Replacement of Refined Carbohydrates with a Combination of Egg Protein and Unsaturated Fatty Acids: Effects on Lipoprotein Particle Concentrations and LDL Peak Size in Adults with Elevated Triglycerides
Authors: Nieman Kristin M , Maki Kevin C , Palacios Orsolya M , Lindner Emily , Huebner Margie , Sorce Jennifer 
Published: November 2023

The aim of this trial was to evaluate the effects of a combination of egg protein (Epro) and unsaturated fatty acids (UFA) substituted for refined carbohydrates (CHO) on lipoprotein particle concentrations and low‐density lipoprotein (LDL) peak particle size in adults with elevated triglycerides (TG). This randomized, controlled‐feeding, crossover study included an evaluable sample of 25 men and women with a mean (± SEM) age and body mass index of 46.3 ± 2.4 y and 31.8 ± 1.0 kg/m2, respectively, and a median (interquartile range) baseline TG of 173 mg/dL (159, 228). Subjects consumed a standardized diet that incorporated at least 3 servings/d of test foods (yogurt, muffins, waffles, and cookies), which provided 40–60% of subjects' daily energy needs. The study foods accounted for 8% higher protein energy (from Epro) and 8% higher fat energy (from UFA) in the Epro/UFA condition and 16% higher CHO energy in the refined CHO condition. Total energy intake was held constant during each condition; dietary CHO, protein and fat comprised 42%, 23% and 35% of total energy intake during the Epro/UFA condition and 58%, 15% and 27% of total energy intake during the refined CHO condition. Both the Epro/UFA and the refined CHO diets were low in saturated fatty acids (7.0 ± 0.1% and 6.5 ± 0.1% of energy intakes, respectively). Fasting blood samples were collected at baseline and the end of each condition, and lipoprotein particle concentrations, apolipoprotein (apo) B level, and LDL peak size and were assessed. Lipoprotein particle concentrations and LDL peak size were analyzed with the ion mobility method, and apo B was assessed using fixed rate time nephelometry. Median change from baseline for non‐high‐density lipoprotein, very low‐density lipoprotein, LDL, intermediate‐density lipoprotein and high‐density lipoprotein particle concentrations did not significantly differ between the conditions. The median change from baseline for apo B concentrations trended (p = 0.104) toward a larger decline following the Epro/UFA condition compared to the refined CHO condition (changes of −11.6% [−15.6%, − 3.4%)] versus −6.4% [−14.2%, 1.3%], respectively). Apo B was also significantly (p < 0.05) reduced from baseline within each condition. The median changes from baseline for LDL peak size following the Epro/UFA diet condition was 0.12 nm (−0.12, 0.28), compared to −0.15 nm (− 0.33, 0.12) following the refined CHO diet condition (p = 0.019 between conditions). In summary, replacement of dietary refined CHO with a combination of Epro and UFA within a low‐saturated fat dietary pattern did not significantly alter lipoprotein particle concentrations in adults with elevated TG, although atherogenic lipoprotein concentrations were reduced during both conditions relative to the habitual diet baseline.Support or Funding InformationFunded by American Egg Board/Egg Nutrition Center, Park Ridge, IL