The Truth About Eggs and Dietary Cholesterol

A study published in the Journal of the American Medical Association (JAMA) on March 19, 2019, made headlines with its finding that consuming two eggs a day was associated with a 27 percent increased risk of developing heart disease. This contradicted the 2015-2020 Dietary Guidelines for Americans, which states there is not strong enough evidence to suggest that foods high in dietary cholesterol impact cholesterol levels and increase risk of heart disease.

But this new research is not reason enough to remove eggs from your diet. It is an observational meta-analysis of pooled data from different studies that demonstrated associations between dietary cholesterol and heart disease. It was not a controlled experiment that can show cause and effect, and therefore cannot conclude that eggs or dietary cholesterol are harmful to your health. Furthermore, the study relied on self-reported food frequency questionnaires that asked study participants to record what they tended to eat over a period of 17 years. It is challenging for people to recall food patterns over that amount of time and compare them with health outcomes, a limitation that was noted by the study researchers.

Why Eggs Are Good for You

One egg contains about 6 grams of protein and 77 calories. It has the highest biological value of all proteins (second only to a mother’s milk), meaning it is readily absorbed by the body and contains all essential amino acids.

“Eggs are a unique diet component because they are so digestion friendly yet high in protein and low in calories, unlike most other protein sources,” says Dr. Orli R. Etingin, director of the Iris Cantor Women’s Health Center at Weill Cornell Medicine.

An egg’s yolk also contains significant amounts of vitamins A, B₂, B₅, B₁₂, D, E and choline—all essential nutrients for energy metabolism and cell function. Eggs also contain selenium, an antioxidant that helps protect cells from oxidative stress. The white of the egg is primarily composed of protein.

Eggs’ Dietary Cholesterol

Eggs do contain considerable amounts of dietary cholesterol at 212 milligrams per egg, also found in the yolk. And that is not necessarily a bad thing—we need cholesterol for proper cell function, digestion, and hormone production. In fact, the liver is designed to make cholesterol. When the body is healthy, it does a good job of regulating the right amount of cholesterol levels to function properly. This means that when we eat foods containing it, like eggs, the body ends up making less of its own cholesterol to achieve healthy levels.

However, too much of a good thing can cause health issues. At high levels, cholesterol can accumulate on artery walls and increase risk of stroke and heart attack. But high levels of cholesterol in the body are caused by a number of factors beyond eating dietary cholesterol. Actually, years of research have shown that eating a lot of sugar, saturated fat, and trans fat can have a greater impact on increasing cholesterol levels than eating the cholesterol that comes from eggs and other dietary sources.

The key to maintaining proper cholesterol levels is to limit processed foods and fatty animal products, and eat moderate amounts of dietary cholesterol. Research has shown that eating eggs in moderation, about one per day, has not been associated with increased risk of heart attack or stroke. Include them as part of a well-balanced diet with a variety of vegetables, fruits, whole grains, lean proteins, and nuts and seeds.

Marisa Silver is a Masters of Science candidate in Clinical Nutrition at New York University.

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