Unscrambling Eggs: Health Food ... or Bad Yolk?

By Liebman, Bonnie | Nutrition Action Healthletter, June 2015 | Go to article overview

Unscrambling Eggs: Health Food ... or Bad Yolk?


Liebman, Bonnie, Nutrition Action Healthletter


"Love to eat eggs? U.S. panel now says they're not a health risk," reported Reuters in February.

"Cholesterol in the diet: The long slide from public menace to no 'appreciable' effect," ran the headline in the Washington Post.

Both articles were referring to a report from a panel of scientists that the government will rely on this year as it revises its Dietary Guidelines for Americans. Did the report get it right? And should you avoid eggs--the food that supplies our biggest dose of cholesterol?

Cholesterol Confusion

"Cholesterol: And Now the Bad News," announced the March 1984 TIME magazine cover.

"Cholesterol is proved deadly, and our diet may never be the same," the magazine reported.

Oops. Not for the first (or last) time, the media mixed up the dangers of cholesterol in blood and cholesterol in foods.

The article was about a major study showing that reducing high blood cholesterol lowers the risk of heart disease. It wasn't about eggs. But since eggs contain more cholesterol than most other foods, eggs got more than their share of the blame, even though foods rich in saturated fat (like red meat, cheese, and butter) are bigger culprits.

"The saturated fat in foods has a greater effect on the average person's LDL, or bad, cholesterol levels than the cholesterol in foods," says Frank Sacks, professor of cardiovascular disease prevention at the Harvard School of Public Health, And the confusion hasn't disappeared.

This past February, when the Dietary Guidelines Advisory Committee issued its report, the New York Daily News mangled the distinction between foods that are high in cholesterol and foods that are high in saturated fat.

"It's ok to dig in to red meat," explained the newspaper. "Embracing red meat and eggs marks a shift from previous versions of the report, which used to cap cholesterol consumption at 300 milligrams a day--the amount in a stick of butter, a 10-ounce steak or two eggs."

In fact, the report urged Americans to eat less red meat. And it urged us to limit saturated fat. But the panel did scrap the previous 300-milligram daily cap on cholesterol in food.

Why?

The Evidence

"After reviewing scores of studies that showed no correlation between dietary cholesterol and serum cholesterol, or 'bad' cholesterol present in the blood, the committee determined that cholesterol was not 'a nutrient of concern for overconsumption,"' reported Reuters.

Really? If the panel reviewed scores of studies, it didn't say so.

The panel's only explanation was brief: "Available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum cholesterol, consistent with the conclusions of the AHA/ACC report." (1)

Only one problem: that's not consistent with the 2013 report from the American Heart Association and American College of Cardiology. That report concluded that there was "insufficient evidence" to know if eating less cholesterol would lower LDL cholesterol in blood. (2)

"No evidence doesn't mean the evidence is no," says Robert Eckel, a professor of medicine at the University of Colorado Denver who chaired the AHA/ACC panel.

"A three-to-four-egg omelet isn't something I'd ever recommend to a patient at risk for cardiovascular disease," adds Eckel, who says that he still uses only egg whites for his omelets.

For decades, experts have relied largely on studies in which people were fed or sent home with either eggs or cholesterol-free egg substitutes.

"When we looked at 17 of those high-quality studies, we showed that eating one egg a day raises LDL cholesterol by 4 points," says Martijn Katan, an expert on diet and cardiovascular disease and an emeritus professor at VU University Amsterdam in the Netherlands. (3) An earlier meta-analysis got virtually identical results. (4)

(To put that in perspective, you'd get the same rise in LDL from eating a daily tablespoon of butter--with 7 grams of saturated fat. …

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