Eggs, Cholesterol, and the 2015-2020 Dietary Guidelines
The 2015 Dietary Guidelines Advisory Committee did indeed report that “available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum [blood] cholesterol.”
But first and foremost, it’s important to ask, “Who is funding the research? Who is providing the evidence?” The studies, and there are several, that have asserted that dietary cholesterol does not raise blood cholesterol have been largely funded by the egg industry. (Egg yolks are a very rich source of dietary cholesterol).
Egg yolks are also relatively high in calorie density, so if you’re adding yolks to your egg-white omelets, you’re adding significant calories. “I suspect that very few people will decrease their three-egg-white omelet to one egg in order to avoid the extra calories,” observes Dr. Tom Rifai, MD, FACP, President of Wellness Coaching and Consulting Company, Reality Meets Science® LLC, and member of the Pritikin Scientific Advisory Board.
Regarding heart health, it still makes sense to limit foods that are high not only in saturated fats and trans fats but also cholesterol, especially in people at increased risk of heart disease.
The Scientific Report of the 2015 Dietary Guidelines Advisory Committee is consistent with this recommendation. In Chapter 2 of their report, they wrote: “Research that includes specific nutrients in their description of dietary patterns indicate that patterns that are lower in saturated fat, cholesterol, and sodium… are beneficial for reducing cardiovascular disease risk.”1
More Dietary Cholesterol, More Total and LDL Cholesterol
The studies showing the dangers of increased intake of dietary cholesterol are numerous and compelling, and, as you might have guessed, they were not financed by the egg industry. Here are four…
- In a tightly controlled clinical trial of 70 men, Dr. F. H. Mattson of the University of Pennsylvania Medical School showed that increasing dietary cholesterol from 0 mg daily to 317 mg for every 1,000 calories consumed increased total blood cholesterol by 25%, on average.2 (One egg yolk has about 200 mg of dietary cholesterol.)
- Another study conducted by Dr. Frank M. Sacks of Harvard Medical School analyzed the effects of adding one extra-large egg a day to the regular diets of young, healthy men and women. All of them were lacto-vegetarians (vegetarians who also ate dairy products). In just three weeks, that one daily jumbo egg increased their LDL (bad) cholesterol by 12%.3
- Another study by scientists at the Stroke Prevention & Atherosclerosis Research Centre in Ontario, Canada, examined the diets of more than 1,200 people, average age 61, who already had coronary artery disease. Using carotid ultrasound imaging, the researchers found that those people who ate the most whole eggs had the most plaque-ridden arteries.4
- In research from Dr. William Connor and colleagues at Oregon Health Sciences University, an “affluent diet” that included egg yolk at every meal was fed to a group of Tarahumara Indians of rural Mexico, who traditionally eat a whole foods diet naturally high in fiber and low in dietary cholesterol – less than 100 mg of dietary cholesterol daily. The affluent diet they were directed to eat contained 1,020 mg of dietary cholesterol daily. In five weeks, their LDL levels shot up 39%.5
Eggs, Cholesterol, and Study Designs
Though solid, well-controlled studies have proven the blood cholesterol-raising results of consuming dietary cholesterol, “scientists affiliated with the egg industry, as well as a few others, have unfortunately become adept at designing studies that minimize the impact of dietary cholesterol on total and LDL cholesterol levels,” states Kimberly Gomer, MS, RD, Director of Nutrition at the Pritikin Longevity Center.
Sometimes, for example, these scientists select subjects known to be less responsive to dietary cholesterol changes, such as obese, insulin-resistant subjects. Or they put people on calorie-restricted diets, diets that are known during the weight-loss phase to blunt the cholesterol-raising impact of both dietary saturated fat and cholesterol.
Or they vary the intake of dietary cholesterol from a high level to a somewhat higher level, even though it is known that the impact of dietary cholesterol on blood cholesterol declines with increasing dietary cholesterol intake.
“It is a sad commentary that with nutrition research it seems increasingly common that those who sponsor that research get what they paid for,” observes Dr. Seth Marquit, MD, Medical Director at the Pritikin Longevity Center. The faculty at Pritikin, including its physicians, have been teaching heart-healthy living skills since 1975.
“And yes, it’s true that some people can eat a lot of eggs and still live to a ripe old age – just as some smokers can, but the odds are against it. For most people, the reality is the more egg yolks you eat and tobacco smoke you inhale, the greater your risk of cardiovascular disease.”
Bottom Line On Eggs, Cholesterol, Saturated Fat, and Optimal Food Choices…
Many foods that are rich sources of saturated fat, like red meat and full-fat dairy foods, are also rich sources of dietary cholesterol. They’re all artery-cloggers, plain and simple.
Foods that are high in dietary cholesterol but not as high in saturated fat, like egg yolks and shellfish, should also be substantially limited. The great majority of studies (those not funded by special interest groups) indicate that the more dietary cholesterol we eat, the higher our blood cholesterol rises, and the more artery-damaging plaque we accumulate.
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In fact, “the amount of cholesterol in the average American diet increases serum [blood] cholesterol much more than the amount of trans fat,” sums up Dr. Marquit.
Moving forward… Keep enjoying egg whites, an excellent source of protein and nutrients.
But most importantly, keep enjoying an overall food plan, like the Pritikin Eating Plan, that is full of whole, naturally fiber-rich foods like fruits, vegetables, whole grains, and legumes (beans), as well as moderate amounts of nonfat dairy and seafood.
In fact, Pritikin guidelines mirror in many ways the 2015-2020 U.S. Dietary Guidelines.
Its Executive Summary states:
“The overall body of evidence examined by the 2015 Dietary Guidelines Advisory Committee identifies that a healthy dietary pattern is higher in vegetables, fruits, whole grains, low- or non-fat dairy, seafood, legumes, and nuts; moderate in alcohol (among adults); lower in red and processed meat; and low in sugar-sweetened foods and drinks and refined grains.”
The overall body of evidence, in short, shows that by living Pritikin-style, you are indeed living well.