In last week’s Nutrition Diva podcast, I talked about the potential benefits of omega-3 eggs. Ironically, shortly before that episode was released, a new study came out that was widely covered in the media, finding that people who ate more than a few eggs a week had an increased risk of heart disease and death.
This headline wouldn’t have raised any eyebrows 20 years ago, when we firmly (but falsely) believed that eating foods that contained cholesterol would contribute to high blood cholesterol and heart disease risk.
But in 2016, the Dietary Guidelines for Americans officially removed cholesterol from the list of nutrients that we need to worry about limiting. This was based on an accumulating stack of epidemiological evidence finding no clear link between dietary cholesterol and heart disease risk.
In addition to these observational studies, there have also been controlled diet studies which are able to provide more reliable information about cause and effect. Most of these found that diets containing more cholesterol did not increase heart disease risk factors compared to similar diets that were lower in cholesterol.
All of this evidence ultimately led the USDA to take cholesterol off the list of nutrients of concern. This decision was not an impulsive one. In fact, many in the health and nutrition community felt that it took the USDA 10 or 20 years longer than it should have to let eggs and cholesterol off the hook.
When this latest study hit the newswire, dozens of concerned Nutrition Diva listeners reached out to me for comment. And I totally sympathize with those of you who feel jerked around. First eggs are bad. Then they’re fine. Now they’re bad again. So let me try to put this latest headline in perspective.
These findings weren’t actually about eggs. They were about cholesterol.
How Risky Is Dietary Cholesterol?
The first thing you need to know about this study is that the increase in risk was pretty modest. Overall, 18% of the people the researchers followed developed heart disease over the course of a couple of decades. Of those who had more cholesterol in their diets, 21% developed heart disease. So, according to this study, if you have a low cholesterol diet, your risk of developing heart disease is just under 1 in 5. If you have a high cholesterol diet, your risk is just over 1 in 5.
The second thing you need to know is that these findings weren’t actually about eggs. They were about cholesterol. The analysis found that those consuming more than 300 mg of cholesterol a day had an increased risk of heart disease. They also found an increased risk among those eating more than 3 eggs a week. But the association between egg consumption and heart disease disappeared when they adjusted for cholesterol consumption. It wasn’t eggs per se that was increasing the risk, it was the cholesterol.
Most of the cholesterol we take in comes from meat, poultry, fish, and dairy products. Eggs account for only 25% of the cholesterol in the typical diet. The conclusion that it’s only safe to consume 3-4 eggs a week is based on the assumption that you are also eating meat, poultry, fish, and/or dairy products on a daily basis. And that may or may not be true for you. If you don’t eat meat, for example, then you could eat a dozen eggs a week.
If you don’t eat meat, for example, then you could eat a dozen eggs a week.
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