Starting in the 1960s, Americans were told that eggs were evil. Dietitians warned that too much cholesterol would clog coronary arteries and contribute to heart attacks. Eggs became a sinful food and sugary cereals took their place. A study in the American Journal of Medicine (Jan. 2021) flips that that archaic advice upside now and suggests that eggs are good for you.
The Enormous Egg Mistake:
Doctors began blaming cholesterol for heart disease back in the 1950s. By the 1960s Americans were warned that they had better avoid foods high in cholesterol or else they would suffer an early death from cardiovascular disease.
Cardiologists conveniently ignored the fact that the body makes cholesterol. Cut back on dietary fat and cholesterol and the body continues to make its own.
What is especially egregious about the dietary recommendation to shun eggs is the lack of science. The medical and nutrition establishment embraced this dietary dogma based on nothing but a bogus theory.
It goes like this: Coronary plaque contains cholesterol. Stop eating cholesterol and you can prevent plaque formation and heart attacks.
There were no studies to confirm this belief. Nevertheless, tens of millions of people cut back on eggs and substituted foods such as high-carb cereals, waffles, bagels, donuts and pancakes.
Kids ate things like Frosted Strawberry Pop-Tarts, Honey Smacks, Froot Loops Marshmallow and Honey Nut Cheerios for breakfast. I leave it to you to decide if the nutrition experts did us a favor when they bad-mouthed eggs.
Eggs Are Good!
Eggs are good, to quote the researchers writing in the American Journal of Medicine (Jan. 2021):
“Eggs are a nutrient-dense (eg, minerals, folate, B vitamins, and fat-soluble vitamins), rich source of bioactive compounds (eg, lutein and zeaxanthin) and high-quality protein. Nutrients and bioactive compounds in eggs may theoretically contribute to improving cardiovascular disease.”
Did you pay attention to that last sentence? “Eggs may theoretically contribute to improving cardiovascular disease.” That is what we call a dramatic U-turn! But the investigators who wrote this article went beyond theory.
The authors conducted a systematic review and meta-analysis of 23 prospective studies covering more than one million individuals. Over the course of more than 12 years of follow-up, on average, the volunteers experienced 157,324 cardiovascular disease events such as heart attacks and strokes.
There was no significant association between the number of eggs people usually ate in a week and their risk of a vascular event. On the contrary, people who ate more than one egg a day were much less likely than those who ate fewer to develop coronary artery disease.
In Their Own Words:
We know that is heresy on top of heresy. Please do not take our word for the idea that eggs are good.
Here is how the researchers describe their findings:
“The present meta-analysis, including studies from 1966 to 2020, identified no significant association between egg consumption and risk of cardiovascular disease events, but we found that egg consumption (>1 egg per day) is associated with a reduction in coronary artery disease risk.”
“Egg consumption may reduce coronary artery disease via a mechanism of promoted carotenoid absorption, enhanced high-density lipoprotein cholesterol function, and increased bioactive compounds (eg, lutein and zeaxanthin), resulting in protecting against atherosclerosis.”
Even More Evidence That Eggs Won’t Hurt You:
Numerous studies have concluded that eating eggs does not elevate blood cholesterol. The most recent research is a study conducted at Duke University.
The scientists assigned 140 volunteers to one of two groups. In one group, the participants consumed no more than two eggs a week. In the other group, people ate a dozen fortified eggs weekly. These eggs from chickens given special feed provide more omega-3 fats, vitamin E, vitamin D, vitamin B12 and lutein than ordinary eggs.
After four months, you might expect that people eating a dozen eggs weekly would have higher cholesterol. Instead, researchers found no elevations in LDL cholesterol and no drops in beneficial HDL cholesterol. The study was presented at the Annual Scientific Session of the American College of Cardiology and has not been published.
Data from Framingham Exonerates Eggs:
Another recent analysis of the benefits or risks of eating eggs made use of long-term data from the Framingham Offspring Study (Current Developments in Nutrition, Feb. 22, 2024). Researchers evaluated dietary records and blood tests from 1854 participants.
They found that the rest of a person’s diet also made a difference. Men who ate a healthful high-fiber diet with fish had lower levels of cholesterol, LDL cholesterol and triglycerides if they ate more eggs. We don’t know why these associations did not show up among the women in the study.
Eggs in China:
A study conducted in China found that people consuming as much as an egg a day over nine years were less likely to suffer a heart attack or stroke (Heart, May 21, 2018). A different study conducted in China found a lower risk of stroke among men (but not women) who consumed eggs daily (Nutrients, April 7, 2023).
Eggs Are Good but Old Theories Die Hard:
This is not the first time that studies have shown a disconnect between dietary cholesterol and the risk of coronary artery disease. Although dietary cholesterol can raise total cholesterol, another meta-analysis did not find an association between cholesterol in the diet and the likelihood of coronary artery disease or stroke (American Journal of Clinical Nutrition, Aug. 2015).
