Eggs and bad cholesterol: Debunking the myth.

The lingering myth that there is a link between eggs, bad cholesterol and heart disease needs to be unscrambled once and for all, say experts.

“An increased intake of dietary cholesterol (including from eggs) has little or no effect on blood cholesterol levels”.

_{Gray, J. & Griffin, B. Eggs and dietary cholesterol – dispelling the myth. British Nutrition Foundation Nutrition Bulletin 34, 66-70 (2009)}

Many people, including health professionals, still mistakenly believe the link exists, but it harks back to the 1970s according to New Zealand Nutrition Foundation CEO Sarah Hanrahan. Ms Hanrahan says “it is rare for a single food to be responsible for any disease process. But for some reason that myth has hung around, especially for older people,” she says.

In recent years robust scientific evidence has proven otherwise. It shows that an increased intake of dietary cholesterol (including from eggs) has little or no effect on blood cholesterol levels ^[1]. Studies carried out on healthy people found no effect of daily egg intake on blood cholesterol levels ^[2,3,4]. Saturated fat was found to have more impact on blood cholesterol levels than dietary cholesterol ^[5]. And a 2015 meta-analysis and systematic review found no association between increased intake of dietary cholesterol and increased risk of heart disease or stroke ^[6]. The Heart Foundation recommends that people with an increased risk of heart disease and Type 2 diabetes can eat up to six eggs per week as part of a heart-healthy diet.

The Heart Foundation says people who are hyper-responders to dietary cholesterol should consult their healthcare provider to discuss their egg intake.And for the general (healthy) population, it doesn’t make any recommendations around limiting egg intake if they are consumed as part of a heart-healthy diet. The Heart Foundation also notes that it is saturated fatty acids that have a greater effect on blood cholesterol levels and therefore the risk of heart disease.

“It’s important to pay attention to what you’re eating your eggs with, for example, limiting bacon and other processed meats.”

Dave Monro, Heart Foundation Chief Advisor Food & Nutrition

People need to look at their overall diet

Heart Foundation Chief Advisor Food & Nutrition Dave Monro says a person’s overall diet is important. “People should in general be eating more plant-based foods like vegetables, healthy fats such as avocado, olive oil, nuts and seeds, and cutting back on highly processed foods,” Mr Monro says. He adds that eggs are a nutritious, versatile whole food and one of several great sources of protein in a balanced and varied diet. They can be eaten at breakfast, lunch or dinner, can be boiled, scrambled or poached, and combined with vegetables in frittatas and omelettes. “It’s important to pay attention to what you’re eating your eggs with, for example, limiting bacon and other processed meats.”

When making its recommendations around eggs, the Heart Foundation looked at the totality of the evidence to inform its recommendations. “Science is a constantly evolving process, and we continue to learn more about the impact of food on health all the time. It’s important for us to constantly review our recommendations but be guided by what the totality of the evidence is saying, instead of the results of a single study.”

Great source of protein, especially for seniors

Eggs are also a great source of protein, which is particularly important for older people who need to have protein spread evenly throughout the day. Ms Hanrahan says eggs are a great way to achieve that. The Ministry of Health also gives eggs the thumbs up. Its Eating and Activity Guidelines state that eggs are a healthy, natural whole food and can be eaten by most people every day of the week. “The reality is that eggs are incredibly nutritious, versatile, and affordable,” she says.

Content originally published in 12/5/21 issue of NZ Doctor.