Can you eat eggs if you have high cholesterol?
Eggs are a delicious and versatile kitchen staple that is the star of a variety of quick and easy meals. However, eggs also have a long history of being vilified as unhealthy because they are high in cholesterol.
As someone with high cholesterol, you may be wondering whether it is OK to include eggs in your diet.
According to the Centers for Disease Control and Prevention, 11.5% of U.S. adults over the age of 20 have elevated total cholesterol levels (240 mg/dl or higher). High cholesterol can lead to atherosclerosis or damage to arteries, which over time leads to heart disease and stroke. Diet and lifestyle play an important role in lowering one's risk of heart disease.
Eggs are a rich source of dietary cholesterol (one large egg contains about 207 milligrams of cholesterol, per the USDA), so they are often the focus of research on diet and blood cholesterol. According to a 2019 publication by the American Heart Association, on average, eggs make up 25% of the dietary cholesterol in the diets of U.S. adults.
Cholesterol aside, eggs offer a variety of essential nutrients. For example, in addition to providing 7 grams of protein each, eggs are also a good source of vitamin D, choline and lutein. Choline is an essential nutrient important for neonatal brain development, and lutein is an antioxidant important for eye health.
What's the Link Between Eggs and Cholesterol?
Cholesterol is made in the body as well as obtained through food. In fact, the majority of cholesterol is produced by your body (about 80%). Besides diet, genetics also play a significant role in a person's cholesterol levels. Cholesterol has many functions in the body, including hormone production and human tissue structure.
There are two different types of cholesterol, per the CDC. Low-density lipoprotein (LDL) is often called "bad" cholesterol because it can accumulate along artery walls and lead to a heart attack or stroke. High-density lipoprotein (HDL), or "good" cholesterol, transports cholesterol to the liver so it can be flushed from the body. Higher levels of LDL are associated with an increased risk of heart disease, while high levels of HDL are protective.
Population-based studies have not consistently found a strong association between egg intake and cholesterol levels. In clinically controlled studies, such as one published in 2018 in Nutrients, egg intake had only a minimal impact on cholesterol for the majority of people (about two-thirds of the population). For those more sensitive to dietary cholesterol, higher intakes of eggs increased both their LDL and HDL. When the ratio of LDL and HDL was maintained, there was no significant increase in heart disease.
Furthermore, according to the AHA, excessive consumption of saturated fats may have a stronger association with increased LDL cholesterol levels.
Can Eggs Increase Your Cholesterol Levels?
Yes, egg intake can have a minimal impact on your cholesterol levels. However, eggs alone will likely not significantly increase the risk of heart disease down the road. "It's time to give eggs a break (pun intended)," says Jess DeGore, RD, CDCES.
"While eggs are high in cholesterol, more recent research shows they may not increase cholesterol levels as much as originally thought. It's actually saturated fat that is in butter, red meat and certain oils that is thought to be more of the culprit in increasing cholesterol. However, everyone is an individual, and those with certain risk factors such as diabetes or heart disease may be more sensitive to dietary cholesterol's effects," says Melissa Mitri, M.S., RD, of Melissa Mitri Nutrition.
Rather than focus on just one food, experts agree that you should focus on an overall healthy diet pattern for cholesterol management.
Are Egg Whites Better for Cholesterol?
Most of the cholesterol in an egg is contained in the yolk. Before better understanding the relationship between dietary and blood cholesterol, experts often recommended eating egg whites instead of whole eggs to avoid most of the cholesterol.
Besides cholesterol, the yolk is also packed with a lot of nutrients like fat-soluble vitamins, choline and lutein. Eating whole eggs means getting all the nutritional benefits out of the egg. However, Mitri suggests that if you are concerned about your cholesterol intake, you could stick to egg whites. It's important to note that your health care provider or registered dietitian can further help you identify what's best for you.
How Many Eggs Can You Eat per Day?
Previous versions of the Dietary Guidelines for Americans have recommended that adults consume less than 300 mg of cholesterol per day; however, this recommendation was removed from the latest guidelines. Rather than focus on a specific cholesterol limit, the 2020-2025 Dietary Guidelines for Americans emphasize adopting a healthy eating pattern and limiting dietary cholesterol consumption without compromising the nutritional adequacy of the diet.
Individuals with normal cholesterol levels can safely include one whole egg in their diet daily as part of a heart-healthy diet, per the AHA. However, more research is needed to determine a specific limit for eggs for those with high cholesterol and other chronic conditions like diabetes.