Archive for eggs
For years I have written on the dietary salt myth*. In a nutshell, it seems taken as conventional wisdom and irrefutable scientific fact that reductions in dietary sodium lead to significant reductions in blood pressure and improvement in cardiovascular mortality and morbidity from things like heart attacks and strokes. Yet despite almost 50 years of scientific study, over 150 randomized controlled trials and 13 population-based studies, the conclusive data is still lacking. Confounding the results of some of these trials was the fact that the consumption of foods that help lower blood pressure were never taken into account in the final analysis.
What are some of these foods?
It turns out that foods that are rich in potassium have a positive effect on lowering blood pressure and potentially reducing cardiovascular morbidity and mortality. These foods include fresh vegetables like Swiss chard, potatoes, yams, acorn and other winter squash, lentils, peas, lima beans, pinto and kidney beans. It includes fresh fruits like papaya, dried apricots, avocados and bananas-although they are not the ultimate source of potassium, per serving, as most people think. Fresh dairy products like yogurt and items like Portobello or crimini mushrooms are also good sources. Fish like salmon, pompano, halibut, tuna and anchovies likewise deliver good amounts of potassium. Herbs like basil and spices like turmeric are also good sources, although these are not usually consumed in significant quantities compared to other foodstuffs.
Further complicating the picture is the fact that in addition to foods rich in potassium, foods rich in both calcium and magnesium have also been shown to help reduce blood pressure. Foods rich in calcium include dairy such as yogurt, goat’s milk, cow’s milk and cheese. It includes fish such as sardines. Vegetable sources include tofu, greens like collard greens and turnip greens, spinach and food products containing sesame seeds like tahini (a major ingredient in hummus). Foods rich in magnesium include vegetables like Swiss chard, spinach, soybeans, black beans, pumpkin seeds, sesame seeds, sunflower seeds and nuts like cashews, almonds and pine nuts. Fish like halibut and mackerel are also a great source of magnesium as are whole grains like brown rice and quinoa.
To completely muddy the waters, a recent study presented at the European Society of Human Genetics meeting in Paris**suggested a significant potentially causal association between low vitamin D levels and the development of hypertension. Humans can produce vitamin D through exposure to sunlight. Foods rich in vitamin D include fish like salmon and sardines and other foods like mushrooms. Milk from grass fed, pasture raised goats and cows and eggs; especially eggs from vegetarian fed, organic, free range chickens.
Interestingly, additional supplementation with minerals, whether it be potassium, magnesium or calcium do not share the positive effects observed with a diet rich in these components. Furthermore, the highly processed versions of these foodstuffs often results in a significant alteration of their natural structure. For example, foods that are naturally rich in potassium and have lower amounts of sodium often wind up after processing with much higher levels of sodium and significant reductions in the potassium content. In fact the bulk of dietary sodium intake, over 70%, comes from the consumption of highly processed, prepared and preserved foods. The clear take away from all this information is to follow a simple three-step approach:
- 1. Avoid the consumption of excessive amounts of fast food, which includes many sit down and dine type chain restaurants.
- 2. When shopping for foods in the market, avoid ready-made highly processed and preserved foods.
- 3. Whenever possible look for the fresh minimally adulterated product; this often means being aware of what is locally and regionally available in any given season.
By following these 3 simple steps, you are on your way to becoming a Grassroots Gourmet™; and that’s the prescription for eating well and living better.
*Read Dr. Mike’s latest article on the salt controversy published in Pacific Standard magazine here:
**Santhanakrishnan VK, et al “A causal association between vitamin D status and blood pressure: a Mendelian randomization study in up to 150,846 individuals” ESHG 2013; Abstract #C18.2.
As the Florida Blueberry Festival approaches, we will be featuring a number of sweet and savory blueberry recipes. Several of these will be featured, in one form or another, on the live web simulcast of Just What the Doctor Ordered-Live from the Florida Blueberry Festival on May 4th and 5th. Read More→
Ever wonder what to do on the weekend with some leftovers? Well here’s an upscale version of a breakfast classic, steak and eggs. Smoked prime rib is added to potatoes, onions, garlic and some exoctic mushroom duxelle to Doc’ up the average hash into a worthy Wellington hash. But it doesn’t stop there, add a slice of seared foie gras and a perfectly poached egg. Now that is a royal repast!
