After being acquitted for causing high cholesterol and heart disease and even making it onto the nutrition guidelines as a safe food to eat, the latest study that has been piped out to every major news outlet is back to saying eggs increase the risk of heart disease.
Instead of writing a brand new post on eggs, I decided to update a prior one by including a critique of the latest study and some additional words of wisdom about eggs.
Scrutinizing the Egg and Similar Studies
Instead of picking apart this specific study on eggs in question, it's best to remind you about my prior content that highlights the intrinsic flaws of most studies on nutrition which is why you see recommendations regularly switch back and forth. Carbs are good…carbs are bad…carbs are good. Fat is bad…fat is good…fat is bad. Eggs are bad…eggs are good…eggs are bad. Do you detect a pattern? Please read the following:
The Latest Study Questioning Low Carb Diets: I know this post isn't an article about eggs, but explains clearly the flaws of nutrition studies and how you can better analyze these sensational headlines and not be swayed against common sense.
Dr.John Ioannidis: Dr.Ioannidis is a respected physician, researcher and statistician at Stanford University School of Medicine who has done compelling work showing that most of nutrition research is flawed due to lack of randomization and multiple other deficits like a reliance on recall from food questionnaires. Learn more about his work here.
After reviewing the above information, especially my post on low carb diets, you should have an adequate foundation to scrutinize the egg study from Northwestern University cited here. The findings were as follows:
Eating 300 mg of dietary cholesterol per day was associated with 17 percent higher risk of incident cardiovascular disease and 18 percent higher risk of all-cause deaths. The cholesterol was the driving factor independent of saturated fat consumption and other dietary fat.
Eating three to four eggs per week was associated with 6 percent higher risk of cardiovascular disease and 8 percent higher risk of any cause of death.
This was not a randomized control trial, it involved pooled data from 6 studies which already significantly reduces the reliability of the study, and it used the dreaded food frequency questionnaires which relies on participant recall of what and how much they ate, a highly inaccurate way to collect data.
However one unique flaw in this particular study is that they used only a single assessment of the diet and then projected risk 30 years later. That means if I asked you what you ate last week for breakfast and you answered that you had 3 eggs, 2 servings of oatmeal and 4 slices of toast for the entire week, then that would define your breakfast eating pattern for the next 30 years. I'm not alone in my criticism. Even Harvard criticizes this particular element of the study here.
So now you take that questionable study result and print a headline like the one below in the Wall Street Journal, and all of a sudden my inbox fills up with messages from concerned individuals asking if eggs are going to kill them.
As I've commented before, even the most distinguished publications cannot resist printing these types of headlines, even if they may doubt the quality of the study, because it is guaranteed to generate a ton of views, which in turn translates into revenue.
If you still feel uneasy about eating overeasy (eggs that is!) and are having a hard time dismissing this study, then read this study in the prestigious British Medical Journal that found no heart disease risk with egg consumption. I would still consider this study flawed as well for similar reasons as the prior one, but I'm just highlighting how conflicted researchers are on the question of eggs and opinions will continue to flip back and forth for many years to come as long as we continue using such erroneous methods to evaluate nutrition.
Are Eggs Completely Risk-Free?
I have never recommended unlimited egg consumption for all humans. There is some individual customization that needs to be considered and can be based on monitoring your cholesterol results over time.
Most of the patients I see in the clinic are insulin resistant, meaning they are intolerant to a specific amount of carbohydrates and this can manifest as some combination of excess belly fat, high triglycerides, low HDL (healthy cholesterol), high blood sugar, elevated blood pressure and more. In this case switching from a high carb breakfast consisting of even “healthy” cereal, oatmeal or multi-grain toast to eggs can help reduce and even reverse these insulin resistant parameters.
Considering insulin resistance is the top global cause for heart disease and the root cause of type 2 diabetes, making the above change to eggs can actually lower heart disease risk. Do keep in mind that some individuals do see their cholesterol, especially LDL cholesterol, increase significantly as they add more eggs into their diet.
The threshold point varies in each individual. I have patients eating 14+ egg yolks a week with absolutely perfect cholesterol results, while others see a surge in LDL if they eat more than 3 egg yolks a week. This is where your labs can help guide you.
A True Superfood
Assuming you are not “egg-sensitive” with major surges in cholesterol every time you add a few yolks to your diet, then eggs should be fine as a nutritious part of your diet. They're an excellent protein source with all 9 essential amino acids and less than 0.5 grams of carbs, making it ideal for weight loss and insulin resistance.
Eggs are also a great source of selenium (possible anti-cancer nutrient), choline (brain healthy B-vitamin), lutein and zeaxanthin (carotenoids for eye health), vitamin D, folate and more.
For my lacto-ovo vegetarian patients (eat dairy and eggs) who often lack protein and these essential micronutrients, eggs can help fill the gap.
What's Next to Your Eggs?
For people who are already eating eggs, I worry more about what they're eating their eggs with. Toast, bagels, waffles, a low-fat muffin, low quality processed breakfast meats, a glass of orange juice, etc. will damage overall health far more than the eggs.
Unfortunately many past nutrition studies which reported eggs to be risky did not account for the effects of these typical egg accompaniments.
We may call them the “side,” but when it comes to health risks these “sides” are actually the main dish. One study found that eating a two egg breakfast led to more weight loss than eating a bagel in the context of a controlled diet.
So if you're overeating unhealthy foods, don't think this blog permits you to liberally add eggs to a dangerous diet.
You earn the right to add eggs only after improving the overall quality of your diet, which includes eliminating sugar, cutting back excess carbohydrates, and eating more nutrient-dense natural foods.
Your Own Personal Egg Study
If you still have concerns about the effects of eggs on your health, start slow with a few eggs a week (with the yolk) and then get your cholesterol checked in a few months. You must keep all other aspects of your diet consistent to see the effects.
For example, if you happen to be eating more carbohydrates during your study or are more sedentary than usual, then your cholesterol may become abnormal from these habits rather than the eggs.
If you're going to put eggs on trial, make sure it's a fair trial. Remember, eggs, particularly the yolk, feeds the developing embryo and as a result is an ideal nutrient for the growth and maintenance of all vital organs and tissues.
Unless you've noticed significantly worsening cholesterol levels that result from eating eggs (unlikely) or have an allergy, sensitivity or intolerance to them, embrace those eggs as a core part of your eating plan.