Unscrambling the Confusion About Eggs

When it comes to eating eggs, nutrition advice has changed. In 1968, the American Heart Association recommended that Americans consume no more than three whole eggs per week. The belief was that eating cholesterol-rich egg yolks would elevate cholesterol in the blood, which would increase one’s risk of developing cardiovascular disease and having a heart attack or stroke.

By 2015, that belief had changed. Today’s U.S. Dietary Guidelines no longer limit eggs. (As you can see, nutrition is an evolving science. Research has led to new understanding about eggs. Though sometimes confusing, the system is working when further knowledge leads to new recommendations about what’s best to eat to protect your health.)

Studying the role of eggs in our diet has been done by surveying thousands of egg eaters from a cross section of the general population. This led to the conclusion that eating eggs can increase one’s risk of elevated blood cholesterol and heart disease. But that conclusion applied to the average American (fat, unfit) who ate fried eggs plus bacon plus buttered white toast—i.e., a lot of saturated fat.

Today’s heart-healthy dietary guidelines focus on saturated fat as the culprit (and even that is not clear-cut). Of the five grams of fat in an egg, only 1.5 grams are saturated. (The recommended daily limit for saturated fat is about 15 grams per 2,000 calories.) Athletes who eat poached eggs plus avocado plus whole-grain toast likely can enjoy that breakfast worry-free.

Overall, epidemiological evidence suggests that enjoying six to seven eggs a week does not increase heart-disease risk. For most healthy athletes, cholesterol in eggs does not convert into artery-clogging cholesterol in the blood. That said, some people are hyper-responders to dietary cholesterol, meaning that when they eat cholesterol-rich foods, their blood cholesterol increases. If you have a family history of heart disease and/or diabetes, a worry-free choice is to enjoy more oatmeal breakfasts, made yummy by stirring in a spoonful of peanut butter. (Both oatmeal and peanut butter are known to be heart-healthy choices.)

The health of your heart can be enhanced far more by doing other things than eliminating eggs from your diet. Rather than targeting eggs, I suggest you take a good look at your overall lifestyle and food intake. As an athlete, you get regular exercise, but do you get enough sleep? Drink alcohol only in moderation, if at all? Eat an overall well-balanced diet? You might want to focus less on whether or not an omelet for breakfast will ruin your health (doubtful!) and instead make other long-term dietary enhancements. That is, could you add more spinach and arugula to your salads? Munch on more nuts instead of chips? Enjoy more salmon and fewer burgers? There’s no question that whole grains, nuts, beans, fish, and colorful fruits and veggies promote heart health.

Egg truths

• Eggs are nutrient-dense. They contain all the nutrients needed to sustain life. The 150 calories in two eggs offer far more vitamins, minerals, protein, and other nutrients than you’d get from 150 calories of other breakfast foods (i.e., English muffin, energy bar, banana).

• Brown eggs are nutritionally similar to white eggs. The breed of hen determines the color of the eggs.

• Yolks contain nutrients that athletes can easily miss out on, including vitamin D, riboflavin, folate, and for vegans, B-12.

• One large egg has about six to seven grams of high-quality protein that contains all the essential amino acids that are needed to build muscles. Half of an egg’s protein is in the yolk (along with most of the vitamins, minerals, fat, and flavor). The white is primarily protein and water.

• Egg yolks contain the once-feared cholesterol. One egg yolk has about 185 to 200 milligrams of dietary cholesterol. That’s more than half of the 300-milligram limit previously recommended by the American Heart Association (since dropped).

• Eggs are rich in a well-absorbed source of lutein and zeaxanthin, two types of antioxidants that reduce risk of cataracts and age-related macular degeneration.

• For dieters, eggs are pre-portioned, which can be helpful. Eggs are also satiating. Research suggests people who eat eggs for breakfast tend to eat fewer calories later in the day.

• What about omega-3 eggs? Are they all they’re cracked up to be? Yes and no. Omega-3 fats are thought to be protective against heart disease. Eggs from hens fed flaxseed, algae, and fish oils have a higher omega-3 fat content in their yolk, increasing it from about 50 milligrams in an ordinary egg to 125 milligrams in an Eggland’s Best egg. This amount is tiny compared to the 3,000 milligrams of omega-3’s in a standard portion of Atlantic salmon (four to five ounces).

Omega-3 eggs are more expensive than standard eggs: $6 versus $4 per dozen. You’ll get a lot more omega-3s by spending more of your food budget on salmon and less on omega-3 eggs. That said, for non-fish eaters, any omega-3 fats are better than no omega-3’s.

Stay tuned

Someday, we will have a 100-percent clear answer about which foods contribute to high blood cholesterol and if that impacts heart-disease risk. That will put an end to the confusion about egg cholesterol and heart health. In addition, we’ll likely be able to benefit from genetic testing that offers personalized nutrition advice. Targeted research that looks at the genes of specific populations will enable us to know, for example, which athletes can enjoy three-egg omelets (with or without buttered toast) day after day without fear of impairing their heart health.

Until then, if your family is predisposed to heart disease, you certainly want to talk with your doctor and ask about not just eggs but also the possibility of getting tested for biomarkers for heart disease, such as your coronary-artery calcium score, C-reactive protein, and a type of blood lipid called Lp(a). You could also get personalized guidance about a heart-healthy diet from a registered dietitian who specializes in cardiovascular disease. The referral list at eatright.org will help you find that expert!