For Day Four, it’s back to a continental classic! An under appreciated treat of French cuisine is a well prepared classic tri-fold omelet with a little melted brie in the center. Add fresh pasta with a drizzle of Alfredo sauce and….
- 2 cups flour (about 9 ounces)
- 2 eggs
- 2 Tbs olive oil
- 2 Tbs water
- ½ tsp. salt
- Staples: olive oil, salt
Combine all the ingredients of a stand mixer, or make a well with the dry ingredients on a working surface, and add the eggs, water and oil. Gently start the mixer on low, mixing until the dough appears crumbly and binds together when squeezed in your hand. If mixing by hand, add the water to achieve the same consistency. The exact amount of water required may vary by the flour, ambient humidity, and other factors, so you need to go by the look and feel versus specific amounts. Next, knead the dough, if working by hand or use the dough hook attachment if using a stand mixer. Knead until the dough takes on a shiny appearance or pulls away from the ball. Rest at least one hour, wrapped in the refrigerator. Once the dough is rested, use the settings on your pasta rollers or measure out to about 1/32 of an inch for linguine or fettuccine. Cut the pasta with a sharp knife, or use the pasta cutting mechanism of your mixer. Dust the pasta with a little flour to prevent sticking. Bring salted water with a few drops of olive oil added to a boil, add the pasta, reduce to a simmer and cook for about 2 to 3 minutes or until it is out al dente The pasta can be made ahead of time and keep for several days in the refrigerator. Serves 4
- 1 Tbs butter
- 1 Tbs flour
- 4 oz. parmesan cheese, grated
- 2 cups milk
- ½ tsp. white pepper
- Staples: butter, pepper
in a medium saucepan over medium heat, melt the butter. Add the flour was together. When you have a soft white paste (or blonde roux), add the milk. Continue to heat until the sauce it just starts to thicken, about 5 to 10 minutes. Remove from the heat, and whisk in the cheese. Season with the white pepper.
I have received a tremendous amount of inquiry this week regarding a recently released report that splashed dire and perhaps somewhat eggs-aggerated warnings throughout the media. This Canadian study was published in the journal, Atherosclerosis. In this observational trial, over 1250 men and women with average age of 61.5 years attended a university vascular prevention clinic, “filled out questionnaires regarding their lifestyle and medications, including pack-years of smoking, and the number of egg yolks consumed.” The eggs consumed per week were then converted over a longer time course to represent a measurement called “egg-yolk years.” The study participants also had “baseline measurement of TPA by duplex ultrasound.”[i] This refers to a measurement of the total plaque area (TPA) of any blockages found in the carotid arteries as assessed by ultrasound testing. The researchers found that the “plaque area increased linearly with age after age 40, but increased exponentially with pack-years of smoking and with egg-yolk years.” Their conclusion was that the “size of egg yolks appears to be approximately 2/3 that of smoking…Our findings suggest that regular consumption of egg yolk should be avoided by persons at risk of cardiovascular disease.”[ii]
Let’s now examine the study. The hypothesis upon which the study was based, as noted by the authors was that increasingly “the potential harm from high cholesterol intake, and specifically from egg yolks, is considered insignificant.”[iii] Since eggs and other high cholesterol foods were first demonized when the cholesterol hypothesis was put forth, much as been learned. At the time of the initial concern over dietary cholesterol intake, it was thought that if one consumed foods high in cholesterol that would raise your cholesterol and thus translate into more heart attacks, strokes, etc. Since that time we have learned a lot. Firstly, it is not just the cholesterol level that matters, what really matters is the level of oxidized cholesterol in the lining of the arteries as this is what initiates an inflammatory response. This level depends upon amounts and types of lipoproteins (structures composed both of proteins and fat compounds that transport fats like cholesterol in the mostly aqueous and saline blood-remember oil (fat) and water do not mix). There is a highly genetic variable component in this equation. When it comes to cholesterol and intake, the end result is much more dependent upon certain types of saturated fat intake and genetics than actual ingested cholesterol. For example, a study looked at serum cholesterol levels of men and women 5 hours to 54 days after receiving a food load of 465mg (US daily recommendation is 300mg/day) cholesterol or 54 days of 2 eggs every day. The result; the “serum cholesterol level of some subjects increased and others decreased.”[iv] That is why after the initial fright, foods like eggs and shrimp have been placed back on the menu of a healthful, balanced diet. Foods, unless excessively outrageous in cholesterol content, are best evaluated in terms of certain saturated fat contents, processing and other additives rather than absolute cholesterol content. It is interesting to note, that a reassessment of the blood cholesterol levels of 912 participants of The Framingham Study (from which some of the original cholesterol caveats were derived) showed that within “this population differences in egg consumption were unrelated to blood cholesterol level or to coronary heart disease incidence.”[v] Studies have even shown that in general, there is little correlation between saturated fat intake and cardiovascular disease.[vi] The prepackaged snack food chips loaded with artificial flavors, sodium and processed ingredients that boast “zero cholesterol” are not a more healthful food than some lovely fresh shrimp or a poached egg. It appears that the entire study may be biased as the result of an a priori argument.
