half of the world 's population is living in asia they had their own culture of eating .
rice is a main food with different kinds of plant including vegetables , bean , legume , and herbs .
the traditional asian diet is one of the health model diets because of low incidence of chronic diseases in asian countries .
thai food is one of the asian foods , of good taste , and contains various healthy vegetables , herbs , and spices along with rice and noodles but is less in fat .
thai food does not contain big meat chunks of large animals ; on the other hand , they are fortified and shredded with various herbs and healthy vegetables .
thai people consumed lower egg than those in other countries which was only 130 eggs per capita per year whereas 230 and 350 in hong kong and japan , respectively . from 2012 ,
thai people were encouraged to consume more eggs due to low - cost but high - quality protein of eggs .
data from thai national nutrition survey in 1986 revealed that average fat intake in thai people was 21.8% of total calories consumption .
fat consumption in thai people resemble to that of the ncep step i diet ( 30% of total energy as fat ) .
ncep step i diet consists of 30% of total energy as fat , 10% of energy as sfa ( saturated fatty acids ) , and 300  mg dietary cholesterol / day [ 6 , 7 ] .
limited data are available on the effects of egg consumption with thai food in hyperlipidemic patients .
so , this study tries to assess the effects of daily egg consumption with thai food , which is known as low fat diet , on serum lipid profiles in hyperlipidemic subjects without medication .
eighty adults diagnosed as hyperlipidemic participants ( total serum cholesterol ( tc ) > 200  mg / dl ; ldl - cholesterol ( ldl - c )  130  mg / dl ) , without medication , were recruited .
the participants who have been diagnosed as having egg allergy , hypothyroidism , coronary heart disease , liver or kidney problems as well as the use of hormone replacement therapy were excluded from the study .
participants were randomly assigned to one of the two arms of one egg per day ( egg 1 ) and 3 eggs per day ( egg 3 ) for 4 weeks .
each study arm assignment was separated by a four - week washout period ( egg - free , egg 0 ) .
they were asked to maintain their normal routine dietary intake and physical activity during the whole period of the study .
measurement of body weight , body mass index , body composition by bioelectrical impedance , blood pressure , serum lipid profiles , 3-day dietary record , and daily egg consumption were performed and collected every 4-week interval except for height which was done only once at baseline . the biochemical tests including plasma glucose , renal and liver function tests , and haematological parameters were measured before and after the study .  
the study protocol had been reviewed and approved by the ethical committee on human rights related to researches involving human subjects of ramathibodi hospital , mahidol university .
all participants were informed in detail about the study , and written informed consents were obtained . dietary assessment for macronutrients
they were required to maintain the food records for 2 weekdays and 1 weekend day .
the interviewers collected the data and estimated the serving portions with the use of household measuring cups , spoons , and ruler to assist the subjects in the recall of eaten foods .
serum lipid profile was assessed every 4-week interval , including total serum cholesterol ( tc ) , triglyceride ( tg ) , and high - density lipoprotein cholesterol ( hdl - c ) which were measured by enzymatic methods ( boehringer mannheim corporation , mannheim , germany ) after 12 hours overnight fast .
low - density lipoprotein cholesterol ( ldl - c ) was calculated from friedewald 's formula .
body mass was recorded to the nearest 100 gram on a calibrated digital scale .  
participant characteristics and serum lipid profile of all subjects were reported by using mean  standard deviation ( sd ) .
all outcome measurements among baseline and each period data were assessed using two - way repeated measures anova .
the final results of 2 arms were assessed using paired student 's t - test .
they were 23 to 75 years old , with a mean age of 50.79 years ( table 1 ) .
five participants dropped out from the study because of unwillingness to consume eggs every day , and four participants dropped out because of poor compliance to 12-week program of the study .
body weight , bmi , bmr ( basal metabolic rate ) , % body fat , whr ( waist over hip ratio ) , % body cell mass , % lean body mass , total body water , and systolic , diastolic bp did not show significant change ( table 1 ) .  
no statistical difference of time sequence effect to consume 1 or 3 eggs was found during the study , the results from the two groups were pooled .
