When I recommend to my patients that they should eat eggs and vegetables for breakfast rather than breakfast cereals (which have high sugar content and nasty gut inflaming gluten proteins) they often ask “well what about my cholesterol ?”. I tell them that eggs are a health food and that they do not need to worry about their cholesterol.
I first read about the man who ate 25 eggs per day for 15 years here.
He was 88 years old when some cholesterol fearing physicians studied his plasma lipids (HDL, LDL, triglycerides etc.) and other aspects of his health (blood pressure, weight, etc.) and discovered that he was very healthy at the ripe age of 88.
This article was published in 1991 and the authors concluded that this man was exceptional in lacking adverse health consequences from eating 25 fat and cholesterol laden eggs every day for 15 years. Since that time, many studies on the health effects of eggs have demonstrated that they are in fact a health food and do not increase cardiovascular risk. In fact they provide a nutrient dense assortment of important vitamins, minerals, fat, and protein. Perhaps most importantly they are very high in choline, an important nutrient which is not hard to come by. Eggs and liver provide an abundance of choline.
Choline is widely used in the human body for many important functions. These include:
- building block for an important neuro-transmitter called acetyl-choline (you cannot live without it)
- essential component of the phospholipids that form the outer membrane of all living cells
- chemical precursor to betaine which is essential to health, particularly for eyesight
- methyl metabolism (methylation is an essential physiologic chemical process in our body)
- protects against fatty liver disease
You can read more about the importance of choline here:
Regular egg consumption has been demonstrated to improve insulin sensitivity and cardiovascular risk profiles in healthy individuals and in individuals with metabolic syndrome as demonstrated here:
Daily egg consumption with modest carbohydrate restriction in that study resulted in:
- improved insulin sensitivity (good)
- reduction in oxidized LDL (very good, oxidized LDL is the major instigator for atherosclerosis)
- reduced triglycerides (high triglycerides are a marker for metabolic syndrome, precursor to diabetes, heart attack and stroke)
- reduction in other blood lipid markers for cardiovascular risk (apoE, apoC-III, large VLDL, total IDL, small LDL and medium LDL)
- increase in the size of HDL and LDL particles (reduction in cardiovascular risk)
They concluded that:
“Atherogenic dyslipidemia improved for all individuals”
In adults with metabolic syndrome (hypertension, insulin resistance, obesity, high triglycerides) three whole eggs per day with moderate carbohydrate restriction resulted in:
- reduced waist size
- reduced % body fat
- reduction in inflammation as measured by plasma tumor necrosis factor alpha and serum amyloid
The authors concluded that:
“on a moderate carbohydrate background diet, accompanied by weight loss, the inclusion of whole eggs improves inflammation to a greater extent than yolk-free egg substitute in those with MetS.”
In yet another study:
Daily intake of 3 whole eggs, as part of a CRD, increased both plasma and lipoprotein lutein and zeaxanthin. Egg yolk may represent an important food source to improve plasma carotenoid status in a population at high risk for cardiovascular disease and type 2 diabetes.
See for yourself:
In another study:
Consumption of 2 and 4 egg yolks/d for 5 wk increases macular pigment concentrations (lutein and zeazanthin) in older adults with low macular pigment taking cholesterol-lowering statins.
“Lutein and zeaxanthin may reduce the risk of dry, age-related macular degeneration because of their photo-oxidative role as macular pigment.”
Studies of the benefits of high-cholesterol egg consumption have been so convincing that even the American Heart Association has removed advice to avoid eggs.
“…there have been a number of epidemiological studies that did not support a relationship between cholesterol intake and cardiovascular disease. Further, a number of recent clinical trials that looked at the effects of long-term egg consumption (as a vehicle for dietary cholesterol) reported no negative impact on various indices of cardiovascular health and disease”
From an evolutionary medicine point of view, eggs and ample dietary cholesterol have been around a long time in the human diet.
“Paleoanthropologists suggest that dietary cholesterol has been in the human diet for millions of years (7–10). Sources included eggs, bone marrow, and organ meats. Stone Age intake of cholesterol is uncertain, but it may well have exceeded current dietary recommendations.
There are many important biological roles for cholesterol that span the spectrum from cell membrane structure to steroid hormone synthesis, bile acid synthesis, and others. The vital role of cholesterol in human metabolism and the well-established place of dietary cholesterol in the native human diet provide a robust theoretical challenge to the view that dietary cholesterol poses a threat to human health.
More important still are prospective, population-based studies that, when similarly scrupulous about variation in other dietary components, find no association between cholesterol intake in general, or egg intake in particular, and the risk of CVD (13).”
Here are more links to discover that eggs are a health food.
Endothelial function is the term used to describe how well the arteries can expand and contract to meet the needs of blood flow. It is considered an important tool for assessing cardiovascular risk and it is impaired in metabolic syndrome, diabetes and in patients with coronary artery disease. Compromise of endothelial function is part of the process of atherosclerosis and heart attacks.
“There is thus a case to be made that endothelial function is potentially a summative measure of overall cardiac risk status and at least a valuable addition to standard risk measures (45). The ever-expanding footprint of research in this area in the cardiology literature attests to its importance.”
Despite (or because of) their high fat and cholesterol content, eggs have not been found to have any negative effects on endothelial function.
So far since launching this blog a few weeks ago we have discovered that saturated fat and cholesterol containing foods are not the villains portrayed by the media, doctors and professional organizations that give us nutritional advice.
We have reviewed evidence that added sugar, sweetened beverages, refined carbohydrates (especially flour foods), trans-fats, and excessive polyunsaturated omega six fats from processed “vegetable oil” are the culprits with regards to obesity, diabetes, heart attack and stroke. These culprit components of the modern Western diet were definitely absent from the diets of our paleolithic ancestors. We have not evolved to tolerate them. These modern manufactured and processed “foods” represent an unhealthy deviation from our evolutionary past.
There is so much more to discuss. In the spirit of more work ahead during this 50th anniversary week of John F Kennedy’s assassination. I will close with a quote from JFK’s favorite poet and friend, Robert Frost.
“I have promises to keep, / And miles to go before I sleep, / And miles to go before I sleep.”
Bob Hansen MD