Journal of the American College of Nutrition, Vol 16, Issue 6 551-561, Copyright © 1997 by American College of Nutrition

CLINICAL TRIAL

A double-blind, randomized, controlled trial of the effects of two eggs per day in moderately hypercholesterolemic and combined hyperlipidemic subjects taught the NCEP step I diet

R. H. Knopp, B. M. Retzlaff, C. E. Walden, A. A. Dowdy, C. H. Tsunehara, M. A. Austin and T. Nguyen
Northwest Lipid Research Clinic, University of Washington, Seattle 98104, USA.

OBJECTIVE: We investigated the effect of egg feeding in 161 hypercholesterolemic (HC) or combined hyperlipidemic (CHL) free-living subjects taught the NCEP Step I Diet. METHODS: Subjects had LDL-C between 3.36 and 4.91 mmol/L (130 and 190 mg/dL). HC subjects had triglyceride concentrations < 75th %-ile, CHL > or = 75th %-ile. Six weeks after instituting the Step I Diet, subjects were randomized to two eggs or egg substitute daily for 12 weeks. RESULTS: Mean dietary intake (9-day food records) was within NCEP guidelines and 131 subjects finished with stable weight and adherence > 80%. Placebo group lipoprotein lipids were unchanged at study end for both HC (n = 35) and CHL (n = 21) subjects. Egg-fed HC subjects (n = 44) increased LDL-C nonsignificantly, 0.07 mmol/L (3 mg/dL) (p = 0.49). Egg-fed CHL subjects (n = 31) increased LDL-C 0.31 mmol/L (12 mg/dL) (p < 0.001). HDL-C increased significantly in both HC and CHL groups, 0.10 and 0.08 mmol/L (4 and 3 mg/dL, p = 0.003 and 0.02), respectively. HC and CHL subjects did not differ by apo E phenotype distribution. Postprandial triglyceride-rich lipoproteins and LDL subclass phenotype were unaffected by egg feeding in subsets of subjects. CONCLUSIONS: CHL subjects ingesting a Step I Diet in a free-living setting are sensitive to egg feeding and should benefit from dietary cholesterol restriction. The limited LDL-C rise in HC subjects resembles that seen in egg-fed normocholesterolemic subjects ingesting a Step I Diet, but requires confirmation.

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