It's true that whole eggs are high in cholesterol. It's also true that high blood levels of cholesterol increase your risk of developing heart disease. However, it's not the case that eating whole eggs increases your risk of developing heart disease.
This chicken-and-egg scenario has resulted in a lot of confusion over the years about what's healthy and what's not healthy about eating eggs. So, let's unscramble the scientific research behind the link between eggs and blood cholesterol and come to some rational advice about what to make tomorrow morning.
The history behind why eggs became linked to cholesterol.
To understand how breakfast became so complicated, it helps to remember what happened in the 1960s. Studies following the dietary habits of large populations that were published in the 1950s and 1960s suggested a link between cholesterol and heart disease. High blood cholesterol, after all, can lead to fatty deposits on artery walls that can harden and break off, forming clots that can cause heart attacks and strokes.
Despite follow-up studies that did not find a link between dietary cholesterol intake and blood cholesterol, in 1968, the American Heart Association advised people to reduce their consumption of cholesterol to 300 milligrams a day, a little more than you get in the yolk of an egg, and eat no more than three whole eggs a week. Suddenly dietary cholesterol (and eggs, shrimp, lobster, and other high cholesterol foods) became public enemy #1. Food marketers started touting "cholesterol-free" on their packages. Egg consumption in the United States plummeted. And that was unfortunate because eggs are a very inexpensive source of protein and many other healthy nutrients like vitamins A, D, and B12.
Recent data suggests that egg consumption does not affect serum cholesterol.
After reviewing more recent scientific data, in 2015 the U.S. Dietary Guidelines Advisory Committee, a federal group that provides science-based advice for the Dietary Guidelines, changed its tune. The group announced that extensive research did not show evidence of dietary cholesterol's role in the development of cardiovascular disease. One piece of research the group looked at was a 1999 study that showed no increase in heart disease even among healthy people who ate one egg every day, a total of seven a week.
As a result, the 2015-2020 Dietary Guidelines for Americans removed the recommendation to restrict dietary cholesterol to 300 milligrams per day.
Subsequent research continued to support this updated guidance. A 2018 study published in The American Journal of Clinical Nutrition involved people with prediabetes and type 2 diabetes, people who are typically considered to be at increased risk of heart disease. The researchers found that participants who ate at least 12 eggs a week for three months while following a healthy weight-loss diet, did not increase cardiovascular risk factors.
So, can you eat eggs if you have high cholesterol?
First, a word of caution: before making any changes to your diet—whether that's removing or eating more eggs—you should always consult your healthcare professional. Every person's health status is different and what works for one person may not always work for you.
Generally, if you don't have heart disease or its precursors—high LDL cholesterol, high blood pressure, type 2 diabetes—and you eat a healthy diet full of fruits and vegetables and whole grains and low in saturated fats and other sources of cholesterol, research suggests that eggs will not have an effect on blood cholesterol.
But don't go crazy eating dozens of them every week as some protein-heavy diets recommend. Health experts still advise keeping dietary cholesterol to a minimum. Why? Because our Standard American Diet is too high in saturated fat, and saturated fat has a greater effect on raising LDL "bad" cholesterol than dietary cholesterol (what you get from eggs and shrimp, etc.) does. In other words, eating high levels of saturated fat plus a few eggs can lead to high levels of serum cholesterol.
If you already have cardiovascular disease or are headed in that direction, talk to your doctor about your diet about whether you should be eating egg yolks (the whites do not contain cholesterol).
How to cook eggs and be mindful of cholesterol levels.
If you're a healthy person, you have the blessing of the American Heart Association to eat eggs in moderation, not abandon them. In a 2020 issue of the medical journal Circulation, the AHA recommended that most healthy people can eat one egg per day or fewer if you have high cholesterol and diabetes or are at risk for heart failure.
If you enjoy eggs, and you don't have heart concerns, cook them in monounsaturated fat like avocado oil or olive oil that are low in saturated fat rather than butter. Saturated fats have been linked to increasing levels of LDL, the so-called "bad" cholesterol. In a small 2021 study researchers added 1,000 calories worth of either saturated fats, unsaturated fats, or simple sugars to participants' diets for three weeks and found that only the group of people overfed with saturated fats experienced a dangerous aggregation of LDL particles.
To keep saturated fat to a minimum at breakfast, you'll want to avoid adding cheese to your omelets or layering a slice of cheese on your egg sandwiches. Skip out on the bacon and sausage and instead consider additional protein sources like sliced ham, Greek yogurt, or nuts.
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