To eat or not to eat?

Eggs are a versatile food and a great source of protein.
The American Diabetes Association considers eggs an excellent choice for people with diabetes. That’s primarily because one large egg contains about half a gram of carbohydrates, so it’s thought that they aren’t going to raise your blood sugar.
Eggs are high in cholesterol, though. One large egg contains nearly 200 mg of cholesterol, but whether or not this negatively affects the body is debatable.
Monitoring your cholesterol is important if you have diabetes because diabetes is a risk factor for cardiovascular disease. High levels of cholesterol in the bloodstream also raise the risk of developing cardiovascular disease. But dietary intake of cholesterol doesn’t have as profound an effect on blood levels as was once thought. So, it’s important for anyone with diabetes to be aware of and minimize other heart disease risks.

BENEFITS
Benefits of eggs

A whole egg contains about 7 grams of protein. Eggs are also an excellent source of potassium, which supports nerve and muscle health. Potassium helps balance sodium levels in the body as well, which improves your cardiovascular health.
Eggs have many nutrients, such as lutein and choline. Lutein protects you against disease and choline is thought to improve brain health. Egg yolks contain biotin, which is important for healthy hair, skin, and nails, as well as insulin production. Eggs from chickens that roam on pastures are high in omega-3s, which are beneficial fats for people with diabetes.
Eggs are easy on the waistline, too. One large egg has only about 75 calories and 5 grams of fat, only 1.6 grams of which are saturated fat. Eggs are versatile and can be prepared in different ways to suit your tastes. You can make an already-healthy food even better by mixing in tomatoes, spinach, or other vegetables. 
As healthy as they are in so many ways, eggs should be consumed in moderation.

CHOLESTEROL
Cholesterol concerns

Eggs got a bad rap years ago because they were considered to be too high in cholesterol to be part of a healthy diet. A lot has changed since then. The role of dietary cholesterol as it relates to a person’s total blood cholesterol count appears to be smaller than previously thought.
Family history may have much more to do with your cholesterol levels than how much dietary cholesterol is in your food. The bigger threat to your cholesterol levels is food that is high in trans fats and saturated fats. 
Eggs still shouldn’t be consumed in excess if you have diabetes. The current recommendations suggest that an individual with diabetes should consume no more than 200 milligrams (mg) of cholesterol each day. Someone without diabetes or heart health concerns may consume up to 300 mg per day. One large egg has about 186 mg of cholesterol. There isn’t much room for other dietary cholesterol once that egg is eaten.
Research suggests that high levels of egg consumption may raise the risk of developing type 2 diabetes and heart disease. While the connection isn’t clear, researchers believe that excessive cholesterol intake, when it comes from animal foods, may increase those risks.
Since all of the cholesterol is in the yolk, you can eat egg whites without worrying about how they’re affecting your daily consumption of cholesterol. Many restaurants offer egg white alternatives to whole eggs in their dishes. You can also buy cholesterol-free egg substitutes in the stores that are made with egg whites.
Keep in mind, however, that the yolk is also the exclusive home of some key egg nutrients. Almost all the vitamin A in an egg, for instance, resides in the yolk. The same is true for most of the choline, omega-3s, and calcium in an egg.

TAKEAWAY
So what’s for breakfast?

If you have diabetes, you should limit egg consumption to three a week. If you only eat egg whites, you can feel comfortable eating more.
Be careful though, about what you eat with your eggs. One relatively harmless and healthy egg can be made a little less healthy if it’s fried in butter or unhealthy cooking oil. Poaching an egg in the microwave only takes one minute and doesn’t need any additional fat. Likewise, don’t serve eggs with high-fat, high-sodium bacon or sausage very often.
A hard-boiled egg is a handy high-protein snack if you have diabetes. The protein will help keep you full without affecting your blood sugar. Protein not only slows digestion, it also slows glucose absorption. This is very helpful if you have diabetes. Having lean protein at every meal and for the occasional snack is a smart step for anyone with diabetes.
Just as you’re getting to know the carbohydrate and sugar content of various foods, you should also pay attention to the cholesterol levels and saturated fats in your food. If that means swapping out some whole eggs for egg whites or a plant protein like tofu, well, that’s just a wise way to enjoy protein and keep your health risks to a minimum.

In the past, whole eggs got a bad rap for their cholesterol and fat content. But thanks to new studies and a fresh perspective in the medical community, this budget-friendly protein source has reemerged as a dietitian favorite — even for people with diabetes.
“We’re getting away from limiting eggs in the diet of people with diabetes, as their benefits are quite extensive,” says Elizabeth Ebner, a registered dietitian and a certified diabetes educator with Hackensack Meridian Health in Fair Haven, New Jersey. “They’re considered a high biological value protein, which means they provide all the amino acids required in the body.” When a protein source contains the essential amino acids in the right proportion required by humans, it is considered to have a high biological value.
But before an egg could be seen as a protein-and-healthy-fat powerhouse, it had to shed its negative reputation.

Eggs for Diabetes: What Changed?

