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News: Study Suggests Eggs Raise Risk of Heart Disease and Early Death

News: Study Suggests Eggs Raise Risk of Heart Disease and Early Death

Americans are eating more eggs than before, but is this trend hurting our heart health? Here’s what you should know.

Americans love their protein-packed eggs, which incidentally are also one of the richest sources of dietary cholesterol. Considering conventional wisdom on the potential risks and benefits of eating eggs has changed dramatically over the years, it’s no surprise that the breakfast of choice for so many has become a source of confusion and concern.

For years, experts advised adults to limit their intake of eggs and other foods high in cholesterol. But in 2015, after decades of warnings, health officials revised the Dietary Guidelines for Americans, omitting the previous recommendation to limit dietary cholesterol intake to 300 milligrams (mg) per day. The decision was based on mounting scientific evidence suggesting that genetics and saturated fat have a much greater effect on blood cholesterol levels than cholesterol in food.

Since then, we’ve been eating more eggs. In fact, in 2019 alone, the U.S. Department of Agriculture estimates that egg consumption per person will amount to about 279 eggs!

Once again, however, Americans’ love affair with omelets is being challenged. A March 2019 study from Northwestern University published in JAMA found that higher egg and cholesterol consumption was associated with increased risk for heart disease and death. The study’s authors contend that their findings should prompt a review of the 2015 dietary guidelines on cholesterol, which set no limits on daily dietary cholesterol intake.

So, the pendulum of generally accepted nutritional wisdom swung from one extreme (eggs are high in cholesterol and bad for your heart) to the other (the dietary cholesterol in eggs won’t significantly increase the risk for heart disease in otherwise healthy people, so scramble away). And now, it appears to be swinging again—but it’s unclear how far it will go.

While throwing caution to the wind seems liberating, the egg-eating trend of the past few years begs the question: can we really eat as many eggs as we want?

Probably not. But eggs can likely be a part of a healthy diet for many people, according to Keith Roach, MD, Sharecare’s chief medical officer and a long-standing member of its Scientific Advisory Board.

The truth is, there is no simple, one-size-fits-all answer to this question. Here’s everything you need to know about the ongoing egg debate, which will help you make an informed decision that works for you.

Eggs: what’s good and what’s not so good
An egg is a low-calorie, low-carbohydrate nutrient powerhouse. One large egg contains only about 70 calories, but it’s got a whopping 6 grams of protein. It’s also rich in good stuff like vitamin D, B12, choline, lutein and zeaxanthin, supporting your bones, liver and vision. (Some eggs are also enriched with beneficial omega-3 fatty acids.)

One large egg has nearly 5 grams of fat—including 8 percent of the recommended Daily Value (DV) of saturated fat—but most of the fat in eggs is actually the good kind (monounsaturated and polyunsaturated). The bigger issue is that it also contains about 186 mg of cholesterol.

The body packages fat and cholesterol into particles called lipoproteins. The “bad” ones, known as LDL cholesterol (low-density lipoproteins) can build up in the arteries, potentially limiting blood flow. This increases the risk for heart attack and stroke. It seems logical, therefore, that reducing intake of dietary cholesterol would help protect the heart. And for years, that was the recommendation.

Why the egg debate continues
More recent research suggested that the cholesterol you get from food doesn’t have a huge impact on blood cholesterol levels, and that the real dietary culprits are instead saturated fats and carbohydrates. The evidence was so compelling that in 2015, health officials dropped cholesterol as a nutrient of concern in its Dietary Guidelines, and many people starting buying and eating a lot more eggs.

The latest study to investigate the risks associated with eating eggs, however, calls this dietary habit back into question. The Northwestern researchers examined pooled data on a diverse group of 29,615 U.S. adults from six different studies. Information on the participants’ diets was collected at one point in time (so even if someone’s diet changed, they were still considered “egg eaters.”) The people were followed for up to 31 years to track how their diet and egg consumption, in particular, affected their heart health.

The study found that consuming 300 mg of dietary cholesterol per day was linked to a 17 percent higher risk of heart disease and an 18 percent higher risk of death. Eating three to four eggs on a weekly basis was associated with a 6 percent higher risk of heart disease and an 8 percent higher risk of death from any cause. The main driving factor, the researchers noted, was cholesterol in particular—not saturated fat intake or other forms of dietary fat.

The study’s authors pointed out that the average American adult eats about three to four eggs each week. So, is it time to cut back or avoid eggs entirely?

Don’t sell the chicken coop just yet
The Northwestern study was well-designed, but “the absolute increase in heart disease and mortality risk was modest,” Roach says.

It’s also important to remember that the Dietary Guidelines haven’t changed—at least not yet. More research is likely needed to settle the egg debate or provide more clarity about how eggs affect heart health.

In the meantime, there are some variables to consider when deciding what to have for breakfast. For example, high cholesterol tends to run in families. If your parents or close relatives were diagnosed with the condition, it’s more likely to affect you, which may limit some of your food choices. Cholesterol levels tend to increase with age, Roach points out. So, as you get older, you may want to be more mindful about how many eggs you’re eating. If you smoke, are not active or are overweight, you’re at greater risk for high cholesterol levels. So, limiting your egg intake in these cases may be a good idea.

It’s also important to consider your overall diet. You may need to be careful about how many eggs you’re eating, but they’re likely still a healthier option than many sugary cereals, pancakes drenched in syrup or a buttered bagel, which may have fewer nutrients but a lot of “empty calories,” which can lead to weight gain and a reduction in your heart health.

Meanwhile, you wouldn’t be doing yourself any favors by replacing your daily morning egg with bacon or sausage. Red or processed meat and whole milk dairy products contain saturated fat, which is a known contributor to high cholesterol levels.

But if you’re otherwise healthy and rarely or never eat foods high in saturated fat, you can probably incorporate eggs into an overall heart-healthy diet that emphasizes a wide variety of fruits, vegetables and whole grains. If your LDL or “bad” cholesterol level is low (or less than 70 without medication) then you don’t need to worry about it, advises Roach.

How much is too much
Like most things in life, moderation is key. The American Heart Association (AHA) has long advised that most healthy adults could safely have one egg each day as part of a healthy diet. Having one egg per day, or no more than seven per week, while limiting other foods high in dietary cholesterol, remains a smart strategy, Roach says.

That said, if you’re looking for ways to curb your egg habit, opt for just the whites sometimes, which are high in protein but not cholesterol (the cholesterol is in the yolk).

It’s important to talk to your doctor about your diet and your risk factors for high cholesterol and heart disease to determine what’s right for you. A registered dietitian could also help you incorporate eggs into your diet in a healthy way (hint: don’t cook them in bacon grease).

Keep in mind, however, that those who already have high cholesterol or have an inherited genetic condition called familial hypercholesterolemia (FH), which causes them to have very high LDL cholesterol levels at a young age that worsen over time, should avoid eggs or more carefully limit their dietary cholesterol consumption.

People with certain conditions that increase the risk for high cholesterol and heart disease, including obesity and type 2 diabetes, may also need to more strictly limit their egg intake.

Know your numbers
Being aware of your cholesterol levels can help you make wise decisions about your diet and protect your long-term health.

Adults age 20-years or older should have their cholesterol checked every 4 to 6 years, according to the AHA. If you have heart disease or risk factors for heart disease, you may need more frequent screenings. Your doctor can help you understand what your cholesterol levels mean and whether or not you would benefit from certain lifestyle adjustments, cholesterol-lowering medications or other treatment options.

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