Eggs: Healthy or Risky? A Review of Evidence from High Quality Studies on Hen's Eggs.

Hen's eggs (from Gallus gallus domesticus) provide choline, folate, vitamin D, iodine, B vitamins and high-quality protein and are no longer viewed by national bodies as a risk factor for hypercholesterolaemia and cardiovascular disease (CVD). Yet, questions remain about the benefits and risks of eating eggs regularly. This review evaluates recent high-quality evidence from randomised controlled trials (RCT) and meta-analyses of observational studies and considers new areas of interest, such as weight management, protein metabolism, allergy risk and sustainability. In several RCT, eggs increased muscle protein synthesis and lowered fat mass, which could support optimal body composition. Eggs within a meal improved satiety, which could translate into lower energy intakes, although more RCT are needed. In observational studies, higher egg consumption was associated with a null effect or a modest reduced risk of CVD. For type 2 diabetes (T2D) incidence and risk of CVD in people with T2D, there were inconsistencies between observational and RCT data, with the former noting positive associations and the latter seeing no effect of higher egg intake on markers of T2D and CVD. Sustainability metrics suggest that eggs have the lowest planetary impact amongst animal proteins. To lower allergy risk, earlier introduction of eggs into weaning diets is warranted. In conclusion, the balance of evidence points to eggs being a nutritious food suggesting there are broad health benefits from including eggs in the diet at intakes higher than that currently consumed by European populations.

Dietitians' and nutritionists' knowledge and views on aspects of health claims regulation in the UK: Do we inadvertently shoot the messenger?

Article 12(c) of the Nutrition and Health Claims Regulation (NHCR) prohibits authorised health claims in consumer-facing commercial communications which make reference to the recommendations of individual doctors or health professionals. However, this has been controversial amongst dietitians and nutritionists who work in commercial settings. Given the lack of empirical data, a survey was conducted amongst UK-based nutrition professionals to assess their knowledge of, and attitudes to, Article 12(c). The findings revealed confusion about the scope of the regulation and how it applies to working practices, with a considerable proportion of respondents being unable to recognise examples of commercial communications or health claims, indicating a need for additional training. There was also a broad interpretation of what nutrition professionals could, and could not, say about a hypothetical food product. This paper explores current guidance in Great Britain and debates the proportionality and fairness of Article 12(c), which, at present, does not regulate authorised health claims made by influencers or celebrities in commercial communications to consumers. It could be argued that consumers are better protected by the articulation of health claims by nutrition professionals who are guided by codes of practice rather than by unqualified, unregulated individuals. Hence, it is essential to level the regulatory playing field either by revising the NHCR to amend Article 12(c) or by updating the guidance to apply an interpretation of the Article's intention which enables a broader role for nutrition professionals in commercial communications. Such action would also be consistent with the UK's better regulation agenda to ensure evidence-based, proportionate regulation for industry.

Promoting and disseminating consistent and effective nutrition messages: challenges and opportunities.

Nutrition messages are a central part of policy making as well as communication via product information, advertising, healthcare advice and lifestyle campaigns. However, with amplified information (and misinformation) from a growing number of sources, inconsistent and conflicting food landscapes, and limited engagement from the public, nutrition messaging tensions have become more accentuated than previously. In this review, we focus on the challenges facing those wishing to effect dietary change through communication; and identify opportunities and future research questions. Beginning with a new working definition and taxonomy for the term 'nutrition message', we consider the evolution of public health nutrition messages from the past century and discuss which types of messages may be more effective. We then turn to the challenges of implementation and highlight specific barriers to recipients' understanding and change. While the evidence has many gaps and there is a need for systematic evaluation of nutrition messages, research indicates that recipients are more likely to act on fewer messages that provide clear benefits and which resonate with their perceived health needs, and which are relatively straightforward to implement. Effectiveness may be improved through consideration of how nutrition messages can be designed to complement key non-health drivers of food choice (taste, cost) and societal/cultural norms. Consistency can be achieved by aligning the wider food and messaging environment to desired public health actions; that is by ensuring that retail settings provide and signpost healthier choices, and that mass media nutrition messages work with, not against, public health advice.

Interpretation of observational studies: the good, the bad and the sensational.

