Eggs and Cholesterol: Unscrambling the Latest Data

Another much-hyped study has served up yet more confusion about eggs and their impact on our health, particularly cholesterol — one of the major risk factors for heart disease.

So are eggs good or bad for you? The conclusion to that question seems to be swinging from one side to the other, depending on the latest research.

The answer is: Eggs are not necessarily bad for you. But make sure you’re eating an overall healthy diet low on saturated fats and keep your blood cholesterol under control — according to your blood lab results ordered by your doctor.

So if you pile on the butter, bacon and cheese — and whatever else that’s high in saturated fat — next to your morning eggs, then you may have a problem. Otherwise, enjoy your eggs — in moderation — and keep tabs of your cholesterol.

The latest research from Northwestern Medicine concluded that eating three to four eggs per week was linked to a 6 percent higher risk of cardiovascular disease and an 8 percent higher risk of any cause of death. They looked at data on nearly 30,000 adults between 1985 and 2016. Participants were asked about their dietary habits over the last month or year in an extensive questionnaire.

By the end of the follow-up period, 5,400 participants experienced cardiovascular events and 6,132 deaths from any cause. But the study seemed to be set up to put eggs in a bad light from the start, says Jonathan Fialkow, M.D., Deputy Medical Director Chief of Cardiology and a certified lipid specialist at Miami Cardiac & Vascular Institute at Baptist Hospital.

“It was kind of to set up to show what they believed — that if you eat a lot of eggs, the cholesterol (from the eggs) will lead to heart disease and that’s been pretty much been debunked,” says Dr. Fialkow. “Dietary cholesterol really is not a major contributor to heart disease. So this was just more hype about eggs that ends up getting published.”

An analysis by the researchers in the latest study found that consuming 300 milligrams of dietary cholesterol per day was associated with 17 percent higher risk of cardiovascular disease and 18 percent higher risk of death.

Eggs were the focus because they are one of the richest sources of dietary cholesterol. One large egg contains about 186 milligrams of dietary cholesterol in the yolk. Before 2015, U.S. nutrition guidelines recommended consuming less than 300 milligrams of dietary cholesterol per day.But the recommendations changed four years ago based on the available data.

Instead, the focus shift toward getting Americans to reduce their intake off foods high in saturated fats. But the problem with the study is the focus on eggs, says Dr. Fialkow and dietitians, who insist that eggs alone are likely not the problem.

“They looked and said that there is a correlation between with the number of eggs, specifically because of the cholesterol content, and heart disease,” explains Dr. Fialkow. “Their major conclusion was ‘yes.’ But they didn’t know whatever else they ate (that is high in saturated fats).”

The cholesterol in the eggs is not the culprit, adds Amy Kimberlain, registered dietitian at Baptist Health South Florida. The current U.S. dietary guidelines urge consuming less than 10 percent of calories per day from saturated fat. The American Heart Association recommends limiting saturated fats – which are found in butter, cheese, red meat and other animal-based foods — to an even lower level, about 5 percent to 6 percent of total daily calories.

“It’s the saturated fat that raises blood cholesterol,” Ms. Kimberlain says. “We have to pay attention to what we’re pairing eggs to — and then again come back to portion control and looking at overall consumption of saturated fat from other animal sources throughout the day.”

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