Cardioprotective Activities Of Whole Eggs On Vascular Endothelial Function In Prediabetic Adults

NCT ID: NCT02364570

Last Updated: 2019-05-03

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 20 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2015-01-31
• Study Completion Date: 2017-06-30

Brief Summary

Cardiovascular disease (CVD) is largely a lifestyle-related condition that is the #1 killer of adults in the United States. Our work is aimed at understanding how short-term increases in blood sugar, like those that accompany eating a meal, affect blood vessel function and the risk of CVD. This research is aimed at understanding how meals composed of eggs affect short-term increases in blood sugar from eating, which are connected with increased risk of CVD. In particular, the investigators are trying to identify a specific meal composed of either whole eggs, egg yolks, or egg whites, that best reduces acute increases in blood sugar brought on by meals that consist of majority carbohydrate. At the same time, the investigators are trying to explore the protective affects that eggs may have on blood vessel function and the reduction of CVD risk.

Detailed Description

Cardiovascular disease (CVD) is the leading cause of death in the United States [1]. The inability of your blood vessels to properly enlarge and shrink, known as vascular endothelial dysfunction (VED), is an early event leading to CVD and can be caused by postprandial hyperglycemia (PPH) [1] or short-term increases in blood sugar that occur after you have eaten. Although we do not know how this occurs, research shows that temporary increases in blood sugar impair the blood vessel's ability to properly enlarge and shrink. We also know that impaired vessel function is an early event leading to CVD and that research shows that short-term increases in blood sugar impair blood vessel function, even in healthy people [2].

Because high blood levels of cholesterol increase CVD risk, this has triggered flawed guidelines to restrict cholesterol in our diet [3], including limiting egg consumption. The misguided fear towards eating eggs has been routinely challenged by large-scale studies failing to associate eggs with heart disease risk [4-8]. Research shows that eggs improve the functioning of insulin to reduce blood sugar [9]. They also contain bioactive peptides that may attenuate oxidative stress [10-11]. This provides rationale for their study as a dietary strategy to reduce PPH and VED. Thus, the objective of this study is to define the potential benefits of eggs and its components (egg yolk and egg whites) on blood vessel health in adults with prediabetes.

Conditions

Prediabetes; Cardiovascular Disease

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: CROSSOVER
• Primary Study Purpose: PREVENTION
• Blinding Strategy: NONE

Study Groups

Oral Glucose Tolerance Test

We will perform fasting measurements of flow-mediated dilation (FMD) using ultrasound, and draw a blood sample, prior to administration of the test meal. Following these baseline measurements, participants will ingest glucose (100 g). FMD will be performed intermittently post-ingestion at 30, 60, 90, 120, 150, and 180 minutes. Blood samples will be collected at 0 min (immediately prior to eating) and at 30, 60, 90, 120, 150, and 180 minutes following the ingestion of the meal. After each blood sample is obtained, the catheter will be flushed with saline in order to prevent the formation of clots and to minimize the likelihood of having to insert a needle again. Subjects will remain supine in a comfortable position for the entire duration of the test.

Group Type: ACTIVE_COMPARATOR

Glucose (100g)

Intervention Type: OTHER

Ingestion of glucose (100g)

Glucose with Whole Eggs

We will perform fasting measurements of flow-mediated dilation (FMD) using ultrasound, and draw a blood sample, prior to administration of the test meal. Following these baseline measurements, participants will ingest glucose (75 g) with 1.5 whole eggs (cooked). FMD will be performed intermittently post-ingestion at 30, 60, 90, 120, 150, and 180 minutes. Blood samples will be collected at 0 min (immediately prior to eating) and at 30, 60, 90, 120, 150, and 180 minutes following the ingestion of the meal. After each blood sample is obtained, the catheter will be flushed with saline in order to prevent the formation of clots and to minimize the likelihood of having to insert a needle again. Subjects will remain supine in a comfortable position for the entire duration of the test.

