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Randomized Controlled Trial
. 2022 May 20;14(10):2138.
doi: 10.3390/nu14102138.

Eggs Improve Plasma Biomarkers in Patients with Metabolic Syndrome Following a Plant-Based Diet-A Randomized Crossover Study

Affiliations
Randomized Controlled Trial

Eggs Improve Plasma Biomarkers in Patients with Metabolic Syndrome Following a Plant-Based Diet-A Randomized Crossover Study

Minu S Thomas et al. Nutrients. .

Abstract

Plant-based (PB) diets are considered a healthy dietary pattern; however, eggs are not always included in this dietary regime. We hypothesized that the addition of two eggs per day would increase HDL cholesterol as well as plasma lutein, zeaxanthin and choline in individuals with metabolic syndrome (MetS). In this randomized controlled crossover intervention, we recruited 30 participants (49.3 ± 8 y) with MetS who followed a PB diet for 13 weeks. A registered dietitian advised all subjects on food selection and followed them through the intervention to ensure compliance. Participants underwent a 2-week washout with no eggs or spinach (a source of dietary lutein and zeaxanthin) and were randomly allocated to consume spinach (70 g) with either two eggs (EGG) or the equivalent amount of egg substitute (SUB) for breakfast for 4 weeks. After a 3-week washout, they were allocated the alternate breakfast. A total of 24 participants (13 women/11 men) finished the intervention. Plasma lipids, glucose, insulin, anthropometrics, plasma lutein, zeaxanthin, choline and trimethylamine oxide (TMAO) were assessed at baseline and the end of each intervention. When we compared individuals consuming the EGG versus the SUB breakfast, we observed a lower body weight (p < 0.02) and a higher HDL cholesterol (p < 0.025) after the EGG diet. There were no differences in plasma LDL cholesterol, triglycerides, glucose, insulin, or blood pressure. The number of large HDL particles measured by NMR was higher after EGG (p < 0.01) as compared to SUB. Plasma choline was higher in both treatments (p < 0.01) compared to baseline (8.3 ± 2.1 μmol/L). However, plasma choline values were higher in EGG (10.54 ± 2.8 μmol/L) compared to SUB (9.47 ± 2.7 μmol/L) p < 0.025. Both breakfasts increased plasma lutein compared to baseline (p < 0.01), while plasma zeaxanthin was only increased in the egg intervention (p < 0.01). These results indicate that consuming a plant-based diet in combination with whole eggs increases plasma HDL cholesterol, choline and zeaxanthin, important biomarkers in subjects with MetS.

Keywords: TMAO; choline; eggs; lipids; lutein; metabolic syndrome; plant-based diet; spinach; zeaxanthin.

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Conflict of interest statement

MST, MP, OM, MJS declare no conflicts of interest. MC, JLC and MLF have been funded by the Egg Nutrition Center.

Figures

Figure 1
Figure 1
Experimental design. Participants underwent a 2-week washout period before being randomly allocated to either 2 eggs/d or equivalent egg substitute (1/2 c/d) for 4 weeks. Following a 3-week washout period, they were assigned the alternate treatment.
Figure 2
Figure 2
Concentrations of large HDL at baseline and after the intervention. Values are presented as mean ± SD. Values in the same row with different superscripts (a, b) are significantly different at a p < 0.01. The EGG breakfast resulted in higher concentrations of large HDL.
Figure 3
Figure 3
Concentrations of lutein and zeaxanthin at baseline (BL) and following the EGG and SUB intervention. Both EGG and SUB interventions resulted in higher concentrations of lutein (p < 0.01), but only EGG increased plasma zeaxanthin (p < 0.01) as indicated by different superscripts (a,b). Values are presented as mean ± SD.
Figure 4
Figure 4
The relationship between large HDL and plasma zeaxanthin during the EGG period (Pearson’s correlation coefficient, r = 0.57, p < 0.01).

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