My family eats a lot of eggs.

My in-laws live on a small farm and my father in-law did what any Italian would do upon retiring….he bought a dozen free range chickens and a rooster to take care of. My family gets to benefit from a seemingly endless supply of farm fresh eggs.

Eggs have a robust list of positives. Eggs are:

• Cheap
• Widely available
• Their production has a very low environmental impact versus other types of animal protein
• Nutrient dense
• Rich source of high quality protein
• They are a source of folate, B-vitamins, fat-soluble vitamins (all of which improve health and cardiovascular disease)

Yet they are consistently pummeled in the media. The cons that are cited? Realistically the only con is the seemingly endless contradictory headlines the public has to decipher on whether eggs are actually healthy or not. In just the past 20 years there have been headlines to:

• Avoid eggs altogether
• Only eat egg whites
• Eat as many eggs as possible
• Avoid eggs as they are ‘high in cholesterol’ and can contribute to cardiovascular disease

On top of this, with each new iteration of dietary guidelines that get released, the number of recommended eggs to consume weekly is drastically different.

Who are we to listen to? SCIENCE OF COURSE!

A quick side note – McMaster University seems to consistently put out more ‘useful’ health research then nearly any other source worldwide right now. My definition of useful is research that changes something about the way I live the day after I read it. The study I am about to discuss fits into this definition. I didn’t even go to Mac, but I’m proud of all of their recent, great, Canadian driven research.

The Population Health Research Institute from McMaster University just published the most important (and definitive) study on egg consumption and health to date.

Prior studies are contradictory regarding egg consumption and cardiovascular disease. Most show no association but that is not always uniform. A study from China on over half a million people showed an egg per day actually LOWERED your risk of cardiovascular disease by 11%. A different, more recent study showed a 2% INCREASE in absolute risk of all cause mortality for each half egg per day you eat. These studies have issues though and may explain their differing conclusions. Each is from one individual country which is a problem as diets differ drastically across the globe. They are often plagued by ‘healthy user bias’ where they only look at otherwise healthy individuals, and by rich countries where people may be eating a very healthy diet in addition to their egg intake.

This current study took data from 3 gigantic studies that are currently ongoing and pooled their data. The total population studied was a whopping 177,555 people from 50 countries and 6 continents that encompassed, low, middle and upper income classes. The studies included healthy, sick, and even very sick people making it more robust then any prior study and allowing them to group data based on health category.

The primary outcome they looked at was cardiovascular events (death from cardiovascular causes and nonfatal events like strokes, heart failure and myocardial infarctions). They also looked at secondary outcomes like blood lipid levels including total cholesterol, high and low density lipoproteins, triglycerides and blood pressure. They grouped people into egg intake (under 1 per week, 3-5/week, 5-7/week and >7/week) based on their last 12 months dietary egg intake.

So what did they find?

In general, the world eats a lot of eggs! In the largest of the 3 studies included in the data, median egg intake was 3.8/week. This topped out in China at 5.6 eggs, and was lowest in South Asia at 1.4 eggs.

The KEY RESULTS:

• There were 12,701 deaths and 13,658 cardiovascular events in the 177,000 people studied (that’s a lot).
• To use the researchers own wording “….We did not find significant associations between egg intake and blood lipids, mortality or major cardiovascular disease events.”
• Moderate intake (1 egg per day!) DOES NOT increase the risk of cardiovascular disease or mortality among those with or without a history of cardiovascular disease or diabetes.
• There was NO ASSOCIATION between egg intake or dietary cholesterol and blood lipids.
  • In fact, in the largest of the 3 studies, (about 135,000 people) they found that higher egg intake was associated with a LOWER RISK of myocardial infarction. Now this wasn’t seen in the other 2 studies so interpret this finding with caution.
• When they looked at dietary cholesterol intake for the study group: “In totality, there is little effect of dietary cholesterol on lipids, cardiovascular disease or mortality.”
  • This has actually been known for quite a while. It is one of those things that is near impossible for people to be receptive to (that eating cholesterol is not necessarily bad for your heart health). BUT, the recent 2015-2020 Dietary Guidelines for Americans and the American Heart Association recently removed the prior limit of 300mg/day of dietary cholesterol. So if you don’t believe us, maybe you will believe them?

Even we were surprised by how definitive these findings were.

Some other notes are that in 2 of the 3 studies, there was an association between more eggs and LOWER blood pressure. And in the largest of the 3 studies, when they removed individuals that had a prior history of cardiovascular disease (leaving only healthy people) and then compared folks that eat on average less then 1 egg per week with those eating more then 7 eggs per week there was STILL NO DIFFERENCE in any outcome.

To push that even further, they performed a dose-response analysis which is essentially a fancy statistical way to look at the effect each additional half egg per day has on people and still found no association with total mortality and major cardiovascular disease. This held true for the small number of people that eat over 7 eggs weekly, even as they went up 2 eggs at a time.

So what are our take homes?

• Eating cholesterol doesn’t really have a huge effect on our cardiovascular health (in fact there was no association between dietary cholesterol increases of 100mg per day and health outcomes in these studies).
• There was actually a marginal DECREASE in risk of cardiovascular disease outcomes with higher egg intake.
• These findings can’t be due to chance alone as the numbers are so robust, and the countries included were vast and varied in terms of both income and dietary practices
• We now know eating eggs is very safe. They are also cheap, a good source of many essential components of our diets, safe for the environment, readily available……and generally delicious.

I’m writing this before my kids wake up……think I’ll make them an omelet for breakfast.