Group Type: EXPERIMENTAL

Glucose (75g)

Intervention Type: OTHER

Ingestion of glucose (75g)

Whole Eggs

Intervention Type: OTHER

Ingestion of 1.5 whole eggs

Glucose with Egg Whites

We will perform fasting measurements of flow-mediated dilation (FMD) using ultrasound, and draw a blood sample, prior to administration of the test meal. Following these baseline measurements, participants will ingest glucose (75 g) with 7 egg whites (cooked). FMD will be performed intermittently post-ingestion at 30, 60, 90, 120, 150, and 180 minutes. Blood samples will be collected at 0 min (immediately prior to eating) and at 30, 60, 90, 120, 150, and 180 minutes following the ingestion of the meal. After each blood sample is obtained, the catheter will be flushed with saline in order to prevent the formation of clots and to minimize the likelihood of having to insert a needle again. Subjects will remain supine in a comfortable position for the entire duration of the test.

Group Type: EXPERIMENTAL

Glucose (75g)

Intervention Type: OTHER

Ingestion of glucose (75g)

Egg Whites

Intervention Type: OTHER

Ingestion of 7 egg whites

Glucose with Egg Yolks

We will perform fasting measurements of flow-mediated dilation (FMD) using ultrasound, and draw a blood sample, prior to administration of the test meal. Following these baseline measurements, participants will ingest glucose (75 g) with 2 egg yolks (cooked). FMD will be performed intermittently post-ingestion at 30, 60, 90, 120, 150, and 180 minutes. Blood samples will be collected at 0 min (immediately prior to eating) and at 30, 60, 90, 120, 150, and 180 minutes following the ingestion of the meal. After each blood sample is obtained, the catheter will be flushed with saline in order to prevent the formation of clots and to minimize the likelihood of having to insert a needle again. Subjects will remain supine in a comfortable position for the entire duration of the test.

Group Type: EXPERIMENTAL

Glucose (75g)

Intervention Type: OTHER

Ingestion of glucose (75g)

Egg Yolks

Intervention Type: OTHER

Ingestion of 2 egg yolks

Interventions

Glucose (100g)

Ingestion of glucose (100g)

Intervention Type: OTHER

Glucose (75g)

Ingestion of glucose (75g)

Intervention Type: OTHER

Whole Eggs

Ingestion of 1.5 whole eggs

Intervention Type: OTHER

Egg Whites

Ingestion of 7 egg whites

Intervention Type: OTHER

Egg Yolks

Ingestion of 2 egg yolks

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

1. fasting glucose 100-125 mg/dL,

2. non-dietary supplement user,

3. no medications affecting vasodilation, inflammation, or energy metabolism,

4. no CVD,

5. nonsmokers,

6. individuals having blood pressure <130/85 mmHg and total cholesterol <240 mg/dL.

Exclusion Criteria

1. unstable weight (±2 kg),

2. vegetarian or egg allergy,

3. alcohol intake >3 drinks/d or >10 drinks/wk), or

4. ≥7 h/wk of aerobic activity.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 50 Years
• Eligible Sex: MALE
• Accepts Healthy Volunteers: Yes

Sponsors

Ohio State University

OTHER

Sponsor Role: lead

Responsible Party

Richard Bruno

Associate Professor and Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Richard Bruno, PhD, RD

Role: PRINCIPAL_INVESTIGATOR

Ohio State University

Locations

The Ohio State University

Columbus, Ohio, United States

Countries

United States

References

Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, Dai S, Ford ES, Fox CS, Franco S, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Huffman MD, Judd SE, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Mackey RH, Magid DJ, Marcus GM, Marelli A, Matchar DB, McGuire DK, Mohler ER 3rd, Moy CS, Mussolino ME, Neumar RW, Nichol G, Pandey DK, Paynter NP, Reeves MJ, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Wong ND, Woo D, Turner MB; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics--2014 update: a report from the American Heart Association. Circulation. 2014 Jan 21;129(3):e28-e292. doi: 10.1161/01.cir.0000441139.02102.80. Epub 2013 Dec 18. No abstract available.

Reference Type: BACKGROUND

PMID: 24352519 (View on PubMed)

DECODE Study Group, the European Diabetes Epidemiology Group.. Glucose tolerance and cardiovascular mortality: comparison of fasting and 2-hour diagnostic criteria. Arch Intern Med. 2001 Feb 12;161(3):397-405. doi: 10.1001/archinte.161.3.397.

Reference Type: BACKGROUND

PMID: 11176766 (View on PubMed)

U.S. Dept of Agriculture and U.S. Dept of Health and Human Services (2010) Dietary Guidelines for Americans. 7th Ed.

