Scientific literature provides mixed findings regarding the effect of egg consumption on blood cholesterol levels, with some studies indicating an impact on serum cholesterol while other research suggests the relationship is more complex or controversial.
Background:
Despite substantial research highlighting the importance of exogenous dietary cholesterol intake and endogenous serum cholesterol level in human health, a thorough evaluation of the associations is lacking. Our study objective was to examine overall and cause-specific mortality in relation to dietary and serum cholesterol, as well as egg consumption, and conduct an updated meta-regression analysis of cohort studies.
Methods:
We conducted a prospective analysis of 27 078 men in the ATBC Study (Alpha-Tocopherol, Beta-Carotene Cancer Prevention). Multivariable-controlled cause-specific Cox proportional hazards regression models were used to calculate hazard ratios and 31-year absolute mortality risk differences. A systematic review and meta-analysis of cohort studies was also performed (PROSPERO [URL:
https://www.crd.york.ac.uk/prospero/
; Unique identifier: CRD42021272756]).
Results:
Based on 482 316 person-years of follow-up, we identified 22 035 deaths, including 9110 deaths from cardiovascular disease (CVD). Greater dietary cholesterol and egg consumption were associated with increased risk of overall and CVD-related mortality. Hazard ratios for each additional 300 mg cholesterol intake per day were 1.10 and 1.13 for overall and CVD-related mortality, respectively; for each additional 50-g egg consumed daily, hazard ratios were 1.06 and 1.09, respectively, for overall and CVD-related mortality (all
P
values<0.0001). After multivariable adjustment, higher serum total cholesterol concentrations were associated with increased risk of CVD-related mortality (hazard ratios per 1 SD increment, 1.14;
P
<0.0001). The observed associations were generally similar across cohort subgroups. The updated meta-analysis of cohort studies on the basis of 49 risk estimates, 3 601 401 participants, and 255 479 events showed consumption of 1 additional 50-g egg daily was associated with significantly increased CVD risk (pooled relative risk, 1.04 [95% CI, 1.00–1.08]; I
2
=80.1%). In the subgroup analysis of geographic regions (
P
interaction
=0.02), an increase of 50-g egg consumed daily was associated with a higher risk of CVD in US cohorts (pooled relative risk, 1.08 [95% CI, 1.02–1.14]) and appeared related to a higher CVD risk in European cohorts with borderline significance (pooled relative risk, 1.05), but was not associated with CVD risk in Asian cohorts.
Conclusions:
In this prospective cohort study and updated meta-analysis, greater dietary cholesterol and egg consumption were associated with increased risk of overall and CVD-related mortality. Our findings support restricted consumption of dietary cholesterol as a means to improve long-term health and longevity.
<h4>Objective</h4>To evaluate the association between egg intake and cardiovascular disease risk among women and men in the United States, and to conduct a meta-analysis of prospective cohort studies.<h4>Design</h4>Prospective cohort study, and a systematic review and meta-analysis of prospective cohort studies.<h4>Setting</h4>Nurses' Health Study (NHS, 1980-2012), NHS II (1991-2013), Health Professionals' Follow-Up Study (HPFS, 1986-2012).<h4>Participants</h4>Cohort analyses included 83 349 women from NHS, 90 214 women from NHS II, and 42 055 men from HPFS who were free of cardiovascular disease, type 2 diabetes, and cancer at baseline.<h4>Main outcome measures</h4>Incident cardiovascular disease, which included non-fatal myocardial infarction, fatal coronary heart disease, and stroke.<h4>Results</h4>Over up to 32 years of follow-up (>5.54 million person years), 14 806 participants with incident cardiovascular disease were identified in the three cohorts. Participants with a higher egg intake had a higher body mass index, were less likely to be treated with statins, and consumed more red meats. Most people consumed between one and less than five eggs per week. In the pooled multivariable analysis, consumption of at least one egg per day was not associated with incident cardiovascular disease risk after adjustment for updated lifestyle and dietary factors associated with egg intake (hazard ratio for at least one egg per day <i>v</i> less than one egg per month 0.93, 95% confidence interval 0.82 to 1.05). In the updated meta-analysis of prospective cohort studies (33 risk estimates, 1 720 108 participants, 139 195 cardiovascular disease events), an increase of one egg per day was not associated with cardiovascular disease risk (pooled relative risk 0.98, 95% confidence interval 0.93 to 1.03, I<sup>2</sup>=62.3%). Results were similar for coronary heart disease (21 risk estimates, 1 411 261 participants, 59 713 coronary heart disease events; 0.96, 0.91 to 1.03, I<sup>2</sup>=38.2%), and stroke (22 risk estimates, 1 059 315 participants, 53 617 stroke events; 0.99, 0.91 to 1.07, I<sup>2</sup>=71.5%). In analyses stratified by geographical location (P for interaction=0.07), no association was found between egg consumption and cardiovascular disease risk among US cohorts (1.01, 0.96 to 1.06, I<sup>2</sup>=30.8%) or European cohorts (1.05, 0.92 to 1.19, I<sup>2</sup>=64.7%), but an inverse association was seen in Asian cohorts (0.92, 0.85 to 0.99, I<sup>2</sup>=44.8%).<h4>Conclusions</h4>Results from the three cohorts and from the updated meta-analysis show that moderate egg consumption (up to one egg per day) is not associated with cardiovascular disease risk overall, and is associated with potentially lower cardiovascular disease risk in Asian populations.<h4>Systematic review registration</h4>PROSPERO CRD42019129650.
