From the Guidelines
Eggs can be consumed in moderation, up to one egg per day, without significantly increasing Low-Density Lipoprotein (LDL) cholesterol levels for most people. This recommendation is based on recent evidence from a 2022 study published in Cardiovascular Research 1, which found that moderate egg consumption is not significantly associated with fatal or non-fatal coronary heart disease. The study suggests that the risk of increased LDL cholesterol may only be a concern for those who consume eggs in excess, and that the overall dietary pattern plays a more significant role in determining cardiovascular risk.
Key points to consider when evaluating the effect of eggs on LDL cholesterol include:
- The variable response to dietary cholesterol, which is partly under genetic control, with some individuals being "hyper-responders" who may experience a greater increase in LDL cholesterol levels 1
- The importance of considering the overall dietary pattern, rather than focusing on a single food, with a diet low in saturated fat and rich in fruits, vegetables, and fiber being less likely to negatively impact cholesterol levels
- The nutritional benefits of eggs, including high-quality protein, vitamins, and minerals, which should be weighed against their cholesterol content when making dietary choices
It is essential to note that individuals with hyperlipidaemia or diabetes may need to exercise more caution when consuming eggs, and those with a western dietary pattern rich in foods with a high content of saturated fats may want to limit their egg consumption to no more than three eggs per week 1. However, for the general population, moderate egg consumption, defined as up to one egg per day, is unlikely to have a significant impact on LDL cholesterol levels.
From the Research
Effect of Eggs on Low-Density Lipoprotein (LDL) Cholesterol
- Consuming ≥5 eggs/wk was not adversely associated with lipid outcomes, and among men, it was associated with a 5.9 mg/dL lower LDL cholesterol level 2.
- Higher egg intake combined with higher dietary fiber was associated with the lowest total cholesterol, LDL cholesterol, and LDL cholesterol-to-HDL cholesterol ratio 2.
- Diets with higher egg intakes in combination with higher total fish or fiber intakes were associated with lower risks of developing elevated (>160 mg/dL) LDL cholesterol levels 2.
- Egg intake has been shown to promote the formation of large LDL, in addition to shifting individuals from the LDL pattern B to pattern A, which is less atherogenic 3.
- Daily consumption of egg substitute for 6 weeks significantly lowered serum total cholesterol and LDL (-14 +/- 20 vs. -2 +/- 19 mg/dL; p = 0.01) in hyperlipidemic adults, while egg consumption was found to be non-detrimental to endothelial function and serum lipids 4.
- The effect of dietary cholesterol on blood LDL cholesterol may vary among individuals, with some being "hyper- or hypo-absorbers" of dietary cholesterol, and the quantity of baseline daily dietary cholesterol and saturated fat intake is important in assessing the effect of added egg yolk cholesterol and saturated fat on blood LDL cholesterol 5.
- Well-controlled, clinical studies show the impact of dietary cholesterol challenges via egg intake on serum lipids is highly variable, with the majority of individuals (~2/3 of the population) having only minimal responses, while those with a significant response increase both LDL and HDL-cholesterol, typically with a maintenance of the LDL/HDL cholesterol ratio 6.
Key Findings
- Eggs may have a beneficial effect on LDL cholesterol levels when consumed as part of a balanced diet with high fiber and fish intake 2, 3.
- The relationship between egg consumption and LDL cholesterol is complex and may vary among individuals depending on their genetic and environmental factors 5, 6.
- More research is needed to fully understand the effects of egg consumption on LDL cholesterol and cardiovascular disease risk 2, 3, 4, 5, 6.