Can eating too many eggs lead to heart disease?

The Feinberg School of Medicine’s research focused on dietary cholesterol intake and its association with cardiovascular disease, specifically highlighting eggs as a major source in traditional diets.
 
It found eating 300 mg of dietary cholesterol per day was associated with a 17% higher risk of incident cardiovascular disease and 18% increased risk of death.
 
With one large egg containing 186 mg of dietary cholesterol in the yolk alone, the researchers were able to link eating 3–4 eggs per week with a 6% higher risk of cardiovascular disease and 8% higher risk of death.
 
Co-corresponding study author Associate Professor Norrina Allen said the research confirmed people who eat lower amounts of cholesterol have a reduced risk of heart disease.
 
‘Our study showed if two people had the exact same diet and the only difference in diet was eggs, then you could directly measure the effect of the egg consumption on heart disease,’ Professor Allen said.
 
‘We found cholesterol, regardless of the source, was associated with an increased risk of heart disease.’
 
The study analysed data collected from nearly 30,000 people, in some cases with 31 years of follow up, during which 5400 cardiovascular events and 6132 all-cause deaths were diagnosed. The researchers also stated exercise, overall diet quality and the amount and type of fat in the diet did not change the association between dietary cholesterol and the risk of cardiovascular disease and death.
 
As recently as 2015, US dietary guidelines recommended eating less than 300 mg of cholesterol per day, but the most recent version omitted a daily limit for dietary cholesterol.
 
Likewise, Australian Dietary Guidelines do not set a limit on dietary cholesterol intake, which Chief Medical Officer Professor Garry Jennings told newsGP is due to the fact saturated fat and trans fat have stronger relationships with low-density lipoprotein (LDL) cholesterol and heart disease risk than dietary cholesterol does.
 
‘The Heart Foundation’s current guidelines recommend healthy eating is more than focusing on one type of food, such as eggs, and one type of nutrient, like cholesterol,’ Professor Jennings said.
 
‘Eggs can be included in a heart healthy eating pattern, but the big picture matters. Accompanying eggs with vegetables, such as spinach and mushrooms, and wholegrain bread will be a healthier choice than processed meat – bacon – and white bread.’
 
As such, Professor Jennings cast doubt on the need for people to cut eggs or cholesterol out of their diets based on the findings of the Feinberg School of Medicine study.
 
‘As an observational study, this research does not establish cause and effect, [and therefore] does not establish that eggs or cholesterol cause heart disease,’ he said. ‘The study demonstrates there is a link between people who eat eggs and developing cardiovascular disease.
 
‘This link may be explained by other factors, including that people who eat more eggs may also be eating more processed meat or may have other unhealthy behaviours, such as low vegetable intake or low physical activity, which also influence cardiovascular risk.
 
‘A prudent amount would be 2–3 egg-based meals per week to ensure that a variety of other foods are regularly being included in a healthy eating pattern, which includes vegetables, legumes, fish, wholegrains and nuts.’

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