Follow up shows no adverse changes in cardiometabolic testing with high-egg diet in type 2 diabetes.

Heart shaped fried eggs

Some dietary and medical guidelines recommend that people with type 2 diabetes limit their consumption of eggs and cholesterol.  Both egg whites and yolks are rich in nutrients to include proteins, vitamins, and minerals.  Eggs are a very good source of inexpensive, high-quality protein.  The yolk also contains choline, cholesterol, fat-soluble vitamins (vitamins A, D, E, and K), and essential fatty acids.  The whites are rich sources of vitamin B6 and B12 and minerals such as copper, iron, selenium, and zinc.  Eggs are regarded as a complete source of protein because they contain all nine essential amino acids.  Beyond the nutrition, eggs are a very important and versatile ingredient for cooking.  For this reason, it is highly unfortunate that so many organization have recommended limiting eggs in people with diabetes and heart disease.  

New research appears to contradict the professional advice I have given my patients for years.  The group that published this randomized controlled study previously published a 3-month weight-maintenance study which showed that a high-egg diet with over 12 eggs per week compared with a low-egg diet of fewer than two eggs per week did not have adverse effects on cardiometabolic risk factors in adults with type 2 diabetes[1].  The current study that I am reviewing is a randomized controlled study that was released in May of 2018[2].  The current study is a follow up of the previously published 3-month weight-maintenance study and assessed the effects of the high-egg compared with the low-egg diets as part of a 3-month weight-loss period, followed by a 6-month follow-up period for a total duration of 12 months.  The 128 subjects of the study had prediabetes or type 2 diabetes and were prescribed a 3-month daily energy restriction and a macronutrient-matched diet.  The subjects were 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-month and 12-month visits.  Researchers confirmed the results of the prior study.  From 3 to 12 months, the weight loss was similar between the high-egg and low-egg consumption.  There were no differences between groups in plasma glucose and glycated hemoglobin or markers of inflammation or cardiometabolic markers.   

This study appears to confirm the results of another prior study from 2011[3].  The 2011 study suggested that a high-protein energy-restricted diet high in cholesterol from eggs improved glycaemic and lipid profiles and blood pressure in individuals with type 2 diabetes.  

The bottom line: Eggs are a fantastic source of protein and nutrition.  We do not need to avoid eggs when trying to lose weight or if you have diabetes/heart disease.  Subjects in this study that had prediabetes or diabetes type 2 consumed high-egg weight-loss diet exhibited no adverse changes in cardiometabolic markers when 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.  More research is needed, but this is very promising.