Beyond a bias in the hypothesis, the study itself begs several questions. Dietary recall, while often the only option, is notoriously flawed as a mechanism by which to accurately reflect food product intake. Secondly, while most folks can remember eating a steak and labeling it as such, a steak is not usually an ingredient in other food products. Eggs are ubiquitous. It is not clear whether, for example, someone who frequently ate pasta (made with an egg containing pasta dough) had the egg content contained in that food accounted for in their “egg-yolk years”. Thus the true amount of egg consumption in the groups may be inaccurate. There was no mention of correlating highly processed meats such as sausage and bacon that are commonly purchased in the mega-markets. Several studies have correlated regular consumption of these products (as opposed to fresh, less processed red meat) with the development of cardiovascular disease and diabetes. If the persons eating eggs more often also more often consumed bacon and sausage (common egg accompaniments), these items may provide an alternative source to the findings. Additionally, this was a correlative study with no morbidity or mortality endpoints.
Moreover, the findings themselves are a bit questionable. While TPA has proven a better measure then simply examining the carotid intimal medial thickness, it is still fraught with limitations. The ultrasound assessment is technically demanding and sensitive to operator acquisition. The researchers did not use more objective measures like CT or MRI quantitative analysis which would be less susceptible to operator variability. The addition of femoral arterial measurement can supply further data and increase sensitivity and specificity versus carotid artery measurements alone. While the negative predictive value of these tests is high, there is still debate as to its positive predictive value. This means that if the test says you have no plaque, it is unlikely you will have a cardiovascular event. A negative result (no plaque) predicts no disease. However, if it finds there is disease it is not necessarily a great predictor that you will have a cardiovascular event in the future.[vii] No commentary was provided on the lesion characteristics, like a measure of echogenicity, which in some studies identifies higher risk lesions irrespective of TPA. Finally, and perhaps most importantly, while these patients were being seen in a vascular prevention clinic, no data regarding actual vascular events for any patients are identified. In other words-so what? We have no idea if the measurements, if they even proved true amongst all the aforementioned issues, mean anything at all. Do these findings translate into meaningful clinical events? We have no idea. The study did not even consider known risk factors and influencing variables like exercise and waist circumference before drawing the conclusion that “egg yolks should be avoided by persons at risk of vascular disease.”[viii]
The media release following the study bought into the hype and immediately started recommending that you “make that an egg-white omelet instead.” It is an erroneous conclusion based on the study data because the study could not tell you if it was the egg whites that caused the increased TPA! This promulgation and fear mongering of tired and unproven hypotheses and suppositions continues to keep us bound in a maelstrom of ignorance eating a highly processed, adulterated diet that results in an increasingly large and ill population. Wholesome foods like eggs are currently accepted as part of a balanced, healthful diet. With the current fad to decrease carbohydrates, eggs may be even more important. A study looking at overweight men put on a carbohydrate restricted diet (CRD), markers of inflammation (which are elevated in conditions like diabetes associated with obesity) were measured. It was found that “eggs make a significant contribution to the anti-inflammatory effects of CRD, possibly due to the presence of cholesterol, which increases HDL-C and to the antioxidant lutein which modulates certain inflammatory responses.”[ix]
I watched the Julia Child marathon on PBS the other day, reliving my childhood. She lived a wonderfully iconic and incomparable life until the end of her very productive 92 years adhering to a simple maxim:“Learn how to cook — try new recipes, learn from your mistakes, be fearless and above all have fun.”…small helpings, no seconds, no snacking, and a little bit of everything.” And she loved eggs.
