American Journal of Clinical Nutrition, Vol. 75, No. 2, 333-334, February 2002
© 2002 American Society for Clinical Nutrition

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Eggs and heart disease risk: perpetuating the misperception
Donald J McNamara
Egg Nutrition Center 1050 17th Street, NW Suite 560 Washington, DC 20036 E-mail: enc~enc-online.org

Conclusion:

The fact that no studies in the past decade have reported a significant relation between either egg consumption or dietary cholesterol intakes and heart disease risk (5) is consistent with the view that the hypothesis that dietary cholesterol is a risk factor for heart disease should be dismissed. A small, statistically significant increase in the ratio of total to HDL cholesterol has little biological importance concerning heart disease risk when considered relative to those dietary and lifestyle factors that do in fact contribute to heart disease risk. Concerning the suggestion by Weggeman et al that eggs make no important contributions to the diet, I refer them to a recent supplement of the Journal of the American College of Nutrition (10) in which the merits of egg consumption are documented. In an evaluation of the relation between dietary cholesterol and the risk of heart disease, it is crucial to not only have accurate estimates of risk but also a practical perspective of what a risk estimate represents.

Bibliography
10. McNamara DJ, ed. Where would we be without the egg? A conference about nature's original functional food. J Am Coll Nutr, 2000;19:495S–562S.

JAMA 1999 Apr 21;281(15):1387-94

A prospective study of egg consumption and risk of cardiovascular disease in men and women.

Hu FB, Stampfer MJ, Rimm EB, Manson JE, Ascherio A, Colditz GA, Rosner BA, Spiegelman D, Speizer FE, Sacks FM, Hennekens CH, Willett WC.

Department of Nutrition, Harvard School of Public Health, Boston, Mass 02115, USA. Frank.hu~channing.harvard.edu

CONTEXT: Reduction in egg consumption has been widely recommended to lower blood cholesterol levels and prevent coronary heart disease (CHD). Epidemiologic studies on egg consumption and risk of CHD are sparse. OBJECTIVE: To examine the association between egg consumption and risk of CHD and stroke in men and women. DESIGN AND SETTING: Two prospective cohort studies, the Health Professionals Follow-up Study (1986-1994) and the Nurses' Health Study (1980-1994). PARTICIPANTS: A total of 37851 men aged 40 to 75 years at study outset and 80082 women aged 34 to 59 years at study outset, free of cardiovascular disease, diabetes, hypercholesterolemia, or cancer. MAIN OUTCOME MEASURES: Incident nonfatal myocardial infarction, fatal CHD, and stroke corresponding to daily egg consumption as determined by a food-frequency questionnaire. RESULTS: We documented 866 incident cases of CHD and 258 incident cases of stroke in men during 8 years of follow-up and 939 incident cases of CHD and 563 incident cases of stroke in women during 14 years of follow-up. After adjustment for age, smoking, and other potential CHD risk factors, we found no evidence of an overall significant association between egg consumption and risk of CHD or stroke in either men or women. The relative risks (RRs) of CHD across categories of intake were less than 1 per week (1.0), 1 per week (1.06), 2 to 4 per week (1.12), 5 to 6 per week (0.90), and > or =1 per day (1.08) (P for trend = .75) for men; and less than 1 per week (1.0), 1 per week (0.82), 2 to 4 per week (0.99), 5 to 6 per week (0.95), and > or =1 per day (0.82) (P for trend = .95) for women. In subgroup analyses, higher egg consumption appeared to be associated with increased risk of CHD only among diabetic subjects (RR of CHD comparing more than 1 egg per day with less than 1 egg per week among diabetic men, 2.02 [95% confidence interval, 1.05-3.87; P for trend = .04], and among diabetic women, 1.49 [0.88-2.52; P for trend = .008]).

CONCLUSIONS: These findings suggest that consumption of up to [the maximum consumption for this study] 1 egg per day is unlikely to have substantial overall impact on the risk of CHD or stroke among healthy men and women. The apparent increased risk of CHD associated with higher egg consumption among diabetic participants warrants further research.

Comment in:
J Am Coll Nutr. 2001 Feb;20(1):93-4.

The impact of egg limitations on coronary heart disease risk: do the numbers add up?

McNamara DJ.

