Elsevier

American Heart Journal

Volume 169, Issue 1, January 2015, Pages 162-169
American Heart Journal

Clinical Investigation
Coronary Artery Disease
Effects of egg ingestion on endothelial function in adults with coronary artery disease: A randomized, controlled, crossover trial

https://doi.org/10.1016/j.ahj.2014.10.001Get rights and content

Background

Prevailing recommendations call for restricting intake of dietary cholesterol and eggs for those at risk of heart disease, despite accumulating evidence challenging this association. Our prior studies showed no short-term adverse effects of daily egg intake on cardiac risk factors in at-risk adults.

Objective

We conducted this study to determine effects of daily egg consumption in adults with established coronary artery disease (CAD).

Methods

Randomized, controlled, single-blind, crossover trial of 32 adults (mean age, 67 years; 6 women, 26 men) with CAD assigned to 1 of 6 possible sequence permutations of 3 different treatments (breakfast with 2 eggs, breakfast with ½ cup Egg Beaters, ConAgra Foods, St. Louis, MO, or a high-carbohydrate breakfast part of an ad libitum diet) for 6 weeks, with 4-week washout periods. The primary outcome measure was endothelial function measured as flow-mediated dilatation.

Results

Compared with the control breakfast (ie, high-carbohydrate breakfast), daily consumption of eggs showed no adverse effects on flow-mediated dilatation (7.2% ± 2.9% vs 7.5% ± 2.9%, P = .33), lipids (total cholesterol: 158.3 ± 28.6 mg/dL vs 156.2 ± 27.4 mg/dL, P = .49), blood pressure (systolic blood pressure: 132.8 ± 14.1 mm Hg or vs 135.5 ± 14.9 mm Hg, P = .52; diastolic blood pressure: 77.2 ± 6.1 mm Hg vs 76.7 ± 6.9 mm Hg, P = .86), or body weight (90.8 ± 17.5 kg vs 91.8 ± 17.1 kg, P = .92). No outcomes differed (P > .05) between eggs and Egg Beaters.

Conclusions

We found no evidence of adverse effects of daily egg ingestion on any cardiac risk factors in adults with CAD over a span of 6 weeks.

Section snippets

Background

Eggs are a concentrated source of dietary cholesterol, and it is a general belief in the medical community that egg intake is a risk factor for high serum cholesterol.1 However, eggs are relatively low in saturated fat and thus have a small effect on total and low-density lipoprotein cholesterol (LDL-C) levels.2 The consumption of whole eggs has been shown to lead to a significant increase in high-density lipoprotein cholesterol (HDL-C), large HDL, and large LDL compared with the consumption of

Study population

A study cohort of 32 adults (6 women and 26 men) with clinically established CAD were recruited from communities in the Lower Naugatuck Valley, CT (an area with a predominantly white population), through newspaper advertisements and posters at frequented sites. Coronary artery disease was defined by the presence of at least 1 coronary artery stenosis >50% determined angiographically or through a documented history of ischemic heart disease. The study population included men older than 35 years,

Study participants

Of the 32 participants recruited into the study, 30 completed the trial. One participant dropped out of the study for a medical reason unrelated to the study; another dropped out due to an inability to continue complying with the study protocol. The study participants were predominantly male (81.2%) and were also mostly white (96.9%). The average age of the participants was 67.1 years. Most participants were using lipid- and blood pressure–lowering medications (ie, 90.6% and 87.5%,

Discussion

To the best of our knowledge, this is the first randomized controlled trial of egg ingestion on endothelial function in patients with CAD. Our findings provide evidence that short-term (6 weeks) consumption of eggs does not adversely affect endothelial function in patients with coronary heart disease. Moreover, consuming 2 eggs daily did not alter serum cholesterol or other measures of the lipid profile.

These results on endothelial function are consistent with our previous studies in other

Conclusion

Daily egg intake for 6 weeks in adults with established CAD was associated with no discernible adverse effects. In the larger context of relevant epidemiologic findings, our study argues against the exclusion of eggs from the diet for the sake of cardiac health promotion. Data from longer-term intervention studies are warranted to inform public health nutrition policy.

Acknowledgements

The authors wish to acknowledge the technical assistance of Mrs Michelle Pinto-Evans.

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  • Cited by (0)

    Clinical Trial Registration Number: NCT01672567

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