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

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.