A client recently asked this question and I thought it might be a useful topic for others, as well.
Before we get started, it’ s important for me to mention that high cholesterol can be the result of dietary and lifestyle choices or it can be genetic. This article discusses the incorporation of eggs into an already healthy diet for people with high cholesterol resulting from dietary and lifestyle choices. This article does not address eating eggs if you have genetically high cholesterol. As always, check with your doctor before making any major dietary changes.
Like many of you, I grew up thinking that cholesterol was bad for me and that I should avoid cholesterol containing foods at all costs, or risk an early death from heart disease. High blood pressure, high cholesterol, and smoking were thought to be the key risk factors for developing heart disease. It was assumed that if we limited the amount of fatty foods, stopped smoking, and exercised, then the risk for heart disease would go down. We began to demonize fat and eat a fat free diet. For breakfast we stopped eating two eggs over easy with a side of bacon and started eating a low-fat muffin or scone, a breakfast bar, or a packet of quick oats with brown sugar and raisins.
However, people in the U.S. are smoking less, exercising more, and cleaning up their diets. Yet, while rates of deaths from heart disease worldwide are going down, the rates of death from heart disease in the U.S. are going up. And stress, obesity, and sleep deprivation are now added to the list of factors that increase the risk of heart disease. And the rates of metabolic syndrome, obesity, and diabetes are going up.
The recommendation of a low-fat diet, replacing fat with carbohydrates, is based on the now debunked diet-heart hypothesis that postulates, saturated fats and cholesterol cause heart disease, and by avoiding the foods that are high in saturated fat and cholesterol, we can avoid developing heart disease1. Since then, we’ve learned more about what is happening in the body to contribute to high cholesterol and increased rates of heart disease, metabolic syndrome, obesity, and diabetes.
Cholesterol is a type of fat that is essential for normal functioning of the body. It helps build healthy cell membranes, protects nerve cells, helps our organs function properly, assists in absorbing vitamin D, makes hormones, and creates digestive juices. Cholesterol is a good thing and we need it!
Cholesterol is made and regulated by the liver. A healthy liver can produce enough cholesterol for the body’s needs all by itself. When we ingest cholesterol from foods like meat, fish, eggs, butter, cheese, cream, and milk, a healthy liver produces less in order to keep cholesterol levels stable.
The Mayo Clinic recommends no more than 300 mg of dietary cholesterol a day if you are healthy and no more than 200 mg of dietary cholesterol a day if you have signs of heart disease. According to the U.S. Department of Agriculture, a large egg contains approximately 186 mg of cholesterol.
Cholesterol comes in two forms – Low-density lipoprotein (LDL) and high-density lipoprotein (HDL). It has long been thought that LDL is the “bad” cholesterol because it goes into, and can build up in, your arteries and that HDL is the “good” cholesterol because it helps rid your body of excess LDL cholesterol, so it’s less likely to end up in your arteries.
However, there is now some evidence that it’s not as simple as avoiding LDL and making sure we get lots of HDL. In fact, the size of the LDL cholesterol (or fat molecule) may actually determine how it impacts the body. One study suggests that “…egg consumption may increase the size of LDL particles…”, making them less dangerous for the heart. The study also states that eggs are “…also a major dietary source of lutein and zeaxanthin, two potent antioxidants, which may reduce LDL oxidation…”, further increasing their benefit to heart health2.
When we replaced the eggs and bacon with that low-fat muffin or scone, or that packet of quick oats with brown sugar and raisins, we replaced a diet high in saturated fats and cholesterol with a diet full of sugar, trans-fats, sodium, and processed foods. Flash forward many years later and now we’re learning that SUGAR may be more of a culprit in developing heart disease than saturated fats and cholesterol3. Trans-fats are also definitively related to higher rates of heart disease. This isn’t to say that we should go back to eating a breakfast of bacon and eggs every morning! The Mayo clinic points out that, “The foods people typically eat with eggs, such as bacon, sausage and ham, may do more to boost heart disease risk than eggs do. Plus, the way eggs and other foods are cooked — especially if fried in oil or butter — may play more of a role in the increased risk of heart disease than eggs themselves do.” The Mayo clinic asserts that healthy individuals can eat up to 7 eggs in a week without increasing the risk of heart disease.
Where we get our eggs from is hugely important to their nutritional quality. The fatty acid profile and nutritional quality of an egg is highly dependent on the diet of the hen4. The healthier the diet of the hen, the more nutrient packed the egg. We can actually see this in the color of the egg yolk. A store bought, conventional egg is a pale yellow compared to a pastured, local egg, which is often bright orange. So, if you eat eggs, make sure you find a source that is pastured, locally raised, and organic to ensure the highest nutritional quality and the best lipid profile.
What we eat, how much sleep we get, how much stress we’re exposed to, and the lifestyle choices we make, all impact our health. These decisions and factors are highly bio-individual, meaning that we all need to take into consideration the different genetic, environmental, and health realities that we live with to determine what choices will be most healthy for us. That’s why no diet is one size fits all.
Ultimately, it’s really best not to focus on one food for health and instead focus on the big picture. If we eat locally bought, pastured, organic eggs, but also eat foods that are processed with added sugars and trans-fats, then our health is going to suffer and we’re probably going to have higher cholesterol as a result. However, if we eat organic, locally sourced, whole foods, lots of fresh vegetables and fruits, a wide variety of colors on our plate, that are properly prepared, and nutrient dense, then eggs can be a healthy addition to our diet, even if you are working to lower your LDL and raise your HDL.
- Alberts et al. Molecular Biology of the Cell: 4th edition, NY: Garland Science, 2002.
- Zampelas A. Still questioning the association between egg consumption and the risk of cardiovascular diseases. Atherosclerosis. 2012;224:318–9. [PubMed] [Google Scholar] [Ref list]
- DiNicolantonio, J., Lucan, S., O’Keefe, J. “The Evidence for Saturated Fat and for Sugar Related to Coronoray Heart Disease.” Journal for Progress for Heart Disease, Volume 58, Issue 5, 2015, ncbi.nlm.nih.gov/pmc/articles/PMC4856550/.
- Bouvarel I., Nys Y., Lescoat P. Hen nutrition for sustained egg quality. In: Nys Y., Bain M., Van Immerseel F., editors. Improving the Safety and Quality of Eggs and Egg Products, Vol 1: Egg Chemistry, Production and Consumption. Woodhead Publ Ltd.; Cambridge, UK: 2011. pp. 261–299.