- Email: [email protected]
Daily egg consumption should be still limited in hypercholestrolemic patients
+
MODEL
Journal of the Formosan Medical Association (2017) xx, 1e1
Available online at www.sciencedirect.com
ScienceDirect journal homepage: www.jfma-online.com
LETTER TO THE EDITOR
Daily egg consumption should be still limited in hpercholestrolemic patients It is appreciated to read the local guidance of “2017 Taiwan lipid guidelines for high risk patients” in the recent issue of the Journal of Formosa Medical Association.1 The guideline clearly points out the target values of low-density lipoprotein cholesterol (LDL-C) in specific population. It also suggests that egg intake do not associated with increased risks of cardiovascular disease and mortality in “general” population. However, additional egg consumption was known to be associated with increased serum LDL-C in patients with “dyslipidemia”.2 Hypercholesterolemic patients, who were randomly assigned to have one and half egg yolk per day with a study period of 12 weeks, had greater values of serum LDL-C by approximately 9 mg/dl as compared with the control group.3 In hyperlipidemic patients already on moderateintensity statin treatment, additional three eggs consumption per day did not change serum LDL-C after a study period of 12 weeks; the result implied that additional eggs consumption attenuated the most effect of lowering LDL-C by statin treatment.4 Consistently, additional two egg yolks per day neutralized the effect of lipid lowering therapy, mainly statin, in a randomized controlled trial with an experimental period of 5 weeks. The serum values of LDL-C did not change significantly from baseline.5 The aforementioned evidence summarized that additional egg consumptions might be a critical factor when treating these high-risk patients with statin or statin/ezetimibe. Additionally, dietary cholesterol is not necessary for a physiological response of our body need as the suggestion of “2015e2020 dietary guidelines for Americans”. The definite number of egg consumption per day remains controversial currently, but daily egg consumption vs. weekly egg consumption was associated with atherosclerosis by increased coronary calcium scores.6 With respect of LDL-C and atherosclerotic cardiovascular diseases, it is suggested that egg consumption should not exceed one egg
Conflict of interest: No conflict of interest should be declared.
per day in hyperlipidemic patients, especially those who are already on statin treatment.
References 1. Li YH, Ueng KC, Jeng JS, Charng MJ, Lin TH, Chien KL, et al. 2017 Taiwan lipid guidelines for high risk patients. J Formos Med Assoc 2017;116:217e48. 2. Liu CW, Lin TC, Tseng GS, Jiau SS. Egg consumption associated with increased concentration of serum total and low-density lipoprotein cholesterol in prospective randomized-controlled trials, thereby possibly associating with an increased risk of developing coronary heart disease e from a view of cardiologists. J Am Coll Nutr. [Accepted but unpublished] http://dx.doi. org/10.1080/07315724.2016.1277171. 3. Severins N, Mensink RP, Plat J. Effects of lutein-enriched egg yolk in buttermilk or skimmed milk on serum lipids & lipoproteins of mildly hypercholesterolemic subjects. Nutr Metab Cardiovasc Dis 2015;25:210e7. 4. Klangjareonchai T, Putadechakum S, Sritara P, Roongpisuthipong C. The Effect of Egg Consumption in Hyperlipidemic Subjects during Treatment with Lipid-Lowering Drugs. J Lipids 2012;2012:672720. 5. Vishwanathan R, Goodrow-Kotyla EF, Wooten BR, Wilson TA, Nicolosi RJ. Consumption of 2 and 4 egg yolks/d for 5 wk increases macular pigment concentrations in older adults with low macular pigment taking cholesterol-lowering statins. Am J Clin Nutr 2009;90:1272e9. 6. Choi Y, Chang Y, Lee JE, Chun S, Cho J, Sung E, et al. Egg consumption and coronary artery calcification in asymptomatic men and women. Atherosclerosis 2015;241:305e12.
