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Go easy on the eggs if you have diabetes

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Love eggs Benedict but worried about cholesterol? The best advice is to eat eggs in moderation.

Recommendations on egg intake have lightened up, but eggs Benedict for breakfast every morning still isn't a good idea.

Scrambled, fried or baked into pastries, Americans love their eggs. But what about all that cholesterol? One large egg has about 200 milligrams (mg) of cholesterol. Until last year, the Dietary Guidelines (DG) placed a 300 mg cap on daily cholesterol intake, but the new 2015 DG Advisory Committee Report dropped that recommendation, stating cholesterol is no longer a nutrient of concern. So is that a green light for eggs Benedict every day?

All about foods, not nutrients. A closer look at the DG Advisory Committee report, along with guidelines from the American Heart Association and the American College of Cardiology, reveal a shift away from focusing on single nutrients, like cholesterol, toward diet patterns such as the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets. These well-researched diets — rich in fish, whole grains, vegetables and fruits — naturally contain lower cholesterol levels.

Science on cholesterol and eggs. It's easy to think that eating foods high in cholesterol will lead to high blood cholesterol, but research suggests it is actually a pretty weak link for most people. A meta-analysis (American Journal of Clinical Nutrition, 2001) that pooled results from 17 studies on the relationship between dietary cholesterol and blood cholesterol concluded that for every additional 200 mg cholesterol consumed, LDL (“bad”) cholesterol in the blood increased by about four points. A recent 12-year prospective study found that daily egg consumption was not associated with risk of heart attack or stroke (American Journal of Clinical Nutrition, 2015).

However, there may be a stronger link among people with diabetes. Among women with diabetes, each increase of 200 mg cholesterol per 1,000 calories resulted in a 37 percent increased risk of developing heart disease (American Journal of Clinical Nutrition, 2004). And eating eggs daily was associated with 77 percent increased risk of developing type 2 diabetes (Diabetes Care, 2009). A 2013 meta-analysis concluded that egg consumption may be linked with an increased risk of type 2 diabetes among the general population and cardiovascular disease among people with diabetes.

The bottom line. The best advice is to eat eggs in moderation. For healthy adults, that's no more than one egg a day; if you're at higher risk for type 2 diabetes limit yourself to four to five per week. But instead of focusing on eggs, aim for a Mediterranean or DASH eating style, which reduces red and processed meats and emphasizes vegetables, legumes, whole grains, fruits and plant-based oils such as olive oil.

Registered dietician Clare Tone writes for Environmental Nutrition, the independent newsletter by nutrition experts. Details: environmentalnutrition.com