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What Does the Latest Study on Eggs and Cholesterol Mean?

02/10/2021

Mickey Rubin, PhD, Executive Director, Egg Nutrition Center

 

Many of you may have seen the headline this morning touting another study on eggs and cardiovascular disease, with the headline “Are eggs good or bad for you? The truth may be somewhere in between.” This is one where your readers, followers or patients may have questions. I would encourage you to read past the headline because there are some important points made by experts, including Dr. Walter Willett from the Harvard School of Public Health.

 

“The study results are problematic because they only asked people once about their egg consumption, then followed them for many years without checking to see if their diet had changed” according to Dr. Willett, while other experts in the same article stated that "The conclusions of this study are overblown.”

 

What does the latest study on eggs and cholesterol mean? See below for a brief summary of the results and the broader context:

 

  • This new study reported an increased risk for all-cause mortality, cardiovascular mortality, and cancer mortality.

 

  • However, this study was limited by the fact it only assessed diet once at the start of the study 25 years ago and then never again.
    • In contrast, a stronger study from the Harvard School of Public Health assessed diet multiple times over decades and found no link between egg intake and cardiovascular risk.

 

  • Several studies published just in the last year on the topic of eggs, dietary cholesterol, and cardiovascular risk contradict the findings from this new study, including the Harvard study linked above, a meta-analysis of 23 studies that found egg intake reduced the risk of coronary artery disease, as well as a global analysis across 50 countries that found no link between eggs and cardiovascular disease.

 

  • One point not discussed extensively in this new study or the news article is the finding that consumption of eggs was linked to a reduced risk of Alzheimer’s disease. While this should be viewed in the context of the limitations of the study described above, this is consistent with other studies on choline – a nutrient for which eggs are an excellent source - that have shown favorable results for cognitive outcomes and reducing risk for dementia.

 

  • Finally, recent guidance from the American Heart Association (AHA) as well as the Dietary Guidelines for Americans 2020-2025 that have assessed the totality of evidence on the topic state that eggs can be a part of heart-healthy diet patterns.
    • The AHA stated in 2019 that healthy individuals can include up to a whole egg daily in heart-healthy dietary patterns, older healthy individuals can include up to 2 eggs per day in heart-healthy diets, and vegetarians who do not consume meat-based cholesterol-containing foods may include more eggs in their diets within the context of moderation.
    • The Dietary Guidelines for Americans 2020-2025 include eggs in all recommended healthy eating patterns starting from when children are first introduced to solid foods.

 

As always, there are often competing headlines in nutrition science, with one study showing one thing, and another study showing the opposite. Rather than getting caught with nutrition science whiplash, it is important not to focus too much on any one study, but rather view the research in totality. As is reflected in the latest nutrition guidance, nutrient-rich eggs are an important part of healthy dietary patterns across the lifespan.