Cholesterol: How many eggs can I eat a week, doctor?

What’s wrong with eggs?

This is a question I am often asked – but why?  Eggs are an excellent source of important nutrients, including high quality protein and essential fatty acids and contain plenty of vitamins and trace minerals.
But they also contain cholesterol. For many years now there has been a lot of concern over the rising incidence of heart disease and its heavy costs, so the medical establishment is trying to reduce the risk.  A study into women’s health followed a group of women for an average of eight years and found a relationship between levels of LDL (Low Density Lipoprotein or ‘Bad Cholesterol’) and heart disease, other studies also concluded that lowering cholesterol reduced the risk of heart attack and strokes.
So, in the belief that diet is an important factor for blood cholesterol levels, in order to reduce the risk of heart disease, the American Heart Association (AHA)  recommended that everyone  eat less than 300 mg of cholesterol per day.  And a large egg may contain up to 210 mg, so we should eat fewer of them.
But are these assumptions based on scientific evidence?  This is now being questioned.

Cholesterol has been part of the human diet for millions of years.  Sources include eggs, bone marrow and offal – just what our ancestors must have been eating.  We don’t know how much cholesterol was consumed in the Stone Age, but it must have been more than the current recommendations.
Cholesterol plays a vital role in human metabolism, forming part of the cellular membranes, synthesising steroid hormones, vitamin D, bile – need I go on?
These facts challenge the view that dietary cholesterol presents a threat to human health.   In fact it would be logical to think that we are well adapted to what we find in our native diet. An interesting debate has opened up about what are adequate amounts to recommend, and recent  studies show that:

  • There is no link between eating one egg a day and the risk of heart disease.  There is actually a positive correlation between heart disease and egg consumption in diabetic patients, and a reduction in the risk of heart attacks.
  • In approximately 75% of the population no correlation could be seen between egg consumption and blood cholesterol levels.
  • In the 25% of the population that did respond to an increase of cholesterol in the diet, this could be seen as much in HDL as LDL cholesterol (the same in children as adults and the elderly). So there was no increased risk of blood clots.
  • Small LDL particles are more dangerous than large ones, as they can penetrate the blood barrier and lead to hardening of the arteries. Egg consumption leads to an increase in the ratio of large sized particles of both LDL and HDL lipoproteins compared with small ones.

 Cholesterol and Eggs

So, if we accept this information,  we can reach the conclusion that for a healthy person to eat up to one egg a day should, in principle, pose no risk to our health and we can benefit from many vitamins and minerals that are vital to a healthy metabolism.

But we can’t say which came first, the egg or the chicken!

Nestor_compartir_jpg_EN_b

 References

  1. Ballesteros MN, Cabrera RM, Saucedo MS, Fernandez ML. Dietary cho- lesterol does not increase biomarkers for chronic disease in a pediatric population from northern Mexico. Am J Clin Nutr. 2004;80:855–61.
  2. Baigent C, Blackwell L, Emberson J, Holland LE, Reith C, Bhala N, et al. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet 2010;376:1670-81.
  3. Briel M, Ferreira-Gonzalez I, You JJ, Karanicolas PJ, Akl EA, Wu P, et al. Association between change in high density lipoprotein cholesterol and cardiovascular disease morbidity and mortality: systematic review and meta-regression analysis. BMJ 2009;338:b92.
  4. Cholesterol Treatment Trialists’ (CTT) Collaborators. The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. Lancet 2012;380:581-90.
  5. Eaton SB. Evolutionary health promotion. Prev Med. 2002;34:109–18. 8.
  6. Eaton SB, Eaton III SB, Konner MJ. Paleolithic nutrition revisited: a twelve-year retrospective on its nature and implications. Eur J ClinNutr. 1997;51:207–16.
  7. Fernandez ML. Dietary cholesterol provided by eggs and plasma lipoproteins in healthy populations. Curr. Opin Med Nutr Met Care. 2006;9:8–12.
  8. Greene CM, Zern TL, Wood R, Shrestha S, Aggarwal D, Sharman M, Volek JS, Fernandez ML. Maintenance of the LDL cholesterol: HDL cholesterol ratio in an elderly population given a dietary cholesterol challenge. J Nutr. 2005;135:2793–8.
  9. Herron KL, Lofgren IE, Sharma M, Volek JS, Fernandez ML. A high in- take of dietary cholesterol does not result in more atherogenic LDL particles in men and women independent of response classification. Metabolism. 2004;53:823–30.
  10. Kanter MM, Kris-Etherton PM, Fernandez ML, Vickers KC, Katz DL. Exploring the factors that affect blood cholesterol and heart disease risk: is dietary cholesterol as bad for you as history leads us to believe? Adv Nutr 2012;3:711-7.
  11. Koba S, Hirano T, Ito Y, Tsunoda F, Yokota Y, Ban Y, Iso Y, Suzuki H, Ka- tagiri T. Significance of small dense low-density lipoprotein-cholesterol concentrations in relation to the severity of coronary heart diseases. Atherosclerosis. 2006; 1889:206–14.
  12. Lichtenstein AH, Appel LJ, Brands M, Carnethon M, Daniels S, Franch HA, et al. Summary of American Heart Association Diet and Lifestyle Recommendations revision 2006. Arterioscler Thromb Vasc Biol 2006;26:2186-91.
  13. Lichtenstein AH, Appel LJ, Brands M, Carnethon M, Daniels S, Franch HA, et al. Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee. Circulation 2006;114:82-96.
  14. Lev-Ran A. Human obesity: an evolutionary approach to understand-ing our bulging waistline. Diabetes Metab Res Rev. 2001;17:347–62. 10. Konner M, Eaton SB. Paleolithic nutrition: twenty-five years later. Nutr Clin Pract. 2010;25:594–602.
  15. Mutungi G, Waters D, Ratliff J, Puglisi M, Clark RM, Fernandez ML. Eggs distinctly modulate plasma carotenoids and lipoprotein subclasses in adult men following a carbohydrate-restricted diet. J Nutr Biochem. 2010;21:261–7.
  16. Ridker PM, Rifai N, Rose L, Buring JE, Cook NR. Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events. N Engl J Med 2002;347:1557-65.
  17. Rong Y, Chen L, Zhu T, Song Y, Yu M, Shan Z, Sands A, Hu FB, Liu L. Egg consumption and risk of coronary heart disease and stroke: dose-response meta-analysis of prospectivecohort studies. BMJ. 2013 Jan 7;346.
  18. Sniderman AD, Williams K, Contois JH, Monroe HM, McQueen MJ, de Graaf J, et al. A meta-analysis of low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and apolipoprotein B as markers of cardiovascular risk. Circ Cardiovasc Qual Outcomes 2011;4:337-45.

Leave a Reply

Your email address will not be published. Required fields are marked *