Cholesterol

The NZ Heart Foundation advises that “For the general healthy population, eggs can be included as part of a heart healthy eating pattern. There are more important changes people should be focusing on, such as increasing vegetable intake, eating more whole and less processed foods and reducing saturated fat intake, rather than restricting egg intake”. (ref 2)

And based on current evidence, the Heart Foundation is making a prudent recommendation that New Zealanders who are at increased risk of heart disease, including those with Type 2 diabetes, can eat up to six eggs per week as part of a heart-healthy eating pattern. This amount is unlikely to have any substantive influence on their risk of heart disease. (ref 2)

Studies conducted in healthy people show no effect of daily egg intake on blood cholesterol levels. (ref 3- 5). In addition, the latest scientific evidence shows no association between increased intake of dietary cholesterol and increased risk of heart disease or stroke (ref 6). Cholesterol in the diet is obtained from animal foods such as meat, dairy and eggs. All plant foods are cholesterol-free. Contrary to popular belief, cholesterol from foods causes only a small increase in total cholesterol and LDL cholesterol, and substantially less than saturated fat and trans fat intakes. In fact, the majority of people don’t respond to dietary cholesterol. 

There are two main types of cholesterol in the body which are known as LDL and HDL cholesterol. LDL stands for low-density lipoprotein and is commonly referred to as ‘bad cholesterol’. HDL stands for high-density lipoprotein and is commonly referred to as ‘good cholesterol’. Both LDL and HDL cholesterol enable transport of different fat molecules around the body. LDL particles, however, can transport cholesterol into artery walls, where it can build up to form plaques, resulting in heart disease. HDL’s role is to remove this build-up from arteries. It is therefore preferable to have lower levels of LDL cholesterol and higher levels of HDL cholesterol to protect against heart disease.

A small percentage of the population classed as hyper-responders are particularly susceptible to dietary cholesterol having an impact. Advice for hyper-responders would be best based on their individual response to egg intake, as limits will vary according to the individual. It would be best to discuss your individual requirements with your GP and a registered dietitian. People concerned about this should consult with their health care professional, GP or dietitian.

It is important to note, however, that dietary cholesterol has been shown to increase HDL cholesterol (the good cholesterol) which is important for heart health. Dietary cholesterol has also been shown to increase the size of both LDL and HDL particles making LDL cholesterol less likely to build up in arteries and cause heart disease and making HDL particles more effective at removing cholesterol from the arteries.

In the past, it was thought eating foods containing cholesterol would increase the concentration of cholesterol in the blood. High blood cholesterol is linked to an increased risk of heart disease. Cholesterol is only found in animal products, and this led to people altering the types of food they consumed.

Recent research has shown that it is in fact the saturated fat in our foods that affects our cholesterol, increasing both total and LDL (‘bad’) levels.

What about Saturated Fat?

The NZ Ministry of Health Guidelines recommends limiting foods high in saturated fat (ref 1). Eggs contain only 1.1  grams of saturated fat per egg (59.7 g egg); (ref 7)

More information is available on the Everybody Patient Sheet High Blood Cholesterol May 2021 edition – at the bottom of this page.

References

1. Ministry of Health. 2015. Eating and Activity Guidelines for New Zealand Adults. Wellington: Ministry of Health.
2. Heart Foundation. 2015. Evidence Paper: Eggs and the Heart. Auckland, New Zealand: Heart Foundation.
3. Katz, D.L., et al., Egg consumption and endothelial function: a randomized controlled crossover trial. Int J Cardiol, 2005. 99(1): p. 65-70.
4. Rueda, J.M. and P. Khosla, Impact of breakfasts (with or without eggs) on body weight regulation and blood lipids in university students over a 14-week semester. Nutrients, 2013. 5(12): p. 5097-113
5. Clayton, Z.S., et al., Influence of Resistance Training Combined with Daily Consumption of an Egg-based or Bagel-based Breakfast on Risk Factors for Chronic Diseases in Healthy Untrained Individuals. Journal of the American College of Nutrition, 2015. 34(2): p. 113-9.
6. Berger, S., et al., Dietary cholesterol and cardiovascular disease: a systematic review and meta-analysis. The American Journal of Clinical Nutrition, 2015. 102(2): p. 276-94.
7. SIVAKUMARAN, Subathira The Concise New Zealand Food Composition Tables, 12 the Edition 2017. S. Sivakumaran, L Huffman, S. Sivakumaran, Palmerston North, New Zealand. The New Zealand Institute for Plant & Food Research Limited and Ministry of Health, 2017.