For further discussion on topics like this and others, see “Eating Well Living Better”, available at amazon.com: Eating Well, Living Better (the book)
[i] (Spence, Jenkins, & Davignon, 2012)
[ii] (Spence, Jenkins, & Davignon, 2012)
[iii] (Spence, Jenkins, & Davignon, 2012)
[iv] (Kummerow FA, 1977)
[v] (Dawber TR, 1982)
[vi] (Patty W Siri-Tarino, 2010)
[vii] (Griffin M, 2010)
[viii] (Spence, Jenkins, & Davignon, 2012)
[ix] (Joseph C Ratliff, 2008)
Dawber TR, N. R. (1982). Eggs, serum cholesterol, and coronary heart disease. American Journal of Clinical Nutrition, 36:617-25.
Griffin M, N. A. (2010). Plaque area at carotid and common femoral bifurcations and prevalence of clinical cardiovascular disease. International Angiology, Jun;29(3):216-25.
Joseph C Ratliff, G. M. (2008). Eggs modulate the inflammatory response to carbohydrate restricted diets in overweight men . Nutrition & Metabolism , Volume 5, Number 1 (2008), 6, DOI: 10.1186/1743-7075-5-6.
Kummerow FA, K. Y. (1977). The influence of egg consumption on the serum cholesterol level in human subjects. American journal of Clinical Nutrition, 30:664-73.
Maria Luz Fernandez, M. C. (2010). Revisiting Dietary Cholesterol Recommendations: Does the Evidence Support a Limit of 300 mg/d? . Current Atherosclerosis Reports , Volume 12, Number 6 (2010), 377-383, DOI: 10.1007/s11883-010-0130-7 .
Patty W Siri-Tarino, Q. S. (2010). Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. The American Journal of Clinical Nutrition, vol. 91 no. 3 535-546 .
Spence, J. D., Jenkins, D. J., & Davignon, J. (2012). Egg yolk consumption and carotid plaque. Atherosclerosis, doi:10.1016/j.atherosclerosis.2012.07.032.
Here’s a tasty treat that’s great for any brunch. I know my friend, Chef Christo, will appreciate this as he is as passionate about deliciously prepared eggs as I am. Eggs were poached inside some from scratch herb pasta and topped with crispy parma prosciutto and chopped tomato that was on the vine only minutes before! Eggs are amazingly good for you and a great part of any healthy diet; read more about the benefits of eggs in Eating Well, Living Better (available now at Amazon.com).
Taurine is an organic acid found in dark meat poultry, beef, lamb, eggs, dairy and some seafood such as white fish like cod, mussels and clams. It is not found in any substantial amount in plant products. It is a requirement for some carnivores like felines because, unlike humans, they cannot synthesize it. Feline deficiencies can result in blindness, heart disease and a host of inflammatory conditions. A small study from NYU was recently published in the European Journal of Nutrition. Researchers examined blood samples and diet information from 223 womenages 34 to 65 between 1985 and 1991 who developed heart disease or died from it during the study follow-up from 1986 to 2006 compared to an equal number who did not. For those women with baseline total cholesterol over 250 mg/dL who were in the highest tertile of taurine consumption, there was a 60% reduction in coronary heart disease. The exact mechanism is unclear, although taurine does have anti-inflammatory and antioxidant properties. It also appears to effect blood pressure regulation. While the association is correlative, not causative it is intriguing. The current study is small and involves only women but provides interesting food for thought for women (and possibly men) with high cholesterol levels.