Despite recent changes in the US Dietary Guidelines indicating that dietary cholesterol is no longer a nutrient to be limited, the question of whether eggs should be part of a healthy diet remains controversial, particularly in populations at increased risk for cardiovascular disease. To address this question, a randomized, single‐blinded, crossover trial was conducted in 20 overweight and obese (BMI 25–35 kg/m2) postmenopausal women to compare the effects of whole eggs (equivalent to 2 large eggs/day) vs. egg whites in a breakfast meal on lipoprotein profiles. After a 2‐week lead‐in period all women consumed breakfast meals containing whole eggs and egg whites for 4 weeks each, in randomized order (10 starting with whole eggs, 10 starting with egg whites), with a 4‐week washout period between the two arms. Fasting blood samples and 4‐day diet records were collected at the beginning and end of each intervention period. Consumption of whole eggs was associated with a larger change from baseline (change in the egg arm minus the change in egg white arm) in the intake of dietary cholesterol, mean±SE: (394.9±13.7 mg), total fat (8.2±2.1%), and saturated fat (2.9±0.9%). Analysis of variance showed that HDL‐C increased significantly more during whole egg vs. egg white consumption (1.2±1.3 mg/dl vs. −1.6±1.4 mg/dl, p<0.05) whereas total cholesterol (TC) and LDL‐C did not change significantly. Six women, classified as dietary cholesterol hyper‐responders due to an HDL‐C increase in the upper quartile (ΔHDL‐C ≥9 mg/dl), had higher baseline total cholesterol (240.2±10.2 mg/dl vs. 207±8.1 mg/dl, p=0.02) and LDL‐cholesterol (156.3±8.9 mg/dl vs. 128.4±6.3 mg/dl, p=0.02) than hypo‐responders. The hyper‐responders also differed from hypo‐responders in baseline dietary cholesterol intake (184.2±20.3 mg/dl vs. 108.2±13.4 mg/dl, p=0.03), but did not differ in any other baseline dietary measurements or any baseline anthropometric measures including BMI, waist and hip circumference. The results of this study show that egg consumption is accompanied by a modest increase in HDL‐C in overweight/obese postmenopausal women without significant increases in TC or LDL‐C.
ry cholesterol consumption should be <300 mg/day [ 1 ]. A large egg yolk contains approximately 275 mg of cholesterol—near the recommended daily limit of cholesterol intake [ 2 ]. The 2015–2020 Dietary Guidelines for Americans removed the limitation of dietary egg consumption [ 3 , 4 ]. One study indicated that dietary cholesterol contained in whole eggs is not well-absorbed and is not associated with longer-term plasma cholesterol control [ 5 ], while other studies indicated that the concentration of low-density lipoprotein cholesterol (LDL-c) and high-density lipoprotein cholesterol (HDL-c) significantly increased in an egg-consuming group [ 6 , 7 ]. To clarify this controversy, some systematic reviews tried to determine whether egg consumption influences cholesterol levels, but most of them only focused on LDL-c, HDL-c, total cholesterol and triglycerides [ 8 , 9 , 10 , 11 ]. However, current evidence indicates that LDL-c/HDL-c ratio is a better predictor of cardiovascular diseases than isolated parameters [ 12 ]. To our best knowledge, only one of the previous systematic reviews investigated LDL-c/HDL-c ratio, and concluded that egg consumption had insignificant effect on LDL-c/HDL-c ratio [ 9 ]. Unfortunately, the conclusion was not based on all of the available data. There is still a need to reexamine this issue using a larger scale.
Eggs are an important food source because they contain many proteins, lipids and minerals [ 13 ]. A boiled egg (50 g) provides 6.29 g protein, 0.56 g carbohydrate, 1.6 g saturated fat, 2.0 g monounsaturated fat and 0.7 g polyunsaturated fat. Moreover, eggs contain various minerals (calcium, iron, magnesium and phosphorus) and many vitamins except vitamin C [ 14 ]. After consuming eggs, the intestines are responsible for absorbing dietary cholesterol. Cholesterol absorption includes dietary cholesterol and biliary cholesterol. Between dietary and biliary cholesterol, biliary cholesterol accounts for most of the cholesterol in in
Eggs are a highly nutritious food and an excellent source of carotenoids, lutein and zeaxanthin, which contribute to antioxidant defenses and ocular health. However, eggs have been viewed skeptically because of their impact on serum cholesterol levels. This review summarizes the evidence from clinical trials, observational studies, and worldwide ecological studies relating egg consumption to serum lipid profiles, antioxidant status, and cardiovascular outcomes. Recent meta-analyses on egg consumption have reported an increase in serum cholesterol but limited or no impact on atherosclerosis and cardiovascular disease risk. Clinical studies have reported that the additional consumption of an egg per day for 4 weeks improved high-density lipoprotein-cholesterol levels and decreased oxidized low-density lipoprotein levels. Most recently, a cross-sectional study of Japanese patients who underwent coronary angiography reported no significant association between egg intake and the prevalence of coronary artery disease or multi-vessel disease. Among patients not receiving lipid-lowering drugs, moderate egg intake (3-4 eggs/week) was associated with a lower prevalence of multi-vessel disease. Furthermore, worldwide ecological analyses have identified a significant negative association between egg intake and the incidence and mortality of ischemic heart disease. Given their high nutritional value, relatively low cost, and the evidence presented, eggs could contribute to healthy diets in many countries worldwide.