Cheng-Wei Liu* Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, Songshan branch, National Defense Medical Center, Taipei, Taiwan *Fax: þ886-2-8837372 E-mail address: [email protected] 5 April 2017
http://dx.doi.org/10.1016/j.jfma.2017.04.004 0929-6646/Copyright ª 2017, Formosan Medical Association. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Please cite this article in press as: Liu C-W, Daily egg consumption should be still limited in hpercholestrolemic patients, Journal of the Formosan Medical Association (2017), http://dx.doi.org/10.1016/j.jfma.2017.04.004
MODEL
Journal of the Formosan Medical Association (2017) xx, 1e1
Available online at www.sciencedirect.com
ScienceDirect journal homepage: www.jfma-online.com
LETTER TO THE EDITOR
Daily egg consumption should be still limited in hpercholestrolemic patients It is appreciated to read the local guidance of “2017 Taiwan lipid guidelines for high risk patients” in the recent issue of the Journal of Formosa Medical Association.1 The guideline clearly points out the target values of low-density lipoprotein cholesterol (LDL-C) in specific population. It also suggests that egg intake do not associated with increased risks of cardiovascular disease and mortality in “general” population. However, additional egg consumption was known to be associated with increased serum LDL-C in patients with “dyslipidemia”.2 Hypercholesterolemic patients, who were randomly assigned to have one and half egg yolk per day with a study period of 12 weeks, had greater values of serum LDL-C by approximately 9 mg/dl as compared with the control group.3 In hyperlipidemic patients already on moderateintensity statin treatment, additional three eggs consumption per day did not change serum LDL-C after a study period of 12 weeks; the result implied that additional eggs consumption attenuated the most effect of lowering LDL-C by statin treatment.4 Consistently, additional two egg yolks per day neutralized the effect of lipid lowering therapy, mainly statin, in a randomized controlled trial with an experimental period of 5 weeks. The serum values of LDL-C did not change significantly from baseline.5 The aforementioned evidence summarized that additional egg consumptions might be a critical factor when treating these high-risk patients with statin or statin/ezetimibe. Additionally, dietary cholesterol is not necessary for a physiological response of our body need as the suggestion of “2015e2020 dietary guidelines for Americans”. The definite number of egg consumption per day remains controversial currently, but daily egg consumption vs. weekly egg consumption was associated with atherosclerosis by increased coronary calcium scores.6 With respect of LDL-C and atherosclerotic cardiovascular diseases, it is suggested that egg consumption should not exceed one egg
Conflict of interest: No conflict of interest should be declared.
per day in hyperlipidemic patients, especially those who are already on statin treatment.
References 1. Li YH, Ueng KC, Jeng JS, Charng MJ, Lin TH, Chien KL, et al. 2017 Taiwan lipid guidelines for high risk patients. J Formos Med Assoc 2017;116:217e48. 2. Liu CW, Lin TC, Tseng GS, Jiau SS. Egg consumption associated with increased concentration of serum total and low-density lipoprotein cholesterol in prospective randomized-controlled trials, thereby possibly associating with an increased risk of developing coronary heart disease e from a view of cardiologists. J Am Coll Nutr. [Accepted but unpublished] http://dx.doi. org/10.1080/07315724.2016.1277171. 3. Severins N, Mensink RP, Plat J. Effects of lutein-enriched egg yolk in buttermilk or skimmed milk on serum lipids & lipoproteins of mildly hypercholesterolemic subjects. Nutr Metab Cardiovasc Dis 2015;25:210e7. 4. Klangjareonchai T, Putadechakum S, Sritara P, Roongpisuthipong C. The Effect of Egg Consumption in Hyperlipidemic Subjects during Treatment with Lipid-Lowering Drugs. J Lipids 2012;2012:672720. 5. Vishwanathan R, Goodrow-Kotyla EF, Wooten BR, Wilson TA, Nicolosi RJ. Consumption of 2 and 4 egg yolks/d for 5 wk increases macular pigment concentrations in older adults with low macular pigment taking cholesterol-lowering statins. Am J Clin Nutr 2009;90:1272e9. 6. Choi Y, Chang Y, Lee JE, Chun S, Cho J, Sung E, et al. Egg consumption and coronary artery calcification in asymptomatic men and women. Atherosclerosis 2015;241:305e12.
Cheng-Wei Liu* Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, Songshan branch, National Defense Medical Center, Taipei, Taiwan *Fax: þ886-2-8837372 E-mail address: [email protected] 5 April 2017
http://dx.doi.org/10.1016/j.jfma.2017.04.004 0929-6646/Copyright ª 2017, Formosan Medical Association. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Please cite this article in press as: Liu C-W, Daily egg consumption should be still limited in hpercholestrolemic patients, Journal of the Formosan Medical Association (2017), http://dx.doi.org/10.1016/j.jfma.2017.04.004