A Nutrition Society member-led meeting was held online on 18th January 2021 to discuss the role of observational studies in developing public health policy and dietary guidelines. In addition, participants debated media reporting of observational studies and the implications for public perception and trust in science. Speakers outlined the benefits of observational studies and how they fit within the suite of research tools available for estimating dietary intakes and determining their impact on health and disease risk. However, there are clear limitations, such as conscious and unconscious bias, measurement error, confounding and representativeness of populations. Researchers can overcome some of these issues with careful design, awareness of inter-individual variation, open and transparent reporting of findings, and hypothesis-driven statistical analysis to avoid multiple testing errors. Although there is evidence that data provided by nutritional epidemiology can be misleading, strong and thoughtful methodology including pre-registration, risk of bias assessment, awareness of confounders, and evidence grading can minimise potential bias, particularly when conducting systematic reviews. Translation of relative risk into population health impact is important and feeds into the need for responsible lay communication of results via mass media, especially regarding assumptions about cause and effect. Although use of mass media can bring benefits to academia, responsible dissemination is essential and starts with the press release. In conclusion, nutritional epidemiology is an important tool for exploring the risk/benefits of dietary patterns and contributing to health improvement via dietary guidelines, evidence-based policy and responsible lay communication provided its limitations are fully understood.

Fruit Juices: Are They Helpful or Harmful? An Evidence Review.

Dietary guidelines often deal with 100% fruit juice (FJ) inconsistently because it represents a source of free sugars. However, FJ also provides bioavailable micronutrients and plant bioactives at levels similar to those found in whole fruits. The present review weighs up the evidence from high-quality studies investigating a potential health harm for FJ against evidence from studies which indicate a potential health benefit. The findings reveal that FJ consumption, at moderate intakes consistent with the dietary guidelines for the US and some European countries (75-224 mL daily), does not increase the risk of obesity, type 2 diabetes, cardiovascular disease or poor glycaemic control. In contrast, regular consumption of FJ-even up to 500 mL per day in short-to-medium-term studies-appears to confer a health benefit in terms of vascular function and reduced blood pressure. Emerging evidence for cognitive health benefits requires further investigation in human trials. Observational studies report associations between FJ and nutrient adequacy and suggest that FJ consumption is associated with reduced risk of stroke. In conclusion, FJ appears to offer more benefit than risk and there appears to be no justification for discouraging FJ within a balanced diet for children and adults.

Food science and food ingredients: the need for reliable scientific approaches and correct communication, Florence, 24 March 2015.

This report summarises the proceedings of a conference organised by the Italian Association of Hospital Cardiologists. The aim was to consider the process by which dietary guidelines (DG) are developed and the quality of evidence underpinning these guidelines, as well as debating whether or not this has resulted in DG that are effective in terms of health improvement. Key points were a caution about false positives in research, the importance of holistic DG rather than single nutrient targets, the need for appropriate disease endpoints in studies and control of confounders, a plea for less reliance on observational studies which cannot address cause-and-effect relationships and a need to bear in mind unintended consequences. Options for improving the system and the quality of evidence were discussed.

Fluoride in the UK diet.

Fluoride is a naturally occurring mineral that can be obtained from foods and fluids originating from soils containing fluoride, as well as by drinking water that has been fluoridated. While consuming adequate fluoride intake can deliver benefits for dental and bone health, there have been concerns that excessive fluoride intake could lead to dental fluorosis, or even cause harm to bones. This article considers the balance of evidence in this area, and discusses the benefits and potential risks of fluoride in the UK diet. The role of tea as a major contributor to normal fluoride intake is highlighted, alongside some positive implications of this. Information is also provided to help nurses and midwives communicate the latest advice and guidance on fluoride to their patients.

A novel topical ingredient derived from seaweed significantly reduces symptoms of acne vulgaris: a general literature review.

Currently, benzoyl peroxide, antibiotics, and retinoids are the mainstay topical treatments for acne vulgaris. However, potential benefits may be offered by natural, marine-derived ingredients, such as those derived from brown seaweed (Laminaria digitata). This article will review the available literature on two ingredients; "seaweed oligosaccharides," which are those derived from the polysaccharide membrane of Laminaria digitata, and a novel seaweed oligosaccharide-zinc complex (SOZC) (Phycosaccharide AC, The Mentholatum Company, East Kilbride, UK). Findings from a recent double-blind, placebo-controlled, randomized clinical trial (RCT) will also be reported and likely mechanisms discussed. The findings taken together suggest that SOZC can significantly ameliorate symptoms of acne vulgaris, particularly in terms of reducing sebum production and populations of Propionibacterium acnes.

Dietary approaches to promote bone health in adults.

Osteoporosis is a major public health issue, affecting around three million people in the UK. Several lifestyle factors play a role in the development of the condition, including low physical activity, smoking, excess alcohol consumption and low intakes of bone health nutrients. The most important of these nutrients are vitamin D and calcium, which work in combination to strengthen and stabilise bone tissue. However, intake of calcium is low in some people, while vitamin D deficiency is widespread. across the age spectrum. This article identifies key actions for improving bone health, with a focus on increased intake of beneficial nutrients.

Value of eggs during pregnancy and early childhood.

