Egg Cholesterol

Eggs are one of the richest sources of dietary cholesterol, providing 215 mg per large egg. In the 1960s and 1970s the simplistic view that dietary cholesterol equals blood cholesterol resulted in the belief that eggs were a major contributor to hypercholesterolemia and the associated risk of cardiovascular disease. While there remains some controversy regarding the role of dietary cholesterol in determining blood cholesterol levels, the majority of studies have shown that saturated fat, not dietary cholesterol, is the major dietary determinant of plasma cholesterol levels (and eggs contain 1.5 g of saturated fat) and that neither dietary cholesterol nor egg consumption are significantly related to the incidence of cardiovascular disease. Across cultures, those countries with the highest egg consumption actually have the lowest rates of mortality from cardiovascular disease, and within-population studies have not shown a correlation between egg intake and either plasma cholesterol levels or the incidence of heart disease. A 1999 study of over 117000 men and women followed for 8-14 years showed that the risk of coronary heart disease was the same whether the study subjects consumed less than one egg a week or more than one egg a day.

Clinical studies show that dietary cholesterol does have a small influence on plasma cholesterol levels. Adding one egg per day to the diet would, on average, increase plasma total cholesterol levels by approximately 5 mgdl_1(0.13 mmol/L). It is important to note, however, that the increase occurs in both the atherogenic LDL cholesterol fraction (4 mg dl_1(0.10 mmol/L)) and the anti-atherogenic HDL cholesterol fraction (1 mgdl~1(0.03mmol/L)), resulting in virtually no change in the LDL:HDL ratio, a major determinant of cardiovascular disease risk. The plasma lipopro-tein cholesterol response to egg feeding, especially any changes in the LDL:HDL ratio, vary according to the individual and the baseline plasma lipopro-tein cholesterol profile. As shown in Table 7, adding one egg a day to the diets of three hypothetical patients with different plasma lipid profiles results in very different effects on the LDL:HDL ratio. For the individual at low risk there is a greater effect than for the person at high risk, yet in all cases the effect is quantitatively minor and would have little impact on their heart-disease risk profile. Overall, results from clinical studies indicate that egg

Table 7 Changes in plasma lipoprotein cholesterol levels with addition of one large egg per day to the diet

Cholesterol (mgdr1) LDL:HDL ratio

Table 7 Changes in plasma lipoprotein cholesterol levels with addition of one large egg per day to the diet

Cholesterol (mgdr1) LDL:HDL ratio

LDL

HDL

(% change)

Baseline

125

50

2.50

+1 egg day"1

129

51

2.53 (+1.2%)

Baseline

150

50

3.00

+1 egg day"1

154

51

3.02 (+0.6%)

Baseline

175

50

3.50

+1 egg day"1

179

51

3.51 (+0.3%)

feeding has little if any effect on cardiovascular disease risk. This is consistent with the results from a number of epidemiological studies.

A common consumer misperception is that eggs from some breeds of bird have low or no cholesterol. For example, eggs from Araucana chickens, a South American breed that lays a blue-green egg, have been promoted as low-cholesterol eggs when, in fact, the cholesterol content of these eggs is 25% higher than that of commercial eggs. The amount of cholesterol in an egg is set by the developmental needs of the embryo and has proven very difficult to change substantially without resorting to hypo-cholesterolemic drug usage.

Undue concerns regarding egg cholesterol content resulted in a steady decline in egg consumption during the 1970s, 1980s, and early 1990s, and restriction of this important and affordable source of high-quality protein and other nutrients could have had negative effects on the well-being of many nutritionally 'at risk' populations. Per capita egg consumption has been increasing over the past decade in North America, Central America, and Asia, has remained relatively steady in South America and Africa, and has been falling in Europe and Oceania. Overall, world per capita egg consumption has been slowly increasing over the past decade, in part owing to the change in attitude regarding dietary cholesterol health concerns.

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