I know when I get up in the morning, particularly after a long night, I need my morning coffee. Cocoa may be the Food of The Gods, but this little magic bean is what keeps them, and me, going. Back in the day I had done some research with caffeine basically demonstrating a very negligible effect on heart muscle with the exception of some impaired relaxation at very high doses. The results were so unimpressive it was never published anywhere. But deep down, I knew that cup of Java woke up my neurons so they could get me through the day. Some studies have suggested that coffee drinkers actually learn better, absorbing and maintaining more material than those that don’t partake. Now there’s evidence that coffee will help your noggin long term. Two studies, one from Finland looking at over 26,000 male smokers (a high risk group) found that coffee consumption lowered the stroke risk by 23%, among those that drank 8 or more cups per day. Another study out of UCLA and USC looking at over 9,000 people found the lowest risk for stroke was among those that drank the most coffee; the highest among those that drank none. Women who drank 2 to four cups per day had about a 20% risk reduction according to the Harvard Nurse’s Health Study, which looked at over 83,000 women. A similar sized study looking at 81,000 men and women out of Japan found a likewise 23% risk reduction for 1-2 cups per day.
If you’re going to get that coffee in bed based on the above, you might as well have some grass fed free range beef and cage free vegetarian fed hen produced eggs. Why, you might ask? Because a recent study published in the Journal of Agricultural and Food Chemistry suggested that “some vegetarians may be increasing their risk of heart problems from nutritional deficiencies in their diets… (they) found that vegetarian diets are often lacking in some key nutrients. These include vitamin B12 and omega-3 fatty acids.” Both of those nutrients are found in abundance in the aforementioned steak and eggs. And the implication here that a vegan or vegetarian diet leads to increased risk is just a hypothesis. But who wants to take the risk when the prevention is just so darn tasty?
Believed to be as a result of improvement in the diet fed to the birds, eggs now appear to have gotten healthier. It has been almost a decade (2002) since eggs were randomly examined for nutritional content. Since then, a recent examination reveals that cholesterol levels have dropped by 14% (from 212 to 185 mg) and vitamin D has increased 64% (from 18 to 41 IU of vitamin D). This was performed using the procedures that comply with the National Food and Nutrient Analysis Program (NFNAP). This is the program responsible for analyzing the nutrient composition of a wide variety of foods and making nutrition information publicly available. I use and recommend the free range organically raised (vegetarian diet) birds. It shows an even better, nutritionally superior profile with improvements not only in cholesterol and vitamin D, but also in omega fatty acids and conjugated linoleic acids. Regardless, you may now continue to enjoy these fantastic treats (as, for example in our Guinness Hollandaise) with a little less guilt!
[tweetmeme source=”WCWD” only_single=false]
Here’s another reason I love the French: take some egg, bread, milk and a little sugar and Shazaam, something delicious. I am, of course, referring to a little Pain Perdu. Not just any pain perdu, though; a totally doc’d up version. We stuff le pain with a whipped homemade strawberry jam and cream cheese mixture, soak it in custard like liquid, coat it in a little egg and cook it with some butter. Top it with real maple syrup, some cinnamon and a sprinkle of confectionary sugar. It is the brunch of kings which is why sometimes; it’s good to be the King.
- 5 eggs
- 8 oz cream cheese
- 8 oz jam (homemade is best)
- 1 loaf of bread, preferably a challah or other sweet bread. Best is slightly stale
- 2 cup milk
- ½ cup sugar
- 1 tsp vanilla
- 1 Tbs cinnamon
- Confectionary sugar
- Maple syrup
Whip the cream cheese with a hand held or stand mixer. Add the jam and mix well. Set aside. Beat 3 eggs together and set aside. In a medium saucepan heat the milk and sugar until it dissolves. Place 2 eggs in a bowl and whip them together. As the sugar dissolves, and the milk heats up add a little bit at a time to the eggs to temper them. Add the tempered eggs back to the milk mixture add the cinnamon and heat on the stove until the mixture just starts to thicken. Remove and pour in a container. Add the vanilla to that mixture. Cut a thick slice of the bread and make a pocket, then stuff it with the cream cheese mixture. Soak the bread in the milk mixture for 5-10 minutes, turning as needed so the bread fully absorbs the liquid. Heat some butter in a medium sauté pan over medium heat. Coat the bread in the egg mixture and cook until the egg coating is done. Remove, pour maple syrup over, sprinkle with confectionary sugar, dust with some fresh ground cinnamon and enjoy. Vive La France!