The maternal diet is believed to influence infant health, as does diet in early life following the introduction of solid foods. Eggs, commonly available and low in cost, contain nutrients that may be of benefit during pregnancy as well as during weaning. Key nutrients include vitamin D, folate, iodine, selenium and long-chain n-3 polyunsaturated fatty acids (omega-3 fatty acids). Data from a recent nutritional analysis of eggs are presented and put in context with dietary reference values for the UK. The safety aspects of eggs, including food safety and allergy, are also discussed.

Black tea is not significantly different from water in the maintenance of normal hydration in human subjects: results from a randomised controlled trial.

There is a belief that caffeinated drinks, such as tea, may adversely affect hydration. This was investigated in a randomised controlled trial. Healthy resting males (n 21) were recruited from the general population. Following 24 h of abstention from caffeine, alcohol and vigorous physical activity, including a 10 h overnight fast, all men underwent four separate test days in a counter-balanced order with a 5 d washout in between. The test beverages, provided at regular intervals, were 4 × 240 ml black (i.e. regular) tea and 6 × 240 ml black tea, providing 168 or 252 mg of caffeine. The controls were identical amounts of boiled water. The tea was prepared in a standardised way from tea bags and included 20 ml of semi-skimmed milk. All food taken during the 12 h intervention period was controlled, and subjects remained at rest. No other beverages were offered. Blood was sampled at 0, 1, 2, 4, 8 and 12 h, and a 24 h urine sample was collected. Outcome variables were whole blood cell count, Na, K, bicarbonate, total protein, urea, creatinine and osmolality for blood; and total volume, colour, Na, K, creatinine and osmolality for urine. Although data for all twenty-one participants were included in the analysis (mean age 36 years and mean BMI 25·8 kg/m(2)), nineteen men completed all conditions. Statistical analysis, using a factorial ANOVA approach within PROC MIXED, revealed no significant differences between tea and water for any of the mean blood or urine measurements. It was concluded that black tea, in the amounts studied, offered similar hydrating properties to water.

The role of red meat in a balanced diet.

Lean red meat is rich in essential nutrients, such as iron and zinc. Recent changes in farming practice have lowered the fat content of meat significantly. Observational studies have associated high meat consumption with negative health outcomes, but these studies have limitations. The only consistent data relate to colorectal cancer, although it is unclear whether the risk relates to all red meat or to processed or overcooked meats only. The UK government has recently recommended that high consumers of red meat should reduce their intake to 500g per week, although average meat consumption is actually below this figure. This article describes patterns of meat consumption, discusses associations with health and offers guidance on how patients can consume meat as part of a healthy, balanced diet.

Recommendations for the use of eggs in the diet.

Recommendations about consuming eggs have evolved over the past few years resulting in some confusion. This article reports on changes to egg consumption recommendations with respect to heart disease risk, and reviews the evidence for the nutritional benefits and potential health outcomes associated with regular egg consumption. Data from the National Diet and Nutrition Survey are used to highlight how eggs can best be incorporated into a healthy diet. Suggestions are given on the safe cooking and use of eggs in vulnerable groups of patients.

Can pure fruit and vegetable juices protect against cancer and cardiovascular disease too? A review of the evidence.

While it is widely accepted that fruit and vegetables (F&V) lower the risk of cancer, and cardiovascular disease (CVD), the role of pure fruit and vegetable (PFV) juices is often downplayed. This review poses two questions: Are the protective benefits of F&V dependent upon constituents lacking in PFV juices (e.g. fibre)? Do PFV juices impact on disease risk when considered separately from F&V? Studies comparing the effects of fibre and antioxidants were reviewed, yielding the finding that the impact of F&V may relate more strongly to antioxidants, than to fibre. For the second question, high-quality published studies that considered PFV juices were reviewed. The impact of PFV juices on cancer risk was weakly positive, although a lack of human data and contradictory findings hampered conclusions. For CVD, there was convincing evidence from epidemiological and clinical studies that PFV juices reduced risk via a number of probable mechanisms. It was concluded that the view that PFV juices are nutritionally inferior to F&V, in relation to chronic disease risk reduction, is unjustified.

Health benefits of omega-3 fatty acids.

Evidence suggests that omega-3 polyunsaturated fatty acids play an integral role in cell membrane function and development of the brain and eyes. Optimising intake appears to confer many benefits, including reduced risk of heart disease and possibly a reduced likelihood of behavioural problems, depression and inflammatory conditions such as rheumatoid arthritis. Although there is some disagreement on what level of intake is optimal, British diets are low in omega-3 fatty acids. Good sources include oily fish and novel sources include fortified eggs and oils derived from microalgae.

Obesity in children.

This article reviews the causes of childhood obesity and suggests different approaches to treatment and prevention.