All Cholesterol is Not Created Equal: A Review (Summary) of Egg Consumption and Heart Health

This is something I have been waiting for for a long time. A review article, published by The Academy of Nutrition and Dietetics, looking at egg consumption and finally getting with the times on egg/cholesterol/heart disease research. Without further adieu, here are some of the main points, as highlighted by yours truly:

All Cholesterol Is Not Created Equal: A Review of Egg Consumption and Heart Health.

Clayton, Z. and Fusco. E.  SCAN’S PULSE. Spring 2015, Vol 34. No.2

In several recent studies, egg consumption and thus higher intakes of cholesterol than previously recommended, NO relationships to serum cholesterol, all-cause mortality, coronary heart disease, heart attacks, or angina has been observed. The original cholesterol recommendations (less than 300mg/day – and one egg yolk contains 185-265mg) were based off of a popular study known as Framingham Study (1961) which showed that high SERUM, not dietary, cholesterol did lead to increased risk of  cardio vascular disease (CVD). The study then made the gutsy recommendation that dietary cholesterol be limited, although it never actually showed any link between dietary cholesterol intake and serum cholesterol levels.

“To date, no controlled dietary intervention trials have determined a link between egg consumption and CVD in individuals who are at low risk and at increased risk for CVD. Egg yolks are a fantastic source of potent anti-oxidants lutein and zeaxanthin, which help protect against lipid oxidation (one of the key contributing factors to CVD). ”

Different study findings, with the direct intake of eggs being the key variable: 

• “…consumption of an egg-based breakfast that added 2 eggs per day to normal dietary intake for 12 weeks did not alter lipoprotein concentrations in healthy, active individuals” , “…the egg based breakfast significantly improved triglyceride concentration independent of resistance exercise”
• “…2 eggs, 5 times per week for 14 weeks did not alter blood lipids when compared to an egg-free, calorie matched breakfast”
• “…3 eggs per day for 30 days did not have alterations in their LDL or HDL…”

What about egg intake in people who are at increased risk for CVD?

• “Individuals following an egg based, lower fat diet exhibited significantly decreased adiposity relative to those consuming a bagel based, low-fat diet”
• “…when 3 whole eggs per day for 12 weeks were added to a moderate carb restricted diet in overweight/obese adult men, no difference in LDL was observed, whereas sig. increase in HDL occurred relative to a cholesterol free egg substitute”
• “…the addition of whole eggs to a moderate carb restriction (25-30% energy) was applied, producing a significant increase in HDL, along with decreases in triglycerides, oxidized LDL and VLDL in individuals with Metabolic Syndrome”
• …” individuals consuming whole eggs have significantly decreased tumor necrosis factor, and C-Reactive protein – relative to individuals consuming a cholesterol free substitute.”

The final take away, directly from the article:

“…it is becoming clear that eggs do not place healthy or diseased individuals at increased risk for CVD, and they may ultimately serve to decrease disease risk.”

My take away:

As always, there may be exceptions to these studies, and some people (~10%) have been deemed hyper-responders when it comes to dietary cholesterol. It is always best to check with your doctor, and make sure they are constantly monitoring your cholesterol levels, especially your small particle LDL. Also, by just adding eggs to your diet, and not changing anything else, you may still not have the benefits. Example – if you add 3 eggs to your diet, but still eat sugary cereals, bagels, muffins, and other highly processed carbohydrates on a constant basis, you won’t benefit from just adding eggs. Also, still keep overall calories in mind, as a calorie deficit is still needed to lead to weight loss!

Lastly, here is my breakfast, almost every single morning:

3 eggs, 3 turkey sausage links, 1/2 red pepper, slice of onion, 3 mushrooms – sautéed in coconut oil

1 cup strawberries, 1/2 cup blackberries

410 calories, 25g carbs, 21g fat, 34g protein, 8g fiber