Egg Nutrition Center, Washington, DC 20036, USA. enc~enc-online.org

For over 25 years eggs have been the icon for the fat, cholesterol and caloric excesses in the American diet, and the message to limit eggs to lower heart disease risk has been widely circulated. The "dietary cholesterol equals blood cholesterol" view is a standard of dietary recommendations, yet few consider whether the evidence justifies such restrictions. Over 50 years of cholesterol-feeding studies show that dietary cholesterol does have a small effect on plasma cholesterol concentrations. The 167 cholesterol feeding studies in over 3,500 subjects in the literature indicate that a 100 mg change in dietary cholesterol changes plasma total cholesterol by 2.2 mg/dL. Today we recognize that dietary effects on plasma cholesterol must be viewed from effects on the atherogenic LDL cholesterol as well as anti-atherogenic HDL cholesterol since the ratio of LDL:HDL cholesterol is a major determinant of heart disease risk. Cholesterol feeding studies demonstrate that dietary cholesterol increases both LDL and HDL cholesterol with little change in the LDL:HDL ratio. Addition of 100 mg cholesterol per day to the diet increases total cholesterol with a 1.9 mg/dL increase in LDL cholesterol and a 0.4 mg/dL increase in HDL cholesterol. On average, the LDL:HDL ratio change per 100 mg/day change in dietary cholesterol is from 2.60 to 2.61, which would be predicted to have little effect on heart disease risk. These data help explain the epidemiological studies showing that dietary cholesterol is not related to coronary heart disease incidence or mortality across or within populations.

The Journal of Nutrition, Health & Aging
Volume 5, Number 3, 2001

Diet and Coronary Heart Disease: Findings from the Nurses' Health Study and Health Professionals' Follow-Up Study

F.B. Hu, W.C. Willett

....
Cholesterol and eggs

.... To avoid elevations in blood cholesterol and reduce Coronary Heart Disease (CHD) risk, the public has been advised to consume no more than 300 mg cholesterol daily and limit consumption of eggs which contain about 213 mg cholesterol per egg. Surprisingly, there is little direct evidence linking higher egg consumption and incidence of CHD among 117,933 subjects in the NHS and HPFS, we found no evidence of an overall positive association between moderate egg consumption and risk of CHD in either men or women.
The null association of egg consumption with risk of CHD observed in these studies may be somewhat surprising, considering widespread belief that eggs are a major cause of heart disease. One egg contains about 200 mg cholesterol, but also appreciable amounts of protein, unsaturated fats, folate, B vitamins, and minerals. It is conceivable that the small adverse effect caused by cholesterol is counterbalanced by potential beneficial effects of other nutrients.
...

I found this forum while hunting for information on cholesterol in eggs. I have heard so much conflicting and cunfusing information, even from doctors I am hoping someone can give be some advice.

I am 58, far too lethargic and have been eating eggs in quite large quantities all my life. I am on a low fat diet due to acid reflux problems. My doc says I am not overweight but my stomach is bigger than I would like.

I average around 4 eggs per day but last time it was checked my cholesteral was normal.

Can somebody tell me if I am taking a big risk or is there no problem?

Well Skywolf you have landed in quite an interesting place. You might not be aware you are in a low-carb(ohydrate) forum.

I think if you take a few days and read through this forum you might just find an answer to your problems.

Low-carb would no doubt help with your stomach. Also I've read several testimonials here saying that low-carbing greatly improved their acid reflex problem, after they switched over from low fat.

Furthermore maybe people report that lowcarb gives them quite an increase in energy.

Sorry for being a bit evangelical, but seems from your brief description, you are a prime candidate for being helped by a low carb lifestyle.

As for egg consumption, I have become convinced reading the research posted here and elsewhere that dietary cholesterol has very little impact on blood cholesterol.

Skywolf, to add to Angeline's message. If you are interested in Low-Carbing, check out the link at the top of the sidebar on the right titled, "Which low-carb plan is right for me?" then get the book and read it.

My personal suggestion would be for you to read "The Schwarzbein Principle." That's the program I follow and she just came out with a new book that is very enlightening(TSPII). Dr. S. encourages a "balanced" nutrition that is not as low-carb as some of the other plans, but carbs are still limited.

As Angeline said, low-carbing can help with your lethargy and paunch, and you'll be healthier. Plus you will be eating the nutrients (protein and fat) that will help your body regenerate properly. When you follow a low-fat regime, you are depriving your body of the building blocks that it needs to keep in good working order.

The lifestyles encouraged here will help keep you feeling young and alive all through your life.

;-Deb

Thanks for the replies.

I dont stick to the non-fat diet very stricktly because it does seem I am not getting what I need and I suspect has something to do with the lethargy.

My problem is that I am living in the Philippines which is third world and it is therefore very difficult to get even the basics that I was used to in the UK or even in Hong Kong where I lived for 23 years.

Even getting good quality fresh vegetables is difficult so I really dont have the choices you have in the US.