Eggs, Cholesterol, and Conflicting Cardiovascular Evidence

Okay, so the next question that was also— there was a big interest in this question that was submitted by David. David says, I keep hearing more studies associating egg consumption with overall mortality despite the valuable nutrients they contain. Can you give a summary of where the research currently stands on egg consumption and health outcomes? Is there any safe number of eggs per week or type of egg that is deemed safe and not controversial? Thanks. Okay. So I did cover egg consumption and cardiovascular mortality, which is sort of the big concern with egg consumption. I covered that in Crowdcast number 25. I will go into it a little bit again. I'll say this, with respect to the number of eggs that are safe, you know, per week, per day, that's not controversial.

That has been sort of spelled out by the American Heart Association. And so they think that 2 eggs per day are safe, and not only safe, but reduce stroke risk. So I would say that 2 eggs per day is pretty non-controversial if the American Heart Association is currently saying that that is safe. There was a study that came out of Australia that found eating up to 12 eggs per week for a year did not increase cardiovascular risk factors in people with prediabetes and type 2 diabetes. In general, like, so there was a huge study that came out. This was, again, from the American Heart Association. It was a science advisory meta-analysis. And they found in general, egg intake was not significantly associated with cardiovascular disease risk.

With the stroke meta-analysis data they analyzed, in fact, the high egg consumption, so more than 7 eggs a week, was significantly associated with a significantly lower risk of stroke risk compared to a low intake of eggs, so 1 or less than 1 egg per week. And with coronary heart disease, there was no significant association observed between egg intake and coronary heart disease. However, among individuals with type 2 diabetes, there were 2 out of 3 studies that reported an association. So it seemed as though there was something going on between people that had type 2 diabetes, potentially had type 2 diabetes, and— were eating eggs. A meta-analysis of 17 different intervention trials reported an increase in total cholesterol. It was very minor.

So there was an increase by 11.2 mg/dL, an increase in LDL cholesterol 6.7 mg/dL, and an increase in HDL cholesterol of 3.2 mg/dL. Compared to the control group, and the intervention group included studies that basically I mean it was basically equivalent to consuming between three to seven eggs per week or about zero to two eggs per day. I would say that like generally again two eggs per day is what seems to be pretty safe and non-controversial. The ones— this one kind of study that made headlines, I think it was 2019 study, and, um, you know, it had found an increased risk in cardiovascular mortality with egg consumption.

But then when they started to do all this covariate and adjustment for different types of other lifestyle factors, again, a lot of those associations were no longer significant, you know. So when you start to look at, oh, people eating processed meat and also then eating eggs, then the association with cardiovascular-related mortality went away. Or, you know, when you started to take in other cholesterol components, the cardiovascular mortality went away. So I think that there, you know, again, some of the conflicting data does really come from the fact that like, okay, does this person have type 2 diabetes? What else are they eating? Are they eating a stack of pancakes with syrup? Along with their eggs.

You know, I think there's— there are important things to consider, um, when you're looking at a lot of these, these studies. And then looking at meta-analyses, and that's, and that's really important because like when you're looking at the meta-analyses, they're looking at many, many, many different studies compared to just one study that comes out, even if it's a big study. Uh, you have to look at the totality of evidence. And so You know, I do think that the totality of evidence is really important. Generally speaking, dietary cholesterol, it's not really— like the amount of dietary cholesterol that's actually converted into cholesterol, like it's so minuscule, it's almost just not even important. And that's really just an outdated sort of view of— you know, dietary cholesterol intake.

Like, that was like back in like the '80s, you know, '80s and '90s. And we've now learned that our body's making cholesterol. And in fact, saturated fat is a much more larger component to regulating our cholesterol levels than actual eating dietary cholesterol, which is relatively high in egg yolk. It could be, you know, up to like— 300 milligrams or something like that. It can be found in eggs. I will say this, if you're wanting to be on the safe side, again, 2 eggs per day is pretty non-controversial. And so I think that kind of answers an important part of David's question there, which is like, what amount of eggs per day is considered safe? And I would say 2, for sure, 2. When you start to go beyond that, then, okay, then we maybe start having to consider all these other factors. What else are you eating? Are you sedentary? Are you overweight? Do you have type 2 diabetes? There might be other things to consider that may, a big emphasis on may, influence cardiovascular disease risk. And I still think that it's a big may with that. So eggs are really great because it's an easy way to get protein with your breakfast, which is, I think, a really important thing to get with each meal after the Stuart Phillips podcast, particularly. I'm pretty convinced. And there's also a lot of lutein and choline and other things that are really beneficial in the egg yolk specifically. So I do think that eating 2 eggs is definitely safe. I honestly, you know, most of the time I actually eat 3. I personally am eating 3 eggs a day.

So, you know, obviously, I'm not feeling concerned over eating 3 eggs a day. And again, I think there's so many confounding factors when it comes to nutrition studies. And when you look at the actual intervention trials where they're actually controlling for things, it's not just a dietary recall, they're saying, okay, eat these many eggs, and they're eating them for that designated time, you actually start to see a reduction in, like, stroke disease risk, stroke risk, and stuff like that. So I find intervention trials a lot more compelling, and intervention trials seem to, by and large, be very positive for— with respect to the egg consumption data.

I also try to eat pasture-raised eggs because they're much higher in a lot of these like carotenoids like lutein and, um, it just— they're just, they're just better. I mean, you can tell the difference in the egg yolk when you— my favorite brand is Happy Eggs. Those Happy Eggs, they have really, really just orange and brilliant colored egg yolks compared to, you know, if you just get your, your standard like white egg that's non-pasture-raised. So, um, I do think that, uh, If you can. I mean, food is so expensive these days too, though, unfortunately. It's kind of hard to— you kind of have to choose your battles. I don't think that eating a non-organic egg is going to be terrible for you. So, you know, I think that's okay.