% milk, coconut oil and many baked goods.
(Read more about fats and diabetes and what the 2015 dietary guidelines may mean for those living with diabetes.)
Eggs on the plate
What was once taboo is now back on the table. In unlimited amounts? No, probably not. Although saturated fats are a primary dietary trigger of cholesterol production in the body, some people may be more susceptible than others to the effects of cholesterol in food. And just because researchers deemed dietary cholesterol no longer a nutrient of concern doesn’t mean that we should swing the pendulum so far in the opposite direction and eat plates of eggs daily.
One large population study found that eating seven or more eggs weekly increased the risk of heart disease among study participants with type 2 diabetes. Not all studies find an association between eggs and heart disease, however. I have to wonder if the reason is the rest of the diet. Sometimes eggs sit atop buttery biscuits and are enjoyed alongside fatty meats. Other times, eggs are part of a heart-healthy diet that includes ample fruits, vegetables, fish and legumes. Researchers in Australia took a closer look. They studied what happened when people with type 2 diabetes or prediabetes ate two eggs daily for six days per week compared to those who ate very few eggs. Everyone was advised to limit unhealthy saturated fats. After the three-month study, the group eating lots of eggs had similar cholesterol and blood sugar levels to the group eating very few eggs.
When my clients ask if eggs are good or bad, I advise them – whether they have diabetes or not – to enjoy eggs as part of a heart-healthy, plant-rich meal plan. (Get more healthful eating tips and exclusive diabetes-friendlier recipes.)
Eggs in the supermarket
You have many choices when shopping for eggs. Below are some you might find in your local grocery store. With the exception of omega-3 enriched eggs, the following types of eggs are nutritionally similar:
- Cage-free. Laid by hens allowed to roam a room, building or an open area that includes a nest space.
- Free-range. Laid by hens that have access to the outdoors.
- Pasteurized. Heated just enough to destroy pathogens. Use pasteurized eggs for recipes requiring uncooked or undercooked eggs.
- Omega-3 enriched. Laid by hens that ate a diet rich in omega-3 fatty acids. Each egg contains at least 100 mg omega-3 fatty acids.
- Certified organic. Laid by hens that have access to the outdoors and are fed certified organic feed.
Jill Weisenberger, MS, RDN, CDE*, FAND, CHWC, is the author of Diabetes Weight Loss Week by Week, The Overworked Person’s Guide to Better Nutrition and 21 Things You Need to Know about Diabetes and Your Heart. She is contributing editor for Environmental Nutrition, and has written for many publications including EatingWell, Diabetic Living, Diabetes Forecast and Kids Eat Right. She has a private practice in Newport News, VA. Weisenberger consulted to the Egg Nutrition Center in 2015 and 2016. Weisenberger is a paid contributor for The DX. All opinions contained in this article reflect those of the contributor and interviewees, and not of Sanofi US, its employees, agencies, or affiliates.
*“Certified Diabetes Educator” and “CDE” are certification marks owned and registered by the National Certification Board for Diabetes Educators (NCBDE). NCBDE is not affiliated in any way with Sanofi US. NCBDE does not sponsor or endorse any diabetes-related products or services
© 2016 The DX: The Diabetes Experience