The American Heart Association (AHA) Science Advisory: Dietary Cholesterol and Cardiovascular Risk indicates that “healthy individuals can include up to a whole egg or equivalent daily” as part of a heart-healthy dietary pattern. “For older normocholesterolemic patients, given the nutritional benefits and convenience of eggs, consumption of up to 2 eggs per day is acceptable within the context of a heart-healthy dietary pattern1.” The AHA expresses caution, however, around the consumption of dietary cholesterol for patients with dyslipidemia, suggesting a gap in research for a subgroup of the population at risk for cardiovascular disease. Of importance, a growing body of evidence indicates that eating eggs as part of a healthy diet does not negatively impact blood cholesterol levels and may benefit health, even in people at risk for cardiovascular disease2-5.
A recent randomized controlled crossover intervention recruited 30 men and women aged 35-70 with metabolic syndrome (MetS) to follow a plant-based healthy diet (excluding meat, poultry, fish, and seafood) for 13 weeks. Participants were randomized to eat spinach with two eggs for breakfast or spinach with egg substitute and then crossed over to the opposite intervention. The data showed lower body weight and higher HDL cholesterol after the egg intervention compared to the substitute. No differences were observed in plasma LDL cholesterol, triglycerides, glucose, insulin, or blood pressure. Blood levels of choline were higher after the egg intervention compared to the substitute; lutein increased during both interventions, and zeaxanthin increased only after the egg intervention. The authors conclude, “This study demonstrates that consuming whole eggs in combination with a plant-based diet offers a healthier dietary pattern when compared to egg substitutes by favorably affecting plasma lipids and antioxidant carotenoids, as well as choline, thereby reducing disease risk3.”
Importantly, this is also consistent with other studies that have similarly found a beneficial impact of including eggs in the diet:
- Thirty-five adults at risk for type 2 diabetes mellitus included two eggs daily in the context of a plant-based (vegan) diet for six weeks. Eating eggs improved diet quality without adversely impacting cardiometabolic risk factors when compared to egg exclusion4,6.
- Twenty overweight, postmenopausal women added two whole eggs to the diet for four weeks. This study found improvement in HDL function (cholesterol efflux capacity) with no other changes in lipid biomarkers when compared to eating egg whites only5.
While more research is always needed, these recent intervention studies support the value of eggs as part of healthy dietary patterns for everyone, regardless of cardiovascular disease risk status. For heart-healthy recipe ideas, please see our collection of recipes here.
- Carson, J.A.S., et al., Dietary Cholesterol and Cardiovascular Risk: A Science Advisory From the American Heart Association. Circulation, 2019: p. Cir0000000000000743.
- DiBella, M., et al., Choline Intake as Supplement or as a Component of Eggs Increases Plasma Choline and Reduces Interleukin-6 without Modifying Plasma Cholesterol in Participants with Metabolic Syndrome. Nutrients, 2020. 12(10).
- Thomas, M.S., et al., Eggs Improve Plasma Biomarkers in Patients with Metabolic Syndrome Following a Plant-Based Diet-A Randomized Crossover Study. Nutrients, 2022. 14(10).
- Njike, V.Y., et al., Egg Consumption in the Context of Plant-Based Diets and Diet Quality in Adults at Risk for Type 2 Diabetes: A Randomized Single Blind Cross-over Controlled Trial. Journal of the American Nutrition Association, 2022: p. 1-10.
- Sawrey-Kubicek, L., et al., Whole egg consumption compared with yolk-free egg increases the cholesterol efflux capacity of high-density lipoproteins in overweight, postmenopausal women. Am J Clin Nutr, 2019.
- Njike, V.Y., et al., Egg Consumption in the Context of Plant-Based Diets and Cardiometabolic Risk Factors in Adults at Risk of Type 2 Diabetes. The Journal of Nutrition, 2021. 151(12): p. 3651-3660.