additional consumption of 1 egg ( egg 1 ) and 3 eggs ( egg 3 ) per day for 4 weeks increased subjects ' serum tc ( 8.94 , 13.54  mg / dl ) and ldl - c ( 7.94 , 14.53  mg / dl ) levels from washout period ( egg 0 ) but no significant change of tg , hdl - c , tc / hdl - c and ldl - c / hdl - c ratio from egg 0 ( table 2 ) .
the biochemical tests of plasma glucose , renal and liver function tests , and hematological test had no significant change before and after the study .
the association between dietary cholesterol and coronary events and mortality is generally positive . whether dietary cholesterol and cardiovascular risk , association between dietary and serum cholesterol are related
the results from our study revealed that 1 egg or 3 eggs consumption with thai food had unfavorable influence on serum tc , ldl - c levels in the study population of hyperlipidemic adults without medication .
after 4  wk of egg 1 and 3 the subjects ' serum tc and ldl - c significantly increased from egg 0 ( tc : 221.54 ( p < 0.034 ) , 225.31 ( p
< 0.006 ) versus 212.18  mg / dl and ldl - c : 141.38 ( p < 0.035 ) , 145.48 ( p < 0.0005 ) versus 133.67  mg / dl ) .
the study showed no significant change of serum tg , tc / hdl - c , and ldl - c / hdl - c ( table 2 ) .
additional consumption of 1 egg or 3 eggs per day for 4 weeks tended to increase serum hdl - c level although there was no statistic significant difference .  
a clinical trial in healthy postmenopausal women aged 60 years or older had showed that the participants who were classified as hyporesponders to dietary cholesterol had no change in ldl - c and hdl - c after consuming 3 eggs per day for 4 and 12 weeks . on the other hand , the participants who were classified as hyperresponders exhibit increases in both ldl - c and hdl - c with no change in the ldl - c to hdl - c ratio .
a study of daily 2 eggs consumption for 6 weeks in 40 hyperlipidemic adults ( 24 women , 16 men ) with serum tc of 244  24  mg / dl had no adverse effect on endothelial function and serum cholesterol or other measures of their lipid profiles when compared to sausage and cheese ingestion [ 10 , 11 ] .
the lipid profile after consuming additional 3 eggs per day in hyperlipidemic adults , who were treated with lipid lowering drugs , showed no change in ldl - c , increase in hdl - c , and decrease in ldl - c / hdl - c ratio .
these findings harmonized with a previous study of the effect of egg consumption on patients on hmg - coa reductase inhibitor which showed significant increases in serum hdl - c in subjects given 2 or 4 eggs daily .
the absence of an increase in plasma cholesterol in hyporesponders may be due to their ability to maintain cholesterol homeostasis by decreasing absorption of dietary cholesterol or suppressing endogenous synthesis .   a randomized controlled cross - over study of chakrabarty et al .  
was performed on eighteen healthy young volunteers ( 7 males , 11 females ) on a lacto - vegetarian diet .
their serum tc after 4 weeks of egg consumption were significantly higher than that of the reference values .
furthermore , seven out of 18 subjects had an appreciable elevation of serum tc or ldl - c or both after 8 weeks of egg consumption .
similar results to our data showed increase of serum tc and ldl - c levels in the participants after 4  wk of egg 1 and egg 3 ingestion , probably due to high dietary fat intake habit of our participants but no dietary program provided .
we even expect that our study population will consume low fat in their thai food but we did not suggest that they change their eating habit .   when we compared our study to techakriengkrai et al .
, the results showed no significant change of serum tc , ldl - c , tg and hdl - c while they were strict on a cholesterol lowering diet ( ncep step i diet ) with 1 and 3 eggs ingestion for 4  wk .
the sequence of no egg and 1  egg / d had significant lower serum tc and ldl - c ( p < 0.05 ) as compared to those of the baseline which did not take ncep step i diet which recommends that no more than 30% of total calories be from fat and no more than of 10% of total calories be from saturated fat .
in addition , subjects were instructed to consume less than 300  mg of dietary cholesterol per day .
fat consumption in our study was 34.1234.94% of total calories which was higher than ncep step
thai food contains lots of fibers , carbohydrates , vitamins , and minerals with limited or restricted quantities of animal fats and protein sources as well .
authentic thai cuisine is extremely healthy since it was derived from the best healthy cooking methods such as stewing , grilling , and baking .
globalization , technologies , and socioeconomic have changed people in living style as well as eating habit due to fast growing era .
