Cohen Medical Associates is a family medical center and research center located in Delray Beach, FL.
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Eggs: The Incredible, Edible Enigma

Do eggs dangerously raise your cholesterol or are they the perfect little package of protein? A new study has raised many questions among our patients because it appears to have upended years of research that seemed to show a benefit to regular egg consumption. Our family practice doctors in Delray Beach want to help you sort out the confusion.

Bad to good

The controversy surrounding eggs has existed since the 19th century, when it was discovered that cholesterol in the blood resulted in a build-up of plaque on artery walls, leading to cardiovascular disease (CVD). Further studies in the 1940s appeared to link dietary cholesterol to blood cholesterol. It seemed to make sense: If you eat dietary cholesterol, it will show up in your blood. The scientific community promptly began issuing warnings against such high-cholesterol foods as fats, meat, and dairy products.

In 1961, the American Heart Association (AHA) took aim specifically at eggs, which had been a staple of the American diet, warning that frequent egg consumption raised blood cholesterol because of their high cholesterol content. But in 2014, the organization revised its recommendation to say that up to one whole egg per day could be part of a healthy eating plan, as long as people lowered their consumption of other foods higher in cholesterol, such as meat, poultry, and dairy foods.

This was because further research showed that dietary consumption of cholesterol contributes to only a small amount of the cholesterol found in the body, because our bodies not only create their own cholesterol, but also regulate how much appears in the bloodstream. In addition, it was discovered that about a quarter of the population is more sensitive to dietary cholesterol than the rest of us, who apparently didn’t have to worry as much about consuming high-cholesterol foods.

Back to bad?

This month, however, a study published in the Journal of the American Medical Association (JAMA) concluded that adding an extra 300 mg. of dietary cholesterol a day resulted in a 3.2 percent higher risk of heart disease and a 4.4 percent higher risk of early death (one egg contains about 186 mg. of cholesterol). Each additional egg increased the risk, according to researchers, who reviewed six study groups comprising 29,000 people for an average of over 17 years.

Admitting that the connection between egg consumption and higher risk of CVD and early death was “modest,” Dr. Robert H. Eckel wrote in an accompanying JAMA editorial that the new report “is far more comprehensive, with enough data to make a strong statement that eggs and overall dietary cholesterol intake remain important in affecting the risk of CVD, and more so the risk of all-cause mortality.”

Dr. J. David Spence of the Western University Stroke Prevention and Atherosclerosis Research Center in London, Ontario, runs a stroke prevention center. He is so vehemently opposed to any egg-yolk consumption that he hasn’t eaten one in 40 years, and compares eating eggs to smoking in relation to their effect on health.

Maybe not

But the problem with what are known as “observational” studies is that they depend on accurate reporting from study subjects.

Dr. Leslie Cho, a preventive cardiologist at Cleveland Clinic, noted that while the JAMA report was scientifically sound and well-done, she questioned its conclusions.

“It’s a very large study with a very large number of different types of patients. These are all good things,” she told CBS News. “But in general, any dietary study is fraught with difficulty because of the problem of patient recall. Do you remember what you ate last week? Because I don’t. It’s the same thing with patients.”

Indeed, other studies have reached opposite conclusions from the JAMA study. One performed in China and reported last fall in the journal Heart surveyed 461,213 adults averaging 51 years of age over a nine-year span. It concluded that those who consume an average of one egg a day may have a lower risk of heart attack and stroke than those who avoid them entirely.

“Among Chinese adults, a moderate level of egg consumption was significantly associated with lower risk of (cardiovascular disease), largely independent of other risk factors,” said an excerpt from the study.

So what to believe? Our best recommendation at this point is to check with us. We can provide tailored guidelines based on your family history and specific health condition regarding the healthy consumption of eggs.

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