Dietary cholesterol and other nutritional considerations in people with diabetes

Summary Background: Nutrition therapy is an integral component of lifestyle intervention and self‐management of people with diabetes. The goals of nutrition therapy are to optimise or maintain quality of life, physiological and mental health, and to prevent and treat acute and long‐term complications of diabetes, the associated comorbid conditions and concomitant disorders. Monitoring dietary cholesterol consumption and salt intake are important nutritional aspects to lower the risk for and treatment of cardiovascular disease and hypertension. Aims: To evaluate the role of nutritional therapy and notably the effect of egg consumption on cardiovascular disease (CVD) risk in people with diabetes. Methodology: Literature review of nutritional therapy and clinical studies on egg consumption and CVD risk for people with diabetes were conducted and appraised. Results: The Harvard Egg Study on two large prospective US cohorts found that eating one or more eggs a day had no adverse effects on lipid profile or cardiovascular disease risk in men or women. Similar findings were observed in the NHANES‐I and Physicians’ Health Study. The only exception was people with diabetes, where CVD was increased with eating more than one egg per day. Conclusions: Consumption of one or more eggs per day is associated with an elevated risk of coronary heart disease in people with diabetes. The mechanism for this association remains unknown but should be explored in randomised clinical trials.