Eating Two Eggs, as Part of a Low-Saturated-Fat Diet, Doesn’t Raise Bad Cholesterol

Key Takeaways:

• Two eggs a day can fit into a heart-healthy diet. New research shows that when eaten as part of a diet low in saturated fat, two eggs daily did not raise LDL (“bad”) cholesterol—and actually lowered it compared to a typical Western diet.
• Saturated fat—not dietary cholesterol—is the main driver of high LDL cholesterol. This study reinforces that it’s more important to focus on reducing saturated fat, not dietary cholesterol.
• Eggs are a nutrient-rich, healthy choice. As a healthy, natural source of essential vitamins and minerals, eggs can be part of a balanced eating pattern that supports cardiovascular health.

In 2015, the recommended limit for dietary cholesterol was removed. The Dietary Guidelines Advisory Committee made this change [1] to align with the totality of scientific evidence [2, 3], the new focus on nutrient-dense foods as part of healthy dietary patterns [4], and evidence that mean cholesterol intake was roughly 270 mg/day [4].

Dietary cholesterol is found in animal-source foods, many of which are also higher in saturated fat. But eggs and shellfish are the exception – they contain cholesterol but are low in saturated fat [5].  For this reason, eggs provide a unique opportunity to study the specific effect of dietary cholesterol, independent of saturated fat, on cardiovascular disease (CVD) risk. In fact, the impact of dietary cholesterol in the absence of high dietary saturated fat on LDL cholesterol (LDL-c) levels was identified as an important research gap by the 2020 Dietary Guidelines Advisory Committee [5].

A new study published in the American Journal of Clinical Nutrition offers new insights to help close this gap in the science. This new study evaluated the independent effects of dietary cholesterol and saturated fat on LDL-c concentrations in a randomized, controlled, cross-over study in 61 healthy Australian adults with a baseline LDL-c of <135 mg/dL , each assigned to follow three different dietary patterns in random order [6]:

• Control diet: typical Western diet that is high in saturated fat and dietary cholesterol (maximum of 1 egg/week)
• Egg diet: high in cholesterol (2 eggs/day), low in saturated fat
• Egg-free diet: low in cholesterol (no eggs), high in saturated fat

The key takeaway from this study: Eating two eggs a day as part of a low in saturated fat diet actually led to lower total and LDL cholesterol levels compared to the typical Western diet.

Further analysis of these data indicates a significant relationship between saturated fat intake and LDL-c. Additionally, Apolipoprotein B levels – another strong risk factor for CVD – were significantly lower with the Egg diet compared to the control.

These data align with the vast majority of the scientific literature that indicates egg consumption is not associated with CVD risk [7-14] and confirms that the primary dietary driver of blood LDL-c is saturated fat, not dietary cholesterol. Importantly, eggs are recommended as part of an overall healthy diet [15, 16]; if cholesterol sources likes eggs are consumed with foods higher in saturated fat, there may be increases in blood cholesterol [17]. Check out ENC’s heart-check certified recipes and heart health handbook for healthy meal inspiration and additional information.