Are you confused about nutrition? You’re in good company! Every day, we’re bombarded with news headlines about certain foods that can harm us and help us live longer. To make matters worse, these foods or beverages can be attacked by the media one month and then praised by them a few months later (e.g. coffee).
While we could spend countless hours reviewing conflicting nutrition research studies, let’s focus on the latest food item called into question by the media: eggs.
You may have seen the recent CNN article proclaiming that “Three or more eggs a week increase your risk of heart disease and early death.” Perhaps your mother emailed you this New York Times article, along with a note urging you to stop eating eggs.
If you somehow managed to dodge all the anti-egg headlines on the internet, you may wonder what sparks all these negative news stories. Let’s take a look at the research study that started it all.
In March 2019, the Journal of the American Medical Association (JAMA) published a study on the association between consuming eggs and cardiovascular disease. It found that people who ate more dietary cholesterol or more eggs had a higher risk for cardiovascular disease (heart disease and stroke). They also had a greater risk for death than those who ate less dietary cholesterol or fewer eggs. The main takeaway from this study is that eating eggs was found to be associated with heart disease and death.
How did the researchers come to this conclusion?
The JAMA article reviewed six different observational studies that took place between 1985 and 2016, and included a total of 30,000 people. In most of the studies analyzed, a food frequency questionnaire was used to determine the amount of cholesterol and eggs consumed by each study participant. The participants were then followed for years and their diseases and deaths were recorded.
One major detail that the news headlines seem to miss is that since this was an observational study, it can’t prove that eggs or cholesterol cause cardiovascular disease or death. The study merely shows an association or a correlation. Remember that correlation does not equal causation. An experimental or intervention-based study with a control group and at least one treatment group would be needed to show causation.
Another point to consider is that food frequency questionnaires only give a snapshot of how often a person eats certain foods at that moment in time. Since the average length of the six studies was 17.5 years, it’s very possible that the participants’ eating habits may have changed over time.
While we can’t draw conclusions about causation, this study shows that more research is needed in order to clear up the confusion around eggs and heart disease. Especially since previous studies did not show the same association. An earlier review study, that included data from nearly 120,000 people, found that eating up to one egg per day did not raise the risk for cardiovascular disease.
What About Cholesterol?
Before we get into the recommendations about cholesterol in the diet, let’s define these types:
- Dietary Cholesterol – This is cholesterol from the food in your diet.
- Blood Cholesterol – The cholesterol in your blood, which is made up of High Density Lipoprotein (HDL) or good cholesterol and Low Density Lipoprotein (LDL) or bad cholesterol.
Blood cholesterol is made in the liver and circulates in your body. It has some very important jobs like helping make hormones and serving as a backbone for your cell walls. In order for cholesterol to travel through the bloodstream, it needs to attach itself to transporters called lipoproteins.
LDL cholesterol, the bad cholesterol, is associated with heart disease because it can build up in your arteries. HDL, on the other hand, removes cholesterol from your blood and brings it back to the liver. This good cholesterol is thought to have a protective effect because it helps clear LDL from the blood.
We used to think that eating dietary cholesterol led to high blood cholesterol. But the latest research finds that cholesterol from the diet does not have a large impact on cholesterol in the blood of most people. Those with very high cholesterol levels caused by genetics (familial hypercholesterolemia) are the exception. They may need to limit cholesterol and fat in their diet.
The latest edition of the Dietary Guidelines for Americans removed the previous recommendation of limiting dietary cholesterol to less than 300 mg per day. The guidelines now suggest that foods higher in cholesterol, but low in saturated fat, can be part of a healthy eating pattern. This would include foods such as shrimp and, you guessed it, eggs!
When it comes to heart disease risk, it’s important to limit trans fats and saturated fats found in processed and deep-fried foods. Instead, focus on eating more monounsaturated and polyunsaturated fats that can help lower blood cholesterol. These include nut and seed oils, fish, and avocados.
As you can see, the types of fats in the diet play a much larger role in heart disease risk than dietary cholesterol. At this point, there is no recommendation to avoid eggs. In fact, they have a variety of health benefits.
Benefits of Eating Eggs
Eggs are more than just sources of cholesterol. They’re nutrient powerhouses that are rich in vitamins and minerals such as:
- B vitamins – needed for a variety of essential functions in the body
- Vitamin A – needed for normal growth and development
- Vitamin E – an important antioxidant
- Vitamin D – promotes bone health
- Iodine – needed to make thyroid hormone
- Phosphorus – promotes the health of bones and teeth
- Choline – important for nerves; choline needs increase during pregnancy
While these nutrients can all come from other sources in the diet, eating eggs is an easy way to cover these important nutrient bases.
So, how many eggs can you eat per day? The best answer is to consider your individual needs. One approach may be to check your cholesterol levels and adjust your diet accordingly. But also be sure to check with your doctor.
While the media was quick to call eggs into question based on a single study, it’s important to take the entire body of research into consideration. The current health guidelines allow eggs (and their yolks!) to be included in the diet as part of a healthy eating pattern. Quantity and whole egg consumption, however, will also depend on an individual’s health and risk levels.
If you have questions about whether eggs are right for you, be sure to ask your healthcare provider.
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