Effect of egg yolk feeding on the concentration and composition of serum lipoproteins in man. The effect of egg yolk consumption on the composition of LDL and on the concentration of HDL subclasses was studied in healthy subjects. Six volunteers consumed a diet low in cholesterol for 10 days and then daily added 6 egg yolks to their diet for another 10 days; the experiment was repeated 1 year later with the same subjects. Egg yolk consumption caused the cholesterol intake to increase by 1600 mg/day, and the fat intake by 7 energy % at the expense of carbohydrates; this increase was due almost exclusively to monounsaturated fatty acids. Upon egg yolk feeding the mean level of serum total cholesterol rose by 13%; the bulk of this rise was due to LDL cholesterol, which increased by 21%. VLDL and IDL cholesterol decreased by 19 and 11%, and serum total triglycerides by 17%. Marked relative increases of 35 and 36% were seen in the cholesterol level of the HDL subfractions with densities of 1.055-1.075 g/ml (HDL1) and 1.075-1.100 g/ml (HDL2), respectively. The HDL2/LDL cholesterol ratio increased by 16%. No change in cholesterol in HDL3 (d greater than 1.100 g/ml) was observed.
Eggs contain high quality protein, vitamins, minerals and antioxidants, yet regular consumption is still met with uncertainty. Therefore, the purpose of this study was to compare the effects of consuming two eggs per day or a heart-healthy oatmeal breakfast on biomarkers of cardiovascular disease (CVD) risk and satiety measures in a young, healthy population. Fifty subjects participated in a randomized crossover clinical intervention; subjects were randomly allocated to consume either two eggs or one packet of oatmeal per day for breakfast for four weeks. After a three-week washout period, participants were allocated to the alternative breakfast. Fasting blood samples were collected at the end of each intervention period to assess plasma lipids and plasma ghrelin. Subjects completed visual analog scales (VAS) concurrent to dietary records to assess satiety and hunger. Along with an increase in cholesterol intake, there were significant increases in both low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol following the egg consumption period (p < 0.01). However, there was no difference in the LDL/HDL ratio, a recognized biomarker of CVD risk, nor in the plasma glucose, triglycerides or liver enzymes, between diet periods. Several self-reported satiety measures were increased following the consumption of eggs, which were associated with lower plasma ghrelin concentrations (p < 0.05). These results demonstrate that compared to an oatmeal breakfast, two e
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The truth about egg yolks and cholesterol | National Geographic
Premium HEALTH What you've been told about eggs and cholesterol is wrong, doctors now say Egg yolks have long been blamed for causing high cholesterol. But mounting scientific evidence suggests they were never really the problem. Egg yolks are packed with dietary cholesterol, which was once thought to put you at higher risk of heart disease. But studies show that saturated fat is the bigger culprit—and that consuming two eggs daily as part of a diet low in saturated fat actually led to reductions in LDL cholesterol. Tonje Thilesen, Connected Archives By Stacey Colino Published February 25, 2026 Skip the bland egg-white omelets: egg yolks are no longer the dietary demons they once were. That’s because in recent years there has been a major shift in how experts view dietary cholesterol, or the type of cholesterol found in animal-based foods. Beginning in the 1960s, the dietary guidelines advised limiting cholesterol intake to no more than 300 mg per day, based on the belief that it elevates cholesterol in your blood and puts you at higher risk of heart disease. Egg yolks were considered a particularly potent source of cholesterol. However, that cholesterol-limiting recommendation was finally removed in 2016 because scientific evidence didn’t support a strong link between dietary cholesterol and heart disease. More recent studies have since shown that saturated fat, not dietary cholesterol, is what really makes the difference in affecting blood cholesterol levels. ( Statin drugs are an Internet villain. Do they deserve it? ) In 2025, a randomized, cross-over study published in The American Journal of Clinical Nutrition confirmed that consuming two eggs daily as part of a diet low in saturated fat actually led to reductions in LDL cholesterol after five weeks. By contrast, following a high-cholesterol, high-saturated-fat diet with or without one egg per week did not. Ditching the yolks also deprives you
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