A Question About Eggs

Nemo

I read a recent article in the NY Times that says that eggs are again on the to-be-avoided list because of studies that show that whole eggs add to our blood cholesterol burden in the blood. I am inching toward a more heart-healthy diet and eat a daily hard-boiled egg ( it is, after all, the perfect protein). Any suggestions about egg intake? I am taking a high-dose statin which has dropped my LDL cholesterol to the 40s.

Susan_RD_101

@Nemo

There are certainly flaws with the study that was recently released, most notable of which is there was little detailed recall of what people were actually eating outside of their egg consumption.

That said, it seems that excessive egg intake (i.e. greater than 2 yolks per week) could increase an individual's cholesterol levels, especially among individuals who are susceptible to cardiovascular disease. When people remove eggs from their diet, there is often a decrease in blood cholesterol but it's not always clear if it's because the eggs were removed OR there were other heart-healthy foods added.

Standard heart health advice has been to limit the intake of egg yolks to less than 2 per week (the whites are fine) and to keep total daily cholesterol to < 200 mg. If you want to experiment, I would cut out egg yolks entirely for 6 months, without making too many other changes to your diet or health, and see the impact on your cholesterol levels.

Hope this helps!

Kind regards,

jocoyn

You know I am cool with limiting eggs and don't even like them all that much, but don't see any way to get dietary choline to anywhere near suggested levels without eating high cholesterol foods.

TheNerdy9

I always found the study of eggs daily compelling - that inconsistency is the dangerous part. But, like a lot of people, seems I was swept up in the romance of one study.

FAT intake (and this makes so much sense if you know biochemistry) is what determines blood cholesterol. So a few eggs in a low-fat diet will not cause cholesterol problems. Consumption of many eggs in one sitting can increase LDL (bad) cholesterol, but there is no evidence of even that lifestyle correlating long-term with Coronary Heart Disease (CHD).
Just read the abstract summary from the reviews below for the scientific consensus.

From 1997: https://www.tandfonline.com/doi/abs/10.1080/07315724.1997.10718716

2000: https://www.tandfonline.com/doi/abs/10.1080/07315724.2001.10719008

2006: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1467-3010.2006.00543.x

Susan_RD_101

@jocoyn

Choline is one of those hotly-debated nutrients right now. The recommended target for choline is currently an AI, meaning that we don't have the research to truly know how much choline is needed for good health.

With nutrition, there are so many grey areas. On the one hand, removing eggs from someone's diet could lower cholesterol levels but on the other, a low intake of choline could develop. It really comes down to weighing the risk vs. benefit of each option and making a choice that is ideal for you.

Personally, I'm not alarmed about apparent choline-deficiency since most of the population would fall into this category, yet we're not seeing choline-specific outcomes. In fact, a vegetarian diet was inversely associated with fatty liver disease (the most prominent symptom of choline deficiency).

Hope this helps to shed more light on the topic!

Kind regards,

BRBWaffles

A recent study actually teased out the mechanism by which eggs raise LDL-C and ApoB, and it is not the cholesterol.

https://www.ncbi.nlm.nih.gov/pubmed/29495288

It's the choline. Choline bitartrate supplementation without added cholesterol increased ApoB and LDL-C to the same extent as the eggs. ApoB-100 (a marker of LDL particle number) and LDL-C (the cholesterol content of LDL particles) were the same in both groups! However, the egg group had higher HDL-C, and lower overall hepatic cholesterol synthesis. This means that the average person maintains steady-state cholesterol levels regardless of dietary intake, provided choline intake is held constant.

Now, does this mean that choline is to be feared? In my opinion, no.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4717871/

In this literature review, we learn that choline (and betaine from vegetables, lol) supplementation increases serum cholesterol because it assists with hepatic triglyceride efflux (removing excess fat from the liver). The choline gets methylated by methionine, folate, B12, and glycine to produce phosphatidylethanolamine and phosphatidylcholine. Both are needed to synthesize VLDL particles and shuttle excess fat away from the liver and keep your liver healthy. In the same review, we learn that choline supplementation is absolutely KING at preventing fatty liver in both animals and humans on TPN.

We really can't have it both ways here. We can't say the eggs are bad because they increase ApoB-100 and LDL-C and making us susceptible to heart disease, but then turn around and say that eggs are good because the increase in ApoB-100 and LDL-C is protecting us from fatty liver. One of these ideas has to be wrong, unless preventing fatty liver also causes heart disease. but I don't personally buy that because I see no evidence for it.

jocoyn

Yes, interesting articles and the total cholesterol concern does not bother me. I got my undergrad in biochem waaay back in 1977 and my undergraduate thesis advisor was a specialist in lipid metabolism who asserted the same thing.........and was also well on the anti-trans fats / anti margarine crowd as well. That said I eat such an unprocessed diet I have to make sure I get enough Omega SIX fatty acids (The omega 3s are not hard for me). and that is based on RDA minimums and the realization that their metabolic significance is known. I guess that fact that I have never had signs of fatty liver disease should, however, give relief. It is just that, being older, and apparently quite efficient 1500-1600 calories a day does not give a whole lot of room to play with.