Here’s how this breakfast staple can affect your A1C, your waistline, your cholesterol, and more.
In the past, whole eggs got a bad rap for their cholesterol and fat content. But thanks to new studies and a fresh perspective in the medical community, this budget-friendly protein source has reemerged as a dietitian favorite — even for people with diabetes.
“We’re getting away from limiting eggs in the diet of people with diabetes, as their benefits are quite extensive,” says Elizabeth Ebner, RD, CDCES, who works with Hackensack Meridian Health in Fair Haven, New Jersey. “They’re considered a high biological value protein, which means they provide all the amino acids required in the body.” When a protein source contains the essential amino acids in the right proportion required by humans, it is considered to have a high biological value. As previous research notes, when protein has high biological value, the body processes the macronutrient efficiently.
Before the egg could be seen as a protein-and-healthy-fat powerhouse, it had to shed its negative reputation.
Eggs for Diabetes: What Changed?
The cholesterol found in egg yolks was once cause for alarm among people with diabetes. The Centers for Disease Control and Prevention (CDC) says diabetes puts you at an increased risk of heart issues, and cholesterol was seen as a contributing factor to heart disease.
The message was: Stay away from cholesterol to protect your ticker. According to research published July 7, 2020, in the American Journal of Clinical Nutrition, the American Heart Association (AHA) used to recommend that people with type 2 diabetes limit their dietary cholesterol to 300 milligrams (mg). For reference, one egg has about 200 mg, per the U.S. Department of Agriculture (USDA) — and so the egg-white craze began.
Subsequent research found that the relationship between how much cholesterol a person consumes and his or her blood cholesterol levels wasn’t as strong as once thought. Within the past several years, the American Diabetes Association (ADA) and the AHA removed their cholesterol guidelines, and there’s no longer a limit placed on dietary cholesterol, as a paper published November 2, 2021, in Circulation notes.
In addition to cholesterol, each large egg has 4.35 grams (g) of fat, per the USDA. According to the Harvard T.H. Chan School of Public Health, most of the fat is polyunsaturated and monounsaturated, which are two examples of healthy fats. But there’s also 1.6 g of saturated fat — or nearly 8 percent of your daily allowance for the bad kind of fat — in each egg. Saturated fat can raise cholesterol levels and puts you at a higher risk for heart disease, according to the ADA, so it’s best not to go overboard on yolks, which is where most of the fat is.
If your cholesterol is normal, the AHA recommends that your saturated fat intake be no more than 5 to 6 percent of your total daily caloric intake (or a maximum of 20 g for someone on a 2,000 calorie-per-day diet). If you’re trying to lower your LDL, or “bad,” cholesterol, the recommendation is a maximum of 11 to 13 g of daily saturated fat when you’re consuming 2,000 calories per day.
The New Reputation of the Egg
Today, many nutritionists recommend eating eggs if you’re living with diabetes because they’re satiating and can help with weight loss and weight management. After all, healthy weight is beneficial for people with diabetes because it reduces insulin resistance.
Now the message has shifted to focus on protein. Each egg contains 6 g, per the USDA, which is why Ebner considers eggs a good, inexpensive source of the nutrient. Protein is satiating, meaning eggs may help curb unhealthy cravings and promote a healthy weight in people with diabetes — further aiding diabetes management. Plus, eating protein and carbohydrates together may delay the impact of carbohydrates on blood sugar, Ebner says.
“I always use the analogy that the protein is like the seat belt to the carbohydrate — it kind of holds it back and slows it down a bit from spiking the sugar,” Ebner says. That said, it’s still important to monitor your carbohydrate intake and observe how certain foods affect your blood sugar reading. No matter what nutrients you combine them with, carbs are digested as sugar, which raises blood sugar levels, per Harvard.
How Eating Eggs May Affect Type 2 Diabetes Risk
According to previous research, middle-aged and older men who ate about four eggs each week had a 37 percent lower risk of type 2 diabetes than their peers who ate one egg per week. Another study, published in June 2021 in Clinical Nutrition, involved Chinese adults and found eggs were linked with diabetes. Most research, however, has found that a moderate amount of egg in the diet has no association with diabetes one way or the other, but it’s still wise not to overload on them.
Another previous study found no link between occasionally eating eggs and developing type 2 diabetes, but participants who ate three or more eggs per week were at a slightly higher risk of developing the disease. An earlier study found that seven or more eggs each week increased the risk of type 2 diabetes among men by 58 percent and among women by 77 percent.
Nonetheless, these studies were observational, meaning they didn’t prove a cause-and-effect relationship. Experts agree you don’t need to ban eggs from your diet, but you should eat them in moderation. Researchers behind a study published in the July 2020 American Journal of Clinical Nutrition concluded that one egg a day is safe for people with diabetes. Plus, as mentioned, it makes for a great inexpensive protein source.
“I usually incorporate an egg every other day when I’m writing a meal plan [for someone with diabetes],” Ebner says, adding that there’s no need to limit the amount of egg whites you eat, because they’re predominantly composed of protein (about 3.64 g per egg, per the USDA) and are low in fat. Ebner recommends sticking to egg whites and avoiding yolks altogether if you take large doses of statins or have a strong family history of heart disease. According to the CDC, a person with diabetes is twice as likely to have heart disease or a stroke as someone without diabetes.
The Best Ways to Prepare or Order Eggs When Managing Diabetes
How you prepare your eggs can affect how diabetes-friendly they are, too. When you’re cooking at home, stick to an olive oil spray instead of butter (to promote heart health) and make them in whatever style you like — scrambled, over easy, or sunny-side up.
When you’re dining out for breakfast, Ebner recommends ordering a poached egg “because it’s cooked in water and no additional fat,” she says. Or order egg whites. “At diners, eggs are often mixed with pancake batter to make them fluffy,” Ebner says. “I tell patients to ask for egg whites when they’re at a diner so they aren’t adding carbohydrates.”
Feel free to load up your eggs with vegetables — leafy greens, onions, and mushrooms are all good choices, Ebner says. And when it comes to adding cheese, the sharper, the better. “I recommend you get the strongest cheese you can tolerate — a really hard sharp cheddar or maybe a parmesan — and fine-grate it into the egg,” Ebner says. “It’s so strong you don’t need much of it, so a tablespoon would probably be plenty.” Full-fat cheese tends to be high in saturated fat, as the Mayo Clinic notes; the idea is that a sharper cheese will help you keep your intake in check.
As for salt, it’s okay to add a pinch if it makes the eggs taste better to you. Just don’t load up on both cheese and salt, because cheese is already salty enough, Ebner says.
One Last Thing About Eggs and Diabetes
Eggs are an excellent source of protein. You can certainly add eggs to your meal plan, but be careful not to eat too many egg yolks. Ebner recommends no more than four yolks per week.
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