method , of cooking like frying , deep frying , and stir frying were introduced into preparation procedure of thai diet by western countries as well as fast food .
it is evident that thai people consumed more fat in a past decade from the thai national nutrition survey in 2003   using a 24  hrs food intake recall ; fat intake in thai adult increased from 21.8% of total calories ( 1986 ) to 22.2% ( 1995 ) and 23.9% ( 2003 ) .
adult people who live in rural area consumed less fat than urban ( 22.9 versus 26.9% of total calories ) .
the problem in our study due to high dietary fat intake rather than consumption of thai food . since our study was conducted on a small group of 71 participants who lived in bangkok , the capital city of thailand , where they can buy such fast food easily .
thai diet contains some medicinal , low caloric food additives and condiments for being hot and spicy such as garlic , chillies , lime juice , and lemon grass .
these not only contribute to distinctive textures and flavors , but also add fiber , vitamins , and minerals , also essential for being a healthy diet . according to studies reviewed in  the new york times  the spiciness of thai cuisine has been associated with increased satiety , decreased total caloric intake at a meal , and small boosts in metabolism .
these emphasized on the importance of ncep step i dietary program and the composition of macronutrient together with fat quality and quantity in thai food for consumers .
three - day food diaries , used to track dietary intake , showed no significant difference of macronutrient intake throughout the study .
our study provides valuable data regarding egg ingestion in hyperlipidemic adults with thai food , without medication , showing that even only one egg ingestion significantly increased serum tc and ldl - c levels and the three eggs consumption as well .
our study showed no significant change of serum tg and hdl - c levels after 1 egg or 3 eggs consumption daily for 4  wk when compared to egg washout period .
tc / hdl - c ratio may be associated with risk factors for ischemic heart disease or atherosclerosis .
thus the best ratio according to the american heart association would be 2 or 3 or less than 4 .
the tc / hdl - c ratio in our study was between 3.70 and 3.85 .
the current national cholesterol education program adult treatment panel iii guidelines recommend specific target levels of ldl cholesterol ( ldl - c ) and hdl cholesterol ( hdl - c ) for determining cardiovascular disease ( cvd ) risk   which should be between 2.3 and 4.9 .
the ldl - c / hdl - c ratio in our study was between 2.35 to 2.48 .
both tc / hdl - c and ldl - c / hdl - c ratios during the study showed no significant change and remained within normal limit . from our study results
, we would like to remind ones to be careful about eating even 1 egg per day in order to be aware of the amount and composition of fat in dietary intake especially saturated fat and cholesterol intake .
the recommendation of ncep is still important in the treatment of hyperlipidemia , if you strictly follow the recommendation you can have daily consumption of up to 3 eggs without adding on your serum cholesterol level .
our study demonstrated that consumption of 1 up to 3 eggs daily was likely to have substantial impact on serum tc and ldl - c levels .
we emphasized the importance of the cholesterol lowering diet ( ncep step i diet ) to lower both serum tc and ldl - c levels during egg supplement .
so , daily egg supplementation together with limited fat intake , especially saturated fat and cholesterol intake is likely to provide a great impact on serum lipid levels .
 thai food is one of the healthiest foods . in fact , several thai dishes , such as tom yum soup , are currently under scientific study for their incredible health benefits . 
 limited data are available on the effects of egg consumption with thai food in hyperlipidemic patients . to assess the effects of daily egg consumption with thai food , which is known as low fat diet , on serum lipids profiles in hyperlipidemic subjects without medication treatment , the randomized crossover trial of 71 hyperlipidemic adults ( 8 men , 63 women ) were randomly to one of the two sequences of one and three eggs / day for 4 weeks . 
 each treatment was separated by a four - week washout period ( egg - free ) . 
 our data indicated that one or three eggs / day consumption were significantly increases total serum cholesterol ( 221.54  42.54 and 225.31  45.06 versus 211.57  39.98  mg / dl ) and ldl - c levels ( 141.38  38.23 and 145.48  39.33 versus 133.44  34.52  mg / dl ) as compared to egg - free period . 
 no significant change of serum tg , hdl - c , tc / hdl - c , and ldl - c / hdl - c levels was observed after 1 or 3 eggs consumption daily in this study . 
1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusion