What’s the scoop on eating eggs and are they heart-healthy?

Are eggs good for the heart? And how many eggs are okay to eat? What if you have high cholesterol or diabetes? Scientific opinion about eggs changed years ago, but confusion still lingers.

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In a span of 4 days, I heard that eggs are “the healthiest food on the planet” and they’re “so loaded with cholesterol, they’re a heart attack on a plate.” So, what’s the truth about eggs and health?

You guessed it; it’s somewhere in the middle.

Why are we so confused about eggs?

Even more than I get questions about eggs, I hear complaints about experts changing their minds about what’s healthy and what’s not. But in defense of nutrition experts (myself included), nutrition is a young science, and it’s evolving. If we never changed our opinions, it would be because we stopped learning.

Researchers have been doing their jobs

In recent years, scientists learned new things about cholesterol that dramatically changed general medical opinion about the healthfulness of eggs. Previously, health professionals and organizations like the American Heart Association (AHA) warned us to limit our eggs to a couple each week. Because egg yolks are high in cholesterol and high blood cholesterol is linked to heart disease, putting strict limits on egg yolks seemed logical.

Following this reasoning, I’d toss a few cholesterol-rich egg yolks down the garbage disposal before scrambling eggs for an easy dinner. And I advised my patients to do the same. But these days, health researchers know that the cholesterol in our foods is a small player in heart disease because its impact on blood cholesterol is small.

Several years ago, the AHA and the Dietary Guidelines for Americans removed the limit on dietary cholesterol.

Where does cholesterol in the blood come from?

We now know that the liver makes most of the cholesterol in our blood. When we eat certain saturated fatty acids – say from sausage, tropical oils, and greasy burgers – the liver pumps out more cholesterol, thus the first strategy to manage blood cholesterol levels is to limit saturated fats.

Here’s a primer on healthy fats for your heart and blood sugar.

In addition to saturated fats, many factors influence the levels of the various types of blood cholesterol. We’ve got to consider genetics, physical activity, environmental factors, and other aspects of your diet, including fibers, phytochemicals, and dietary cholesterol.

Dietary cholesterol probably does matter, but for most people, its effect is tiny compared to the amount of saturated fat they eat. Cholesterol in your food is like a drizzle of rain, whereas your saturated fat intake is like a rain storm.

How many eggs are okay to eat a day?

Everybody wants to know how many eggs are okay to eat daily. I wish I could give a simple answer like eat one egg a day or two eggs daily, but nutrition is nuanced. And what’s ideal for you might not be good for me.

What factors might influence how many eggs you should eat?

1. Your overall diet. If you haven’t already limited saturated fats, I’d start there. If, on the other hand, you’ve cut back on fatty meats and tropical oils and switched to lower-fat dairy products, adding another dietary strategy might be a smart choice. In that case, you could cut back on egg yolks and other foods with cholesterol or add more foods with viscous fibers like oats, barley, oranges, lentils, chickpeas, and kidney beans.
2. Your blood cholesterol levels. LDL cholesterol is most harmful to your blood vessels. If your LDL cholesterol is elevated, reducing your cholesterol intake makes good sense.
3. Genetic factors. If you have a strong family history of heart disease, especially premature heart disease, limiting your cholesterol intake is wise.
4. Your health status. People with diabetes have a high risk of developing heart disease and should put limits on cholesterol intake. If you already have heart disease, limit your egg yolks.
5. Your motivation. If you’re highly motivated and want to take no chances, eat a heart-healthy diet like a Mediterranean-style diet plus cut back on eggs, shrimp, and other sources of cholesterol.

Now, back to how many eggs is it okay to eat in a day. As I mentioned above, major health organizations no longer have a specific limit on dietary cholesterol. However, they don’t say you should eat cholesterol in unlimited amounts.

In their 2019 science advisory, the AHA stated that healthy people can enjoy the equivalent of one whole egg daily, but you must consider the 5 factors I just listed above. If your risk for heart disease is low and your diet is wholesome, even 2 eggs a day may suit you. But if you have coronary artery disease or diabetes, eating fewer than 7 eggs weekly is prudent.

Are eggs good for the heart?

Population studies are mixed.

Some – but not all studies – find that eating seven or more eggs weekly increases the risk of heart disease among people with diabetes. Might this have to do with other aspects of the diet? For example, on some plates, eggs keep company with wholesome fruit and whole-grain toast or oats. On other plates, eggs sit atop buttery biscuits and sausage gravy.

Does the company eggs keep influence health? I’m sure it does.

Researchers in Australia studied what happens when people with type 2 diabetes or prediabetes eat two eggs daily for six days per week compared to those who ate very few eggs. A dietitian advised all study participants to eat a low-saturated fat diet. After 3 months, there were no differences in cholesterol levels, blood sugar, blood pressure, or waist circumference. The researchers followed the participants for an additional 9 months and found no differences in weight, blood sugar, or markers of inflammation. At least in this study, high cholesterol intake in a healthy, low-saturated fat diet caused no harm.

And still, other studies suggest that eggs can improve cardiovascular risk by raising the “good” HDL cholesterol.

Eggs also give us choline, a B vitamin important throughout the body. Some population studies suggest that higher choline intakes are associated with lower inflammation, which could help prevent heart disease.

A dietitian’s thoughts on eggs

I love eggs and here are 5 good reasons why.

Eggs are loaded with good nutrition. Packed next to the cholesterol you don’t need, you get choline, selenium, vitamin B12, lutein, and high-quality, belly-filling protein.

I’ve seen too many people, and the nation as a whole, focus extensively on foods and ingredients to avoid. But what we do eat is at least as important as what we don’t eat. So before taking away wholesome foods like eggs, look at your overall diet. What nutritious foods can you add? Hello, vegetables, fish, and pulses! What can you cut back on? Goodbye, coconut oil, fatty meats, toaster pastries, and cheese doodles.

Eggs are affordable and easy to prepare. You don’t need fancy equipment or cooking skills to whip up eggs.

The protein is very satisfying. Eating protein at the three main meals is a smart strategy to maintain your weight. It can also help minimize muscle loss during aging or weight loss.

Eggs are good for the eyes. They contain lutein, a cousin to beta-carotene. Lutein makes its way into the macula of the eye where it helps protect vision.

Eggs are brain food. The choline in eggs is critical for brain development during pregnancy and childhood and for protecting against cognitive decline during aging.

How to include eggs in your healthy diet

An egg a day or a few eggs each week is not a “heart attack on a plate.” And the company eggs keep matters. Enjoy your eggs with whole grains, fruits, and vegetables. Skip the sausage biscuits and the large stack of chocolate chip pancakes with blueberry syrup.

Hard-boiled eggs are perfect for on-the-go eating. Pair them with other healthful foods like fruit or nuts.

Treat your family or guests to a wholesome egg casserole or skillet meal. Try my hashbrown casserole with veggies or shakshuka.

While eggs may not be the healthiest food on the planet, they have lots to celebrate.