Eggs—Cracking the code on protein in the renal diet

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by Marika Wamback, BSc. R.D.
Registered Dietitian

Eggs—protein in the renal diet

Over the years, eggs have been a very controversial food.  The media has generated a lot of mixed messages based on different research causing everyone to question whether eggs are healthy or not.  The center of the controversy is the high cholesterol content of the yolk.

If you have Chronic Kidney Disease (CKD), which increases your risk for heart disease (and vice versa), it begs the question, can you manage your CKD and still eat eggs?  How many? How often? Can they be consumed at all? Below is the latest evidence to help you meet your protein needs, manage your CKD (at any stage), and protect your heart.

Eggs and CKD Management

Eggs are a nutritious protein option to help you manage your CKD.  They are a great source of high biological protein, meaning they contain all of the essential amino acids (building blocks of protein).  Eggs are a convenient and economical protein that should not be avoided if you have CKD. There is a very high risk for protein energy wasting (PEW) of malnutrition if you have CKD. 

Approximately 75% of the CKD population experience some level of malnutrition. This can lead to poor treatment outcomes, decreased immunity, increased risk for infection, decreased quality of life, and an increased risk of mortality.  Poor nutritional status is a very strong risk of health outcomes with CKD; usually more than other risk factors.

Consistent protein intake is essential to prevent PEW. Consuming one egg per day, (which is 1 oz of protein), can contribute to your daily protein needs without adverse cardiovascular outcomes, even with additional risk factors such as diabetes and/or a history of heart disease.

Depending on your level of CKD, your protein needs will vary.  If you are on dialysis your protein needs will be higher due to losses in the dialysate.  If you recently had a kidney transplant, you may need more protein to promote the healing process.  Once your 6 week post-op check in completed, and you’re healing well, your protein needs may change.  Your renal dietitian can determine your personal daily protein needs based on your level of kidney disease.

Heart Disease

Consuming a diet high in saturated and trans fats, and cholesterol significantly contributes to developing cardiovascular disease (along with smoking, lack of exercise, and being overweight).   In processed foods, they may contain trans fats, which can also raise cholesterol levels. If a food is high in cholesterol, but low in saturated fats and trans fat, it does not raise cholesterol.   

Cholesterol in foods such as eggs do not raise blood cholesterol levels since they are low in saturated fat and higher in heart healthy fats (i.e. mono and poly unsaturated fats). So, when consuming sources of animal protein that contain both high amounts of saturated fat and cholesterol (i.e. skin on poultry, visible fat on beef and pork), you have a greater risk for high cholesterol levels.  A diet high in processed foods that contain high amounts of trans fats and cholesterol, you also have a greater risk for high cholesterol levels.  

If you have no heart disease risk factors, one egg a day is fine.  If you have cardiovascular disease risk factors such as a history of heart disease or heart attack, diabetes, CKD, and familial hypercholesterolemia, no more than 2-4 eggs per week are recommended.  This is to err on the side of caution to help protect the heart and avoid contributing to existing heart disease.  

Nutritional Value of Eggs

Eggs are economical and great source of high biological value protein, especially for CKD patients.  If you have CKD, it is vital to maintain your protein levels to maintain your overall health and nutritional status.  Eggs contain the most bioavailable form of protein for the human body-meaning it contains protein that is the easiest to digest, absorb, and utilize by the body.  The protein of the egg is in the white part. The yolk contains B vitamins, vitamin D, and choline-all essential for good health. There are a variety of egg choices in the market today. 

Free Range Eggs

Free range eggs are produced by chickens that are free to run outdoors (weather permitting) and eat bugs and grubs along with any feed that the farmer may provide.

Free Run Eggs

Free run eggs come from chickens that are free to run in the barn and are usually provided feed from the farmer along with perches and scratching areas.

Organic Eggs

The chickens are fed an organic diet by the farmer.  They are free range as well.

Caged Eggs

The hens are in a cage and that the eggs are collected in a container connected to the cage.  The hens do not usually have perches or scratching areas.

Omega-3 Eggs

The hens are fed a diet usually containing flax which provides omega-3 fatty acids.  The hens produce eggs that contain omega-3 fatty acids. The amount of omega-3 in the egg depends on the amount of flax in their diet and how the hens metabolize it. 

Vitamin Enriched Eggs

Vitamin enriched eggs are from hens that have been provided with extra nutrients such as vitamin D or omega-3 in their feed.

Color and Size

The color of the egg is dependent on the breed of hen.  The size of the egg generally increases as the hen gets older.  Neither impacts the nutritional quality of the egg.

Grade A Eggs

Grade A eggs have shells that are contained, the yolks are centered, and that there is little air space or ‘pockets’ in the egg.  These are the eggs available at the grocery store.

The choice of egg-free range, caged, free run, organic, omega-3, vitamin enriched, color and size do not contain significant differences in their protein and cholesterol content.

Consult with your renal health care team, ask questions, and meet with your dietitian to learn about how eggs can be a part of your renal diet for optimal health with CKD.

Disclaimer

The content of this article is for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. KidneyChef urges you to seek the advice of your physician or other qualified health provider with any questions you may have regarding any medical condition. KidneyChef advises you to never disregard professional medical advice or delay in seeking it because of something you have read on the Website.

If you think you may have a medical emergency, call your doctor or local emergency service immediately. KidneyChef does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the website. KidneyChef does not guarantee the accuracy of information on the Website and reliance on any information provided by KidneyChef is solely at your own risk.

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6315879/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165023/

https://academic.oup.com/ajcn/article/102/5/1007/4564430

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5916923/

https://www.sciencedirect.com/science/article/pii/S0211699517301418?via%3Dihub

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3313743/

www.eggs.ca

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