Eggs and Heart Disease

A new study supports consuming eggs in moderation after finding no evidence that eggs increase the risk of cardiovascular disease.

Conditions that affect the heart or blood vessels are collectively known as cardiovascular diseases. These include atherosclerosis (hardening of the arteries), coronary artery disease, heart valve disease, arrhythmia (irregular heartbeat), heart failure, high blood pressure, low blood pressure, shock, endocarditis (bacterial infection of the heart), diseases of the aorta and its branches, disorders of the peripheral vascular system and congenital heart disease.

Reducing dietary cholesterol is important for preventing cardiovascular disease (CVD). Researchers from Harvard Medical School explained that although eggs are high in cholesterol, there is limited and inconsistent evidence that egg consumption increases CVD risk and mortality.

The researchers examined the association between egg consumption and cardiovascular disease in 21,327 participants from the Physicians' Health Study I. Egg consumption was assessed with an abbreviated food questionnaire.

After an average follow-up of 20 years, 1,550 new heart attacks, 1,342 incident strokes and 5,169 deaths occurred. The study found that egg consumption was not associated with incident heart attack or stroke.

The study authors concluded that occasional egg consumption does not seem to influence the risk of CVD in males. However, egg consumption was positively correlated with mortality, especially in diabetic subjects.

Integrative therapies with strong scientific evidence in the treatment of heart conditions include beta-glucan, beta-sitosterol, niacin, omega-3 fatty acids, policosanol, psyllium, red yeast rice and soy. These can be ingested through a healthy diet in addition to eggs.

Beta-glucan is a fiber that comes from the cell walls of algae, bacteria, fungi, yeasts and plants. Numerous trials have examined the effects of oral beta-glucan on cholesterol. Small reductions in total and low density lipoprotein (LDL) cholesterol ("bad" cholesterol) have been reported. Little to no significant changes have been noted to occur on triglyceride levels or high density lipoprotein (HDL) cholesterol ("good" cholesterol) levels.

Beta-sitosterol is found in plant-based foods such as fruits, vegetables, soybeans, breads, peanuts and peanut products. It is also found in bourbon and oils. Many human and animal studies have found that supplementation of beta-sitosterol into the diet decreases total serum cholesterol as well as low-density lipoprotein cholesterol.

Niacin, also known as vitamin B3 or nicotinic acid, is a well-accepted treatment for high cholesterol. Multiple studies show that niacin (not niacinamide) has significant benefits on levels of high-density cholesterol. Niacin has been shown to produce better results than prescription drugs. There are also benefits on levels of low-density cholesterol, although these effects are less dramatic.

Omega-3 fatty acids are found in fish oil and certain plant/nut oils. Fish oil contains both docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Multiple human trials report small reductions in blood pressure with intake of omega-3 fatty acids. There is strong scientific evidence from human trials that omega-3 fatty acids from fish or fish oil supplements (EPA + DHA) significantly reduce blood triglyceride levels. Benefits appear to be dose-dependent. Fish oil supplements also appear to cause small improvements (increases) in high-density lipoprotein. However, increases (worsening) in low-density lipoprotein levels are also observed. The American Heart Association has published recommendations for EPA + DHA. Because of the risk of bleeding from omega-3 fatty acids, a qualified healthcare provider should be consulted prior to starting treatment with supplements.

Policosanol is a natural mixture of alcohols derived from plant-based waxes that has been shown to lower cholesterol. Policosanol has been used and recommended to treat high cholesterol (hypercholesterolemia). Numerous studies have analyzed the effects of policosanol on cholesterol levels and have found benefits. At this time, the evidence supporting the efficacy of this agent is compelling, although greater acceptance in the U.S. market may await additional larger studies.

Psyllium, also known as ispaghula, comes from the husks of the seeds of Plantago ovata. Psyllium is well studied as a lipid-lowering agent with generally modest reductions seen in blood levels of total cholesterol and low-density lipoprotein. Because only small reductions have been observed, people with high cholesterol should discuss the use of more potent agents with their healthcare providers. Effects have been observed in adults and children, although long-term safety in children is not established.

Red yeast rice (RYR) is the product of yeast (Monascus purpureus) grown on rice. Since the 1970s, human studies have reported that red yeast lowers blood levels of total cholesterol, low-density lipoprotein/LDL and triglyceride levels. Other products containing red yeast rice extract can still be purchased. However, these products may not be standardized and effects are unpredictable. For lowering cholesterol, there is better evidence for using prescription drugs such as lovastatin.

