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The Facts About Eggs and Heart Health — Unscrambled

Are eggs a superfood or a dietary villain to avoid? You’ve probably seen frightening headlines like these: “Alert! An egg a day increases risk of stroke death,” “A New Study Wants You to Stop Eating Eggs,” “Study: Cholesterol from egg consumption increases risk of heart attack,” and “Eggs are bad for your heart — it’s no yolk.”

However, the 2015 to 2020 Dietary Guidelines for Americans recommend eggs as an inexpensive, low-calorie source of protein and essential nutrients — and some studies have reported that eating an egg a day lowers heart-disease risk. These conflicting findings have caused confusion and concern. Here is a closer look at the new study and other research on the effects of eggs on arterial and heart health, with key takeaways from the BaleDoneen Method.

What Did the New Study Report About Eggs?

Published in Journal of the American Medical Association (JAMA), the study pooled findings from six studies that included 29,615 people of diverse ethnicities who were tracked for about 17 years. Data was collected about participants’ self-reported diets and rates of cardiovascular events, including fatal and nonfatal heart disease, stroke, heart failure and deaths from other cardiovascular (CV) causes, with the following findings:

For each additional half egg eaten daily, risk for CV events rose by 6%.
For each additional 300 mg. of dietary cholesterol consumed daily, risk for CV events rose by 17% and risk of death from any cause rose by 18%.

The study concluded that for U.S. adults, higher intake of eggs or dietary cholesterol was significantly associated with increased risk for both CV events and all-cause mortality.
The more dietary cholesterol people consumed, the greater their CV risk. For those who ate two eggs a day, risk for developing heart disease increased by 27%.
How Much Cholesterol Do Eggs Contain — and How Nutritious Are They?

On average, one large egg has 186 mg. of dietary cholesterol, all of which is found in the yolk. That’s more than half the amount that was formerly recommended for daily consumption (300 mg.) before government guidelines dropped the numerical goal in 2015, based on a lack of scientific evidence for any specific limit. Other cholesterol-rich foods include cheese, steak, hamburgers, liver and other organ meats, lobster, shrimp, processed meats and full-fat yogurt.

An egg contains 75 calories, 7 grams of protein and 5 grams of fat, along with vitamin D, vitamin A, vitamin B-12, iron, potassium and many other important nutrients. Additionally, the yolks are a good source of lutein and zeaxanthin, which support eye health, lowering risk for cataracts and macular degeneration, the leading cause of blindness in older adults.

How Accurate Are the Study Findings?

One major flaw in the study design is that the participants were only asked about their diet once, so their eating habits could have changed dramatically over the nearly two decades they were followed. Also, this was an observational study, so it cannot prove any cause-and-effect relationship between eating eggs or other foods high in dietary cholesterol and risk for CV events.

What Do Other Recent Studies Say About Eggs and Heart Health?

A 2018 study of nearly 500,000 adults ages 30 to 79 who were tracked for nine years linked eating up to one egg daily to an 11% reduction in risk for heart disease, a 26% drop in stroke risk and an 18% decrease in risk for death from CV causes, independent of other risk factors, compared to those who ate few or no eggs. The research was published in the peer-reviewed journal Heart.

Another 2018 study found that eating 12 or more eggs a week for three months did not increase CV risk factors in people with diabetes or prediabetes when consumed as part of a healthy diet designed to help the people in the study lose weight. Participants who ate a diet high in eggs were compared with those who ate a low-egg diet (fewer than two per week), with both groups checked for changes in their levels of blood sugar, lipids and inflammatory markers, such as high-sensitivity c-reactive protein.

In a 2016 analysis pooling findings from seven previous studies, eating up to one egg daily was linked to a 12% reduction in stroke risk, while no clear association was found between eating eggs and an increased or decreased risk of heart disease.

Does Dietary Cholesterol Clog up Your Arteries?

Although eggs have been demonized as “a heart attack in a shell,” the “lipid hypothesis” — the theory that there is a direct relationship between eating high-cholesterol food and developing arterial disease — has long been controversial. A number of recent studies suggest that dietary cholesterol isn’t nearly as dangerous as most people believe. For example, one study found that when people eat three or more eggs a day, their level of LDL (bad) cholesterol rose as expected, but the surprise was that their level of heart-protective LDL also went up.

Another intriguing finding was that when people ate three or more eggs per day, their bodies produced larger LDL and HDL particles than when they ate no eggs. That is important for two reasons: Bigger LDL particles are less likely to invade the artery wall and clump into plaque, while bigger, more robust HDL particles are better at ridding the bloodstream of harmful cholesterol. The researchers concluded that most people’s bodies can handle dietary cholesterol in a way that is unlikely to harm the heart or blood vessels.

What’s the BaleDoneen Takeaway?

Our genes have much more influence on how we utilize the nutrients in our diet than our cholesterol intake. Eggs, like anything else, need to be consumed in moderation and calculated into our daily intake of fat, carbohydrates and proteins. The biggest threat to our heart health is that most people eat too much fattening foods of all types and exercise too little, expanding our waistlines and increasing our risk for arterial disease.

Rather than issue one-size-fits-all advice based on the average results from large studies, we advise a diet based on your DNA. The BaleDoneen Method uses genetic tests to identify the best diet for each patient, including analyzing your Apolipoprotein E (Apo E) genotype. This gene influences both your lifetime risk for arterial disease and the best diet to avoid it.

Following a diet based on your Apo E genotype fights one of the leading risks for heart attacks and strokes — abnormal lipid levels — by raising levels of HDL and lowering levels of LDL and triglycerides. To learn more about personalizing your eating plan for optimal arterial wellness, check out our blog post, “A Diet Based on Your DNA.” For science-based ideas on how to slim down and improve your fitness, also read our blog posts, “7 Heart-Smart Weight-Loss Tips that Really Work” and “What’s the Best Exercise to Reduce Your Waistline & Heart Attack Risk?”