The cholesterol found in egg yolks was once cause for alarm among people with diabetes. The disease puts you at an increased risk of heart issues, and cholesterol was seen as a contributing factor to heart disease.
The message was: Stay away from cholesterol to protect your ticker. According to a study published in September 2015 in Nutrients, the American Diabetes Association (ADA) used to recommend that people with type 2 diabetes limit their dietary cholesterol to 300 milligrams (mg). For reference, one egg has 200 mg — and so the egg-white craze began.
Subsequent research began suggesting that the relationship between how much cholesterol a person consumes and his or her blood cholesterol levels wasn’t as strong as once thought, according to a study published in March 2016 in The American Journal of Clinical Nutrition. Within the past few years, the ADA and the American Heart Association removed their cholesterol guidelines, and there’s no longer a limit placed on cholesterol, according to 2015 study in Nutrients cited above.
In addition to cholesterol, each large egg has about 5 grams (g) of fat. According to the Harvard T.H. Chan School of Public Health, most of the fat is polyunsaturated and monounsaturated, which are two examples of healthy fats. But there’s also 1.6 g of saturated fat — or nearly 10 percent of your daily allowance for the bad kind of fat — in each egg. Saturated fat has been linked to diabetes and puts you at a higher risk for heart disease, according to the American Heart Association (AHA), so it’s still best not to go overboard in the yolk department.
If your cholesterol is normal, the AHA recommends that your saturated fat intake be no more than 5 to 6 percent of your total daily caloric intake (or a maximum of 20 g for someone on a 2,000 calorie-per-day diet). If you’re trying to lower your LDL, or “bad,” cholesterol, that recommendation is a maximum of 11 to 13 g of daily saturated fat when you're consuming 2,000 calories per day.

The New Reputation of the Egg

Today, many nutritionists recommend eating eggs because they’re satiating and can help with weight loss and management; healthy weight is beneficial for people with diabetes because it reduces insulin resistance.
Now the message has shifted to focus on protein. Each egg contains 6 g, which is why Ebner considers eggs a good, inexpensive source of the nutrient. Protein is satiating, meaning eggs may help curb unhealthy cravings and promote a healthy weight in people with diabetes — further aiding diabetes management. Plus, eating protein and carbohydrates together may delay the impact of carbohydrates on blood sugar, Ebner says.
“I always use the analogy that the protein is like the seat belt to the carbohydrate — it kind of holds it back and slows it down a bit from spiking the sugar.” That said, it’s still important to monitor your carbohydrate intake and observe how what you eat impacts your blood sugar reading. No matter what nutrients you combine them with, carbs are digested as glucose, which raises blood sugar levels.

How Eating Eggs May Affect Diabetes Risk

According to a study published in April 2015 in The American Journal of Clinical Nutrition, middle-aged and older men who ate about four eggs each week had a 37 percent lower risk of type 2 diabetes than their peers who ate one egg per week. That study is an outlier, though. Most research has found eating eggs in moderation isn’t linked to diabetes one way or the other, but you still have to be careful not to overdo it.
A study published in January 2016 in The American Journal of Clinical Nutritionsuggests there’s no link between occasionally eating eggs and developing type 2 diabetes, but people who eat three or more eggs per week are at a slightly higher risk of developing the disease. An earlier study, published in 2009 in Diabetes Care, found that eating seven or more eggs each week increased the risk of type 2 diabetes among men by 58 percent and among women by 77 percent.
However, these studies were observational, meaning they didn't prove a cause-and-effect relationship. Experts agree you don’t need to ban eggs from your diet, but you should eat them in moderation. “I usually incorporate an egg every other day when I’m writing a meal plan [for someone with diabetes],” Ebner says, adding that there’s no need to limit the amount of egg whites you eat, since they’re predominantly made up of protein and are low in fat. Ebner recommends sticking to egg whites and avoiding yolks altogether if you take large doses of statins or have a strong family history of heart disease, which she estimates affects about 1 in 10 people with diabetes. According to the AHA, about 68 percent of people age 65 or older with diabetes die from heart disease.

The Best Ways to Prepare or Order Eggs

How you prepare your eggs can affect how diabetes-friendly they are, too. When you’re cooking at home, stick to an olive oil spray instead of butter and make them in whatever style you like — scrambled, over easy, or sunny-side up.
When you’re out for breakfast, Ebner recommends ordering a poached egg “because it’s cooked in water and no additional fat,” she says, or ordering egg whites. “At diners, eggs are often mixed with pancake batter to make them fluffy,” Ebner says. “I tell patients to ask for egg whites when they’re at a diner so they aren’t adding carbohydrates.”
Feel free to load up your eggs with vegetables — leafy greens, onions, and mushrooms are all good choices, Ebner says. And when it comes to adding cheese, the sharper, the better. “I recommend you get the strongest cheese you can tolerate — a really hard sharp cheddar or maybe a parmesan — and fine-grate it to add to the egg,” Ebner says. “It’s so strong you don’t need much of it, so a tablespoon would probably be plenty.”
It’s okay to add a pinch of salt if it makes the eggs taste better to you. Just don’t load up on both cheese and salt, since cheese is already salty enough, Ebner says.
The bottom line? Eggs are an excellent source of protein. You can certainly add eggs to your meal plan, but be careful not to eat too many egg yolks. Ebner recommends limiting them to no more than four yolks per week.