British Journal of Nutrition

Human and Clinical Nutrition

Egg consumption as part of an energy-restricted high-protein diet improves blood lipid and blood glucose profiles in individuals with type 2 diabetes

Karma L. Pearcea1a2a3 c1, Peter M. Cliftona1 and Manny Noakesa1

a1 Commonwealth Scientific and Industrial Research Organization (CSIRO), Food and Nutritional Sciences, Adelaide, SA 5000, Australia

a2 Department of Physiology, University of Adelaide, SA 5001, Australia

a3 School of Pharmacy and Medical Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia

Abstract

The role of dietary cholesterol in people with diabetes has been little studied. We investigated the effect of a hypoenergetic high-protein high-cholesterol (HPHchol) diet compared to a similar amount of animal protein (high-protein low-cholesterol, HPLchol) on plasma lipids, glycaemic control and cardiovascular risk markers in individuals with type 2 diabetes. A total of sixty-five participants with type 2 diabetes or impaired glucose tolerance (age 54·4 (sd 8·2) years; BMI 34·1 (sd 4·8) kg/m2; LDL-cholesterol (LDL-C) 2·67 (sd 0·10) mmol/l) were randomised to either HPHchol or HPLchol. Both hypoenergetic dietary interventions (6–7 MJ; 1·4–1·7 Mcal) and total carbohydrate:protein:fat ratio of 40:30:30 % were similar but differed in cholesterol content (HPHchol, 590 mg cholesterol; HPLchol, 213 mg cholesterol). HPHchol participants consumed two eggs per d, whereas HPHchol participants replaced the eggs with 100 g of lean animal protein. After 12 weeks, weight loss was 6·0 (sd 0·4) kg (P < 0·001). LDL-C and homocysteine remained unchanged. All the subjects reduced total cholesterol ( − 0·3 (sd 0·1) mmol/l, P < 0·001), TAG ( − 0·4 (sd 0·1) mmol/l, P < 0·001), non-HDL-cholesterol (HDL-C, − 0·4 (sd 0·1) mmol/l, P < 0·001), apo-B ( − 0·04 (sd 0·02) mmol/l, P < 0·01), HbA1c ( − 0·6 (sd 0·1) %, P < 0·001), fasting blood glucose ( − 0·5 (sd 0·2) mmol/l, P < 0·01), fasting insulin ( − 1·7 (sd 0·7) mIU/l, P < 0·01), systolic blood pressure ( − 7·6 (sd 1·7) mmHg, P < 0·001) and diastolic blood pressure ( − 4·6 (sd 1·0) mmHg; P < 0·001). Significance was not altered by diet, sex, medication or amount of weight loss. HDL-C increased on HPHchol (+0·02 (sd 0·02) mmol/l) and decreased on HPLchol ( − 0·07 (sd 0·03) mmol/l, P < 0·05). Plasma folate and lutein increased more on HPHchol (P < 0·05). These results suggest that a high-protein energy-restricted diet high in cholesterol from eggs improved glycaemic and lipid profiles, blood pressure and apo-B in individuals with type 2 diabetes.

(Received February 03 2010)

(Revised May 26 2010)

(Accepted September 01 2010)

(Online publication December 07 2010)

Correspondence:

c1 Corresponding author: K. L. Pearce, fax +61 8 8302 2389, email karma.pearce@unisa.edu.au

Footnotes

Abbreviations: CRP, C-reactive protein; HbA1c, glycosylated Hb; HDL-C, HDL-cholesterol; HOMA2, homoeostatic model assessment; HPHchol, high-protein high-cholesterol; HPLchol, high-protein low-cholesterol; IR, insulin resistance; LDL-C, LDL-cholesterol; TC, total cholesterol

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