Can Eggs Be Part Of A Heart-Healthy Diet?

Guest blog by Jen Houchins, PhD, RD, Director of Nutrition Research, American Egg Board’s Egg Nutrition Center

The American Heart Association (AHA) recommends healthy individuals can include up to a whole egg daily in healthy diet patterns, and up to two egg per day is recommended for aging adults.  However, the AHA placed caution on eating foods higher in cholesterol for people with abnormal blood cholesterol, “…particularly those with diabetes mellitus or at risk for heart failure… [1].”  While this is an area of research that the American Egg Board continues to explore, a growing body of evidence indicates that nutrient-rich eggs can also be enjoyed as part of healthy dietary patterns for those at risk of cardiovascular disease.

In 2015, the Dietary Guidelines Advisory Committee removed the recommendation to limit dietary cholesterol “…because available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum cholesterol…Cholesterol is not a nutrient of concern for overconsumption [2].”  Similarly, in 2019, the AHA concluded that healthy dietary patterns are more likely to improve diet quality and support heart health, as opposed to cholesterol limits [1].  The most recent Dietary Guidelines for Americans also emphasizes healthy dietary patterns and does not include a specific limit on dietary cholesterol [3].

Recent studies have explored how eating eggs can impact blood cholesterol and health outcomes in people who are at risk for heart disease. These studies show a potential benefit of eggs as part of healthy diets for individuals with cardiovascular risk factors.

• Adding three eggs per day to the diet of people who have metabolic syndrome did not increase LDL (bad) cholesterol. “…whole eggs could be considered a healthful food choice for people with metabolic syndrome [4].”
• Eating two eggs daily improved the function of HDL (good) cholesterol and did not impact total cholesterol, HDL cholesterol, or LDL cholesterol levels in postmenopausal women who were overweight [5].
• Consumption of cholesterol from eggs is linked to lower mortality among people with high blood pressure, while consumption of cholesterol from other foods is linked to higher mortality. However, total cholesterol is not related to mortality among a sample of people with high blood pressure who live in China [6].
• Eating two eggs daily, as part of a plant-based diet, did not adversely affect markers of heart health in adults at risk for type 2 diabetes. In fact, eating eggs improved self-reported intake of selenium and choline [7].

What does this all mean for eating eggs if you are at risk for heart disease?  As stated by AHA, “…guidance focused on dietary patterns is more likely to improve diet quality and to promote cardiovascular health [1].”  In other words, focus on healthy eating which includes a variety of vegetables, fruits (especially whole fruit), whole grains, dairy foods, protein foods (including lean meats, poultry, eggs, seafood, beans, peas, lentils, nuts, seeds, and soy products), and oils (including oils in food such as seafood and nuts) [3].

The Egg Nutrition Center will continue to evaluate the impact of egg consumption on health outcomes in different populations, including those who are at risk for heart disease.  The current body of evidence indicates eggs are an important part of healthy diet patterns across the lifespan [8].

For ideas of how to incorporate eggs as part of heart-healthy meals, visit the Egg Nutrition Center or the NC Egg website.

References:

1. Carson, J.A.S., et al., Dietary Cholesterol and Cardiovascular Risk: A Science Advisory From the American Heart Association. Circulation, 2019: p. Cir0000000000000743.
2. Dietary Guidelines Advisory Committee. Scientific Report of the 2015 Dietary Guidelines Advisory Committee: Advisory Report to the Secretary of Health and Human Services and the Secretary of Agriculture,. 2015; Available from: https://health.gov/dietaryguidelines/2015-scientific-report/PDFs/Scientific-Report-of-the-2015-Dietary-Guidelines-Advisory-Committee.pdf.
3. U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2020-2025 Dietary Guidelines for Americans. 2020; Available from: https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf.
4. DiBella, M., et al., Choline Intake as Supplement or as a Component of Eggs Increases Plasma Choline and Reduces Interleukin-6 without Modifying Plasma Cholesterol in Participants with Metabolic Syndrome. Nutrients, 2020. 12(10).
5. Sawrey-Kubicek, L., et al., Whole egg consumption compared with yolk-free egg increases the cholesterol efflux capacity of high-density lipoproteins in overweight, postmenopausal women. Am J Clin Nutr, 2019.
6. Wu, F., et al., Egg and Dietary Cholesterol Consumption and Mortality Among Hypertensive Patients: Results From a Population-Based Nationwide Study. Frontiers in Nutrition, 2021. 8(830).
7. Njike, V.Y., et al., Egg Consumption in the Context of Plant-Based Diets and Cardiometabolic Risk Factors in Adults at Risk of Type 2 Diabetes. The Journal of Nutrition, 2021. 151(12): p. 3651-3660.
8. Papanikolaou, Y. and V.L. Fulgoni, 3rd, Patterns of Egg Consumption Can Help Contribute to Nutrient Recommendations and Are Associated with Diet Quality and Shortfall Nutrient Intakes. Nutrients, 2021. 13(11).