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The Never-Ending Egg Dispute Continues

The egg dispute goes on and on in the pages of medical journals. How risky is it to eat an egg or two for breakfast?

Is it any wonder that Americans are confused about eggs? Fifty or sixty years ago, we were all warned to avoid eggs as if they were poison. After all, they contain cholesterol and doctors assumed that consuming dietary cholesterol would raise blood levels. But the egg dispute really got going about 20 years ago. Studies failed to support the assumption that people eating eggs have higher cholesterol levels. Increasingly, research suggests that people who eat eggs may actually have LOWER blood lipids, depending upon the rest of their diet.

New Fodder for the Egg Dispute:

Scientists from Duke University reported the results of a randomized controlled trial at the American College of Cardiology’s Annual Scientific Session on March 28, 2024. The study was carefully done but not large or long. In it, the investigators assigned 140 volunteers over 50 at risk for cardiovascular problems to one of two groups. One group consumed two or fewer eggs per week. The other ate a dozen fortified eggs weekly (provided by Eggland’s Best, which also supported the study). Over the course of four months, people eating the dozen fortified eggs each week did not develop higher LDL cholesterol or lower HDL cholesterol. We’ll look forward to learning more about this research in the future, possibly when the results are published in a medical journal.

Framingham Weighs In:

Another recent study considered egg consumption in context (Current Developments in Nutrition, Feb. 22, 2024). In this study, 1854 individuals participating in the famous Framingham study submitted three-day records of what they ate in the mid 1980s and early 1990s. Researchers then collected fasting blood tests over subsequent years. This study has a long follow-up period.

The investigators classified egg intake as low (up to one-half egg weekly), moderate (half to 4.5 eggs per week) and high (5 or more eggs weekly). They also considered other components of the diet. In a crummy diet, eggs made no difference. However, men eating a healthful high-fiber diet rich in fish had lower levels of total cholesterol, LDL cholesterol and triglycerides if they ate more eggs. Oddly, the scientists did not find the same associations among women. Previous analyses of Framingham data shows that people who eat more eggs are less likely to develop high blood pressure or diabetes.

Previous Research on How Eggs Affect Health:

A meta-analysis published a few years ago in the American Journal of Medicine concluded that eggs are not linked to cardiovascular disease. In fact, the authors reported that people who eat more than one egg a day are LESS likely to have coronary artery disease than those who eat fewer. On the other hand, in a different study the egg dispute continued with the opposite results.

Eggs and Death:

A study published in PLOS Medicine (Feb. 9, 2021) turned this conclusion on its head.  The researchers analyzed data from more than half a million American volunteers between 50 and 71 years of age. They were followed from 1995 to 2011.

During this time, 129,000 people died. People who ate eggs were MORE likely to die from cancer, cardiovascular disease or for any other reason. The egg dispute was heating up.

The Data:

We’re not exactly sure how the authors came up with this result, but they report that for each half an egg (with the yolk) consumed per day, there was an increase in the risk of death by 7%. That half an egg was associated with a 7% increase in cancer death, cardiovascular death and what researchers call all-cause mortality. In other words, death from any cause. The authors report that the more eggs people ate, the greater the risk. They blamed the increase in deaths to cholesterol.

The researchers go on to report that:

“Egg white/substitute consumers had lower all-cause mortality and mortality from stroke, cancer, respiratory disease, and Alzheimer disease compared with non-consumers. Hypothetically, replacing half a whole egg with equivalent amounts of egg whites/substitutes, poultry, fish, dairy products, or nuts/legumes was related to lower all-cause, CVD, cancer, and respiratory disease mortality.”

The Egg Dispute Confuses Everyone:

By now we suspect you are not only confused but annoyed. We would not blame you one bit.

Ten days ago we cited an article published in the American Journal of Medicine (Jan. 2021) that said:

“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.”

This was a meta-analysis of 23 prospective studies involving over one million volunteers. The researchers reported NO increased risk heart attacks or strokes associated with egg consumption. You can read more details of this and other egg studies at this link.

The Egg Dispute from A Different Perspective:

Although statistically significant, the latest domino in the egg dispute demonstrated a modest increase in cardiovascular risk. Some eminent scientists are not convinced, though.

Dr. Walter Willett is one of our heroes. We have interviewed him many times on our radio show. He is professor of epidemiology and nutrition at the T.H. Chan School of Public Health at Harvard University. (He was once chairman of the department.) He points out that people provided information about their diet only once, at the beginning of the study. Assuming that egg consumption remained static throughout the study, over more than a decade, may have been misleading.

Dr. Willett told CNN (Feb. 9, 2021):

“They’re only getting a snapshot in time.”

People change their eating habits all the time. The subjects in this new study were recruited between 1995 and 1996. They were followed through 2011. But the scientists were not monitoring egg consumption over that time. They authors relied on a single food questionnaire.

Dr. Ada Garcia is a nutrition expert at the School of Medicine of the University of Glasgow, Scotland.

She told CNN:

“The conclusions of this study are overblown. Blaming eggs alone for an increased risk of cardiovascular disease is a simplistic and reductionist approach to the concept of diet and disease prevention.”

Final Words on the Egg Dispute:

We are not at all surprised that people get fed up with scientists who make bold proclamations about diets on month, only to have them contradicted the next. That has been happening with eggs for decades.

Where do you stand on the egg dispute? Share your thoughts in the comment section below.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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