Reference Type: BACKGROUND

Djousse L, Gaziano JM. Egg consumption in relation to cardiovascular disease and mortality: the Physicians' Health Study. Am J Clin Nutr. 2008 Apr;87(4):964-9. doi: 10.1093/ajcn/87.4.964.

Reference Type: BACKGROUND

PMID: 18400720 (View on PubMed)

Hu Y, Liu W, Huang R, Zhang X. Postchallenge plasma glucose excursions, carotid intima-media thickness, and risk factors for atherosclerosis in Chinese population with type 2 diabetes. Atherosclerosis. 2010 May;210(1):302-6. doi: 10.1016/j.atherosclerosis.2009.11.015. Epub 2009 Nov 20.

Reference Type: BACKGROUND

PMID: 20005514 (View on PubMed)

Nakamura Y, Iso H, Kita Y, Ueshima H, Okada K, Konishi M, Inoue M, Tsugane S. Egg consumption, serum total cholesterol concentrations and coronary heart disease incidence: Japan Public Health Center-based prospective study. Br J Nutr. 2006 Nov;96(5):921-8. doi: 10.1017/bjn20061937.

Reference Type: BACKGROUND

PMID: 17092383 (View on PubMed)

Sauvaget C, Nagano J, Allen N, Grant EJ, Beral V. Intake of animal products and stroke mortality in the Hiroshima/Nagasaki Life Span Study. Int J Epidemiol. 2003 Aug;32(4):536-43. doi: 10.1093/ije/dyg151.

Reference Type: BACKGROUND

PMID: 12913025 (View on PubMed)

Scrafford CG, Tran NL, Barraj LM, Mink PJ. Egg consumption and CHD and stroke mortality: a prospective study of US adults. Public Health Nutr. 2011 Feb;14(2):261-70. doi: 10.1017/S1368980010001874. Epub 2010 Jul 16.

Reference Type: BACKGROUND

PMID: 20633314 (View on PubMed)

Blesso CN, Andersen CJ, Barona J, Volek JS, Fernandez ML. Whole egg consumption improves lipoprotein profiles and insulin sensitivity to a greater extent than yolk-free egg substitute in individuals with metabolic syndrome. Metabolism. 2013 Mar;62(3):400-10. doi: 10.1016/j.metabol.2012.08.014. Epub 2012 Sep 27.

Reference Type: BACKGROUND

PMID: 23021013 (View on PubMed)

Davalos A, Miguel M, Bartolome B, Lopez-Fandino R. Antioxidant activity of peptides derived from egg white proteins by enzymatic hydrolysis. J Food Prot. 2004 Sep;67(9):1939-44. doi: 10.4315/0362-028x-67.9.1939.

Reference Type: BACKGROUND

PMID: 15453585 (View on PubMed)

Nimalaratne C, Lopes-Lutz D, Schieber A, Wu J. Effect of domestic cooking methods on egg yolk xanthophylls. J Agric Food Chem. 2012 Dec 26;60(51):12547-52. doi: 10.1021/jf303828n. Epub 2012 Dec 14.

Reference Type: BACKGROUND

PMID: 23205520 (View on PubMed)

McDonald JD, Chitchumroonchokchai C, Li J, Mah E, Labyk AN, Reverri EJ, Ballard KD, Volek JS, Bruno RS. Replacing carbohydrate during a glucose challenge with the egg white portion or whole eggs protects against postprandial impairments in vascular endothelial function in prediabetic men by limiting increases in glycaemia and lipid peroxidation. Br J Nutr. 2018 Feb;119(3):259-270. doi: 10.1017/S0007114517003610. Epub 2018 Jan 16.

Reference Type: BACKGROUND

PMID: 29335039 (View on PubMed)

McDonald JD, Mah E, Chitchumroonchokchai C, Reverri EJ, Li J, Volek JS, Villamena FA, Bruno RS. Co-ingestion of whole eggs or egg whites with glucose protects against postprandial hyperglycaemia-induced oxidative stress and dysregulated arginine metabolism in association with improved vascular endothelial function in prediabetic men. Br J Nutr. 2018 Oct;120(8):901-913. doi: 10.1017/S0007114518002192. Epub 2018 Aug 30.

Reference Type: BACKGROUND

PMID: 30160222 (View on PubMed)

Other Identifiers

2014H0307

Identifier Type: OTHER

Identifier Source: secondary_id

2014H0307

Identifier Type: -

Identifier Source: org_study_id