Soy is a subtropical plant native to southeastern Asia. Numerous human studies report that adding soy protein to the diet can moderately decrease blood levels of total cholesterol and low-density lipoprotein. Small reductions in triglycerides may also occur, while high-density lipoprotein does not seem to be significantly altered. It is unknown if products containing isolated soy isoflavones have the same effects as regular dietary intake of soy protein.

For more information on these therapies, please visit Natural Standard's Foods, Herbs & Supplements and Medical Conditions databases.

 

Comments

[mo]

I’m surprised that studies are still being done on this. Isn’t it old news that the cholesterol in eggs does not translate into cholesterol in blood? It’s saturated fat (and trans fat) that increases cholesterol (bad or LDL cholesterol to be more specific). If my memory serves, the whole anti-egg campaign began in the 1980s when popular attention turned to the link between blood cholesterol and heart disease. This seems like a great example of the lasting effects the media can have by poorly handling health-related issues. It’s almost 30 years later, and people still swear off eggs (which are the best and cheapest source of complete protein available in the diet today). I’ve also heard of people eschewing shrimp and lobster, two delicious low-fat and high-protein food sources, because of their cholesterol content. Just because the nightly news reports it doesn’t mean it’s true.

[Chels]

Mo,

I agree. This study really should come as no surprise, considering that only a small amount of cholesterol from food actually makes its way into the blood. Saturated and trans fats have much bigger effects on blood cholesterol levels.

But, it's one of those things that's going to take a long time to change public opinion. It's similar to how the general public believes vitamin C prevents cold when studies have continually shown that it doesn't.

[Adi]

It's important to note that diabetics who had one egg a day were more likely to develop heart disease than those who rarely ate eggs. For those who are worried, you can still enjoy eggs minus the cholesterol. Try using yolk-free products, such as Egg Beaters. You can also take out the yolk because it contains all of the cholesterol.

[Jen]

Mo - I think this raises a bigger issue in the scientific community, which is the lag time in publications. The average follow up in this paper was 20 years! That means that the whole debate on eggs was open and closed before this study was even completed. From a research perspective, it is interesting to see that, at some point, a long-term study doesn't really pay off because by the time the data are published - it is old news!

[Leah Cohen]

Mo - that is a really good point - and important to raise awareness in the scientific community. The follow-up time for epidemiological and population studies is certainly a concern.

What is interesting to note is that in the study, the authors concluded that OCCASIONAL egg consumption does not seem to influence the risk of CVD in males. HOWEVER, egg consumption was positively correlated with mortality, especially in diabetic subjects.

So, although the effects on egg consumption on normal populations or patients with cardiovascular disease may be a moot point, perhaps research into such effects on other populations, such as diabetics, may in fact, be worthy of further investigation.

[Franz]

It's going to take a long time to change public opinion about eggs and cholesterol. Everyone seems to believe that all high-cholesterol foods will increase your cholesterol levels. But, as other people have mentioned, this is not the case. On the last episode of Top Chef, the competitors were asked to create healthy meals, and one woman was criticized because she used shrimp in her dish. Since shrimp don't significantly increase blood cholesterol levels (even though they do contain a lot of cholesterol), I was angry with the judges' responses.

[mo]

One trick I’ve always used is to decrease the number of yolks I use. For example, I’ll make a big frittata using six eggs, but only two or three of the egg yolks. Some eggs have smaller yolks and bigger whites, which works well for this approach. After all, the yolks aren’t really essential for cooking and baking. But egg yolk does add the characteristic color and a nice texture. It’s sort of like switching from whole milk to 1% and doesn’t require buying additional products like Egg Beaters.

[Emily]

I agree with your informations. I have heard a lot about this, but it's important to note that diabetics who had one egg a day were more likely to develop heart disease than those who rarely ate eggs.

[Leah Cohen]

Does anyone know if there are public health stats on this, or if any further research has been done on cholesterol/egg consumption correlation with diabetic mortality, or mortality in other populations?

[Izzy]

I find it confusing when they say that eggs are not contributing to heart disease, but that they do raise cholesterol, which we are told does lead to heart disease. I have read so many conflicting reports of the health value or risk in egg consumption. I’m not sure they have a handle on this yet.