ACC

ACC 2024: Can eggs still be part of a heart-healthy diet?

April 4, 2024

Eggs are a common and relatively inexpensive source of protein and dietary cholesterol, the latter of which has often given eggs a reputation of being problematic for heart health.

Now, results from the PROSPERITY prospective controlled trial, which will be presented at the ACC's Annual Scientific Session April 6 - 8 in Atlanta, show that cholesterol levels were actually similar among people who ate fortified eggs most days of the week compared with those who didn’t eat eggs.

A total of 140 patients with or at high risk for CV disease were enrolled in the trial, which aimed to assess the effects of eating 12 or more fortified eggs a week vs. a non-egg diet (consuming less than two eggs a week) on HDL- and LDL-cholesterol, as well as other key markers of CV health over a four-month study period.

“We know that CV disease is, to some extent, mediated through risk factors like high blood pressure, high cholesterol and increased BMI and diabetes. Dietary patterns and habits can have a notable influence on these and there’s been a lot of conflicting information about whether or not eggs are safe to eat, especially for people who have or are at risk for heart disease,” said Nina Nouhravesh, MD, a research fellow at the Duke Clinical Research Institute in Durham, North Carolina, and the study’s lead author. “This is a small study, but it gives us reassurance that eating fortified eggs is OK with regard to lipid effects over four months, even among a more high-risk population.”

Experts said a more important consideration than cholesterol, especially in the context of these findings, might be what people are eating alongside their eggs, such as buttered toast, bacon and other processed meats, which are not heart healthy choices.

Study details:

• Patients were randomly assigned to eat 12 fortified eggs a week (cooked in whatever manner they chose) or to eat fewer than two eggs of any kind (fortified or not) per week.
• All patients were 50 years of age or older (average age, 66 years), half were female and 27% were Black.
• All patients had experienced one prior CV event or had two CV risk factors, such as high BP, high cholesterol, increased BMI or diabetes. The co-primary endpoint was LDL- and HDL-cholesterol at four months. Secondary endpoints included lipid, cardiometabolic and inflammatory biomarkers and levels of vitamin and minerals.
• Patients had in-person clinic visits at the start of the study and visits at one and four months to take vital signs and have bloodwork done. Phone check-ins occurred at two and three months, and patients in the fortified egg group were asked about their weekly egg consumption. Those with low adherence were provided additional education materials.
• Results showed a -0.64 mg/dL and a -3.14 mg/dL reduction in HDL-cholesterol and LDL cholesterol, respectively, in the fortified egg group. The differences weren't statistically significant.
• In terms of secondary endpoints, researchers observed a numerical reduction in total cholesterol, LDL particle number, apoB levels, high-sensitivity troponin, and insulin resistance scores in the fortified egg group, while vitamin B levels increased.
• This single-center, unblinded study is limited by its small size and reliance on patients’ self-reporting of their egg consumption and other dietary patterns.

Source:

Napoli, Nichole. American College of Cardiology. (2024, March 28). Eggs May Not Be Bad for Your Heart After All. [Press release]. https://www.acc.org/About-ACC/Press-Releases/2024/03/28/11/43/eggs-may-not-be-bad-for-your-heart-after-all