Department of Nutrition, University of California, Davis, California.
Department of Nutrition, University of California, Davis, California.
J Nutr Biochem. 2022 Feb;100:108906. doi: 10.1016/j.jnutbio.2021.108906. Epub 2021 Nov 18.
Although eggs are a nutrient dense food delivering high quality protein and micronutrients, given that eggs are also rich in cholesterol and choline, whether egg intake is contraindicated for individuals at risk for cardiovascular disease (CVD) remains controversial. In this mini review, we provide a Precision Nutrition perspective, highlighting the importance of two factors: the effect of egg cholesterol on plasma cholesterol concentrations in most people and in cholesterol hyper-absorbers, and the effect of egg choline on plasma concentrations of trimethylamine-N-oxide (TMAO), a microbe-host co-metabolite independently associated with increased CVD risk. We discuss recent evidence from intervention studies showing that in most individuals egg intake does not have a deleterious effect on plasma lipid profiles, but also highlight that some individuals are cholesterol hyper-absorbers or individuals who are not able to maintain cholesterol homeostasis by suppressing endogenous cholesterol synthesis, and that for these individuals the intake of eggs and other dietary sources of cholesterol would be contraindicated. We also discuss the complex relationship between dietary sources of choline vs. phosphatidylcholine, the gut microbiome, and plasma TMAO concentrations, highlighting the high inter-individual variability in TMAO production and gut microbiome profiles among healthy individuals and those with metabolic conditions. Precision Nutrition approaches that allow the clinician to stratify risk and improve dietary recommendations for individual patients are desirable for improving patient compliance and health outcomes. More clinical studies are needed to determine how to identify individuals at risk for CVD for whom egg intake is contraindicated vs. those for whom egg intake is not associated with negative effects on plasma lipid profiles nor plasma TMAO concentrations.
尽管鸡蛋是一种营养密集型食物，提供高质量的蛋白质和微量营养素，但由于鸡蛋富含胆固醇和胆碱，鸡蛋摄入量是否对心血管疾病（CVD）风险人群禁忌仍存在争议。在这个小型综述中，我们提供了一个精准营养的视角，强调了两个因素的重要性：鸡蛋胆固醇对大多数人和胆固醇高吸收者血浆胆固醇浓度的影响，以及鸡蛋胆碱对三甲胺 N-氧化物（TMAO）血浆浓度的影响，TMAO 是一种微生物-宿主共同代谢物，与 CVD 风险增加独立相关。我们讨论了最近的干预研究证据，表明在大多数人中，鸡蛋摄入不会对血浆脂质谱产生有害影响，但也强调有些个体是胆固醇高吸收者，或不能通过抑制内源性胆固醇合成来维持胆固醇稳态的个体，对于这些个体，摄入鸡蛋和其他膳食胆固醇来源是禁忌的。我们还讨论了胆碱与磷脂酰胆碱、肠道微生物组和血浆 TMAO 浓度之间的复杂关系，强调了健康个体和代谢性疾病个体之间 TMAO 产生和肠道微生物组谱的个体间高度变异性。能够对风险进行分层并为个体患者改善饮食建议的精准营养方法是改善患者依从性和健康结果的理想选择。需要更多的临床研究来确定如何识别对 CVD 有风险的个体，对这些个体来说，鸡蛋摄入禁忌，而对那些个体来说，鸡蛋摄入与血浆脂质谱或血浆 TMAO 浓度没有负面影响相关。
