A DOUBLE-BLIND, RANDOMIZED, CONTROLLED TRIAL OF THE EFFECTS OF 2 EGGSPER DAY IN MODERATELY HYPERCHOLESTEROLEMIC AND COMBINED HYPERLIPIDEMIC SUBJECTS TAUGHT THE NCEP STEP I DIET
Rh. Knopp et al., A DOUBLE-BLIND, RANDOMIZED, CONTROLLED TRIAL OF THE EFFECTS OF 2 EGGSPER DAY IN MODERATELY HYPERCHOLESTEROLEMIC AND COMBINED HYPERLIPIDEMIC SUBJECTS TAUGHT THE NCEP STEP I DIET, Journal of the American College of Nutrition, 16(6), 1997, pp. 551-561
Objective: We investigated the effect of egg feeding in 161 hyperchole
steroleric (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 conc
entrations <75th %-ile, CHL greater than or equal to 75th %-ile. Sis w
eeks after instituting the Step I Diet, subjects were randomized to tw
o eggs or egg substitute daily for 12 weeks. Results: Mean dietary int
ake (9-day food records) was within NCEP guidelines and 131 subjects f
inished with stable weight and adherence >80%. Placebo group lipoprote
in 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 nonsignif
icantly, 0.07 mmol/L (3 mg/dL) (p = 0.49). Egg-fed CHL subjects (n = 3
1) 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 no
t differ by apo E phenotype distribution. Postprandial triglyceride-ri
ch lipoproteins and LDL subclass phenotype were unaffected by egg feed
ing in subsets of subjects. Conclusions: CHL subjects ingesting a Step
I Diet in a free-living setting are sensitive to egg feeding and shou
ld benefit from dietary cholesterol restriction. The limited LDL-C ris
e in HC subjects resembles that seen in egg-fed normocholesterolemic s
ubjects ingesting a Step I Diet, but requires confirmation.