Eggs and Cholesterol: What You Need to Know

Eggs are known to provide high-quality protein and several important nutrients that help keep your body healthy.  However, many people are concerned about the cholesterol found in egg yolks and how it might impact health.  Are egg yolks okay for children?  Can older people eat egg yolks?  What about people at risk for heart disease?

The good news is that the recommendations are simple: eggs (including the yolk) are important to healthy diet patterns across the lifespan [1].  The catch?  It is important to explore healthier foods to eat with eggs, such as fruits and vegetables, which most people need more of!

For the average American (2+ years) eggs contribute [2]:

• 26% of the docosahexaenoic acid (DHA)
• 21% of the choline
• 11% of the vitamin D
• 9% of the lutein + zeaxanthin (carotenoids)
• 8% of the selenium
• 7% of the vitamin A
• 6% of the riboflavin (vitamin B₂)
• 5% of the vitamin B₁₂
• 4% of the protein

Eggs contribute all of these nutrients to the American diet, for only 2% of the calories!  Additionally, on average, eggs contribute 33% of the ~293 mg of cholesterol Americans consume daily [2, 3].  However, for most healthy people, the cholesterol from foods like eggs is not related to blood cholesterol levels [4].

Cholesterol is a waxy, fat-like substance that your body needs to function properly [5].  It is an important component of cells, essential for the production of hormones [6], and important for digesting foods [7].  Most cholesterol is produced within the body and a smaller portion of cholesterol comes from foods of animal origin in your diet [4].

Individual responses to cholesterol in foods vary widely, but even in people who “respond” to dietary cholesterol, there is an increase in “good” blood cholesterol along with an increase in “bad” blood cholesterol.  The resulting proportion of good and bad cholesterol does not change, which is one important measure for evaluating health [8].

Overall, eggs are recommended across the lifespan because of their nutritional benefits and links to positive health outcomes [9].  Eggs are recommended for babies (when they are ready to start solid food) in order to meet nutrient needs and reduce the risk of allergy to eggs [1].  Eggs are recommended for aging people because of the high-quality protein and several nutrients important for health [10].  There is also growing evidence that eggs can be beneficial for people at risk for heart disease when part of a healthy diet.

A healthy diet 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 foods such as seafood and nuts) [1].  Eggs should be prepared with no or little added sugars, saturated fat, and sodium [1].  For ideas on how to prepare eggs as part of a healthy diet, please visit the ENC website!

1. 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.
2. American Egg Board’s Egg Nutrition Center. What We Eat in America. NHANES 2015-2018. 2022; Available from: http://www.cdc.gov/nchs/nhanes.htm; https://data.nal.usda.gov/dataset/what-we-eat-america-wweia-database; http://www.incredibleegg.org/wp-content/uploads/2022/12/Nutrient-Contribution-of-Eggs-to-the-American-Diet_21-November-2022.pdf.
3. Xu, Z., S.T. McClure, and L.J. Appel, Dietary Cholesterol Intake and Sources among U.S Adults: Results from National Health and Nutrition Examination Surveys (NHANES), 2001-2014. Nutrients, 2018. 10(6): p. 771.
4. Blesso, C.N. and M.L. Fernandez, Dietary Cholesterol, Serum Lipids, and Heart Disease: Are Eggs Working for or Against You? Nutrients, 2018. 10(4).
5. National Heart Lung and Blood Institute. Available from: https://www.nhlbi.nih.gov/health-topics/blood-cholesterol.
6. The National Academies of Sciences Engineering Medicine. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, Amino Acids. 2005; Available from: https://www.nap.edu/catalog/10490/dietary-reference-intakes-for-energy-carbohydrate-fiber-fat-fatty-acids-cholesterol-protein-and-amino-acids.
7. Centers for Disease Control and Prevention. About Cholesterol. 2021; Available from: https://www.cdc.gov/cholesterol/about.htm.
8. Fernandez, M.L. and D. Webb, The LDL to HDL cholesterol ratio as a valuable tool to evaluate coronary heart disease risk. J Am Coll Nutr, 2008. 27(1): p. 1-5.
9. Fernandez, M.L., The Role of Eggs in Healthy Diets. Supplement to the Journal of Family Practice, 2022. 71(6): p. S71-S75.
10. Carson, J.A.S., et al., Dietary Cholesterol and Cardiovascular Risk: A Science Advisory From the American Heart Association. Circulation, 2019: p. Cir0000000000000743.