The myth that eggs and other cholesterol-containing foods cause heart disease has persisted since the late 1960s. The American Heart Association (AHA) told citizens not to eat more than three eggs a week in 1968 (Nutrients, Oct. 2015). Its experts also warned people to keep their dietary cholesterol under 300 mg a day.
High Cholesterol Foods:
Chicken liver (631 mg per 3.5 ounces)
Beef liver (419 mg per 3 ounces)
Chicken leg (328 mg per leg)
Shrimp (323 mg per cup)
Eggs (186 mg per egg yolk)
Bacon (36 mg per three slices)
Cheese (35 mg per ounce)
Whole milk (33 mg per cup)
Butter (31 mg per tablespoon)
Whole milk yogurt (29 mg per cup)
Embracing the ‘Eggs are Good’ Idea is Hard:
The snubbing of eggs and dietary cholesterol still lingers. Up until 2015, the AHA and the federal government were recommending less than 300 mg of cholesterol a day. Many health professionals remain dogmatic about the dangers of eating eggs or drinking whole milk.
Perhaps it is time to shift our perspective on eggs. This humble food contains vitamins and minerals, as well as choline. This essential nutrient is crucial for the production of the neurotransmitter acetylcholine. Low levels of acetylcholine are associated with cognitive impairment. It is especially important for the developing brain of a fetus or young child.
What About Saturated Fat?
If advice to avoid eggs lasted for so many decades, what other dictates might be misguided? Spurning saturated fat is one possibility. We are still being told to skip foods like butter or whole milk that are rich in saturated fat. Check out the grocery store. Low-fat or non-fat yogurt likely dominates. So does low-fat or non-fat milk.
Yet research does not support such choices. A multinational epidemiological undertaking, the Prospective Urban Rural Epidemiology (PURE) study, concluded:
“Dairy consumption was associated with lower risk of mortality and major cardiovascular disease events in a diverse multinational cohort” (The Lancet, Nov. 24, 2018).
The Heretics Challenge their Colleagues:
One of our favorite cardiologists, Dr. Rita Redberg and her colleagues wrote a controversial editorial in the British Journal of Sports Medicine (April 25, 2017). It was titled “Saturated Fat Does Not Clog the Arteries.”
Here is their introduction:
“Coronary artery disease pathogenesis and treatment urgently requires a paradigm shift. Despite popular belief among doctors and the public, the conceptual model of dietary saturated fat clogging a pipe is just plain wrong. A landmark systematic review and meta-analysis of observational studies showed no association between saturated fat consumption and (1) all-cause mortality, (2) coronary heart disease (CHD), (3) CHD mortality, (4) ischaemic stroke or (5) type 2 diabetes in healthy adults. Similarly in the secondary prevention of CHD there is no benefit from reduced fat, including saturated fat, on myocardial infarction, cardiovascular or all-cause mortality.”
Dr. Redberg is a cardiologist at the University of California, School of Medicine. She was the editor of JAMA Internal Medicine. Not surprisingly, the article she co-authored stirred up a lot of controversy amongst her colleagues. Many still couldn’t believe the idea that eggs are good and that saturated fat doesn’t clog coronary arteries.
Confusing Dietary Data:
Dietary advice is not simple. A recent meta-analysis of 13 studies found that the more high-fat milk people drank, the higher their risk of heart disease (Scientific Reports, Jan. 14, 2021). The same researchers concluded that greater cheese consumption was associated with a lower risk. If there is a lesson to be learned, it is that diet is complicated.
What Do You Believe? Do You Think Eggs are Good?
Some readers of this column, however, have followed their own path.
Judy says,
“I’m almost 80, and I’ve been eating two eggs for breakfast ever since I was 11. At that age, I discovered that the gnawing hunger and weakness I always experienced midmorning could be avoided if I ate eggs rather than cereal. Later, when granola became fashionable, I tried that. Eventually I went back to eggs.
“I now eat three eggs for breakfast because I feel that I need more protein at my age. My cholesterol has always been over 250, so I select my doctors carefully to avoid being bullied about taking statins. My high HDL means the total cholesterol doesn’t much matter. Indeed, I’ve never had the slightest problem with my heart.”
We know that once an idea takes root, it is hard to dig up. When doctors tell people that eggs are bad for 50 years, it is challenging to reverse course. Now, though, even the American Heart Association has changed its tune on eggs.
The AHA notes,
“The 2019 science advisory says healthy people can include up to a whole egg or the equivalent in their diets each day; given the nutritional benefits and convenience, older people with healthy cholesterol levels can have two.”
If you would like to read more about the science behind the suggestion that eggs are good, here is a link to real data. And if you would like to find out about sat-fat, here is a link to an article you might find intriguing:
Just How Scary Is Saturated Fat?
Is your doctor’s nutrition advice outmoded? Many physicians still warn against saturated fat, though they should be targeting sugar and refined carbs.
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