Unscrambling the research: Eggs, serum cholesterol and coronary heart disease

The role of dietary cholesterol in raising plasma cholesterol levels has been debated over the past 25 years. Consequently, eggs, as a food high in dietary cholesterol, have been targeted as a food to limit when advising patients on a diet to lower serum cholesterol levels. The aim of the present review was to evaluate the literature to address the effects of dietary cholesterol from eggs on serum cholesterol levels and risk of coronary heart disease. An increase in dietary cholesterol from eggs by 100 mg daily, equivalent to half a medium egg or three to four eggs a week, results in an increase of approximately 0.05 mmol/L in LDL cholesterol. Adding 100 mg of cholesterol per day (equivalent to three to four eggs a week) to a high saturated fat diet caused an increase in LDL cholesterol of 0.061 ± 0.006 mmol/L, whereas adding the same quantity of cholesterol to a low saturated fat diet caused an increase in LDL cholesterol of only 0.036 ± 0.004 mmol/L (P = 0.03). Despite the small increase in LDL‐cholesterol levels with increasing egg intake, most epidemiological studies have shown little or no association between egg intake and risk of coronary heart disease. However, the impact of dietary cholesterol for people with type 2 diabetes has been poorly studied. In conclusion, in a healthy Western population, there is insufficient evidence to excessively restrict egg intake as part of a healthy diet. Eggs should be considered in a similar way as other protein‐rich foods and selected as part of a varied diet that is low in saturated fat and contains a variety of cardio‐protective foods such as fish, wholegrains, fruits, vegetables, legumes and nuts.