Eggs and Heart Disease

The skeptical cardiologist has been telling his patients for several years not to worry about the amount of cholesterol in the food that they eat. Despite recommendations from the AHA and the USDA’s 2010 Dietary Guidelines for America which suggest limiting daily cholesterol for all to 300 mg and for those with heart disease to 200 mg there has never been any convincing evidence that cholesterol consumption increases an individual’s risk of heart attack or stroke.
I am really happy to discover that the Committee which makes recommendations for the US government published 2015 Dietary Guidelines for America has written that cholesterol is “not a nutrient of concern.”(http://www.health.gov/dietaryguidelines/2015.asp#qanda).
In celebration of this sea change in guideline recommendations I am reblogging one of my earliest posts from two years ago on eggs, cholesterol and heart disease

The Skeptical Cardiologist

The Wonderful Egg and Your Heart

photoI think eggs are wonderful. They are little balls of nutrition that can be prepared in numerous fascinating ways to make breakfast interesting and delicious. I particularly like omelets.  Alas, when I was training as a medical student the medical establishment had embraced the diet-heart hypothesis. It was felt that dietary cholesterol and fat (subsequently modified to saturated fat) by increasing levels of cholesterol in the blood (subsequently modified to raising levels of bad or LDL cholesterol) were responsible for the increasing rate of coronary heart disease that was being observed.

This certainly made sense at the time: If you eat too much cholesterol, of course it’s going to raise your blood cholesterol levels and contribute to the buildup of those nasty cholesterol plaques that would clog your arteries and give you heart attacks and strokes.

Since egg yolks contain 210 mg of cholesterol…

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6 thoughts on “Eggs and Heart Disease”

  1. Hello Doctor,
    I’m a medicine student from Poland and a lucky finder of your blog. Your posts seem to give reliable information and are wonderful source of information. However, i wanted to ask you a question on the topic, you presented above.
    So first of all, what should we think about that study: http://www.ncbi.nlm.nih.gov/m/pubmed/23643053/?i=7&from=egg%20consumption&filters=MetaAnalysis&sort=%5Brelevance%5D
    You know, Doctor, when i see a word “meta-analysis” in the title, I usually believe in its outcomes. However this one strongly contradicts the effects of simiral paper of Shin et al. in American Journal of Clinical Nutrition. You linked this paper in one of your posts, so i don’t repeat it here. Of course Atherosclerosis is a journal of the same great reverence and that’s why I feel so iffy here. My question is – how is it possible, that two meta-analysis on the same subject can have so opposite results? How should I find the most relevant one?
    And the other thing. I know, that is not your field of interest, Doctor, but there are some papers suggesting association between egg consumption and particular types of cancer. Most of such works binds it with hormonal cancers (http://www.ncbi.nlm.nih.gov/m/pubmed/26293984/?i=6&from=egg%20consumption&filters=MetaAnalysis&sort=%5Brelevance%5D – I’m not sure, what is the authors’ point on the end, that’s a bit too sophiaticated English), hovewer there are some with regard to GI tract ones (http://www.ncbi.nlm.nih.gov/m/pubmed/24500371/?i=5&from=egg%20consumption&filters=MetaAnalysis&sort=%5Brelevance%5D – the largest one).
    Of course of course, corelation does not equal causation, hovewer it can be a bit scary (well, maybe just for me). What should I think about that all and how to find the most relevant information?
    Hope to hear something constructive from you 😉 And I don’t declare any conflict of interests.
    Sorry, if it was sometimes hard to understand me

    1. Amsel, thanks for you kind comments and questions.If you run into my former research fellow, Dr. Tomasz Pasierski, in Warsaw, say hi for me.
      I don’t have the same reverence for meta-analyses as you have and I’m especially careful about drawing any conclusions from meta-analyses of observational studies. As you pointed out, association does not equal causation.
      We would need well done randomized studies to clearly associate egg consumption with cardiovascular risk.
      I think you can take comfort in a recent study showing no difference in coronary artery calcification in patients eating zero eggs versus those eating multiple eggs/ day.
      The authors discussed two recent meta-analyses that came to opposite conclusions

      “the majority of prospective cohort studies have found no association between egg consumption and risk of CHD.19-20 The latter finding was further supported by a recent meta-analysis of six studies between 1999-2011.4 However, another recent systematic meta-analysis found a dose-response relationship between egg consumption and both cardiovascular disease (CVD) and diabetes.5 In the analysis by Li et al5, twelve relevant papers were selected using coronary heart disease, ischemic heart disease, and congestive heart failure as CVD outcomes. Their findings of increased risk of CVD with increasing egg consumption contrasts with the majority of findings in recent literature,”

      I haven’t looked extensively at the data on egg consumption and cancer, that must be so weak that it hasn’t been promoted by the plant-based diet community.

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