The debate surrounding eggs and their effect on cholesterol levels has gone back and forth over the years. One of our followers on Instagram posed a great question that you may also have been wondering about: How often should you be eating whole eggs if you have higher cholesterol? 

Eggs 101

If you’re wondering about the distinction between whole eggs and just egg whites, we covered that debate in a previous blog post that you can find here.

Cholesterol 101

First, it is important to understand exactly what cholesterol is. Cholesterol is simply a type of lipid. Lipids are essential for various biological functions including the formation of cell membranes and proper functioning of hormones, so your liver naturally produces cholesterol to support these systems [1].

Lipoproteins are also produced in the liver and help to transport cholesterol in your blood. You are probably familiar with the two major types of lipoproteins, LDL and HDL [1]. Oftentimes we hear LDL described as the “bad cholesterol” and HDL termed as the “good cholesterol”. Why? 

On one hand, LDL helps transport cholesterol to your arteries. So if you have increased LDL levels, more cholesterol is brought to your arteries, and it can clump up causing atherosclerosis aka the hardening of arteries. This thereby impedes blood flow and can lead to cardiovascular disease (CVD) and increase your risk for heart attacks or strokes [1]. 

On the other hand, HDL helps to transport LDL cholesterol back towards your liver so that your liver can process it and remove it from your body [1]. This thereby avoids atherosclerosis and consequential CVD. 

It is important to remember that high cholesterol levels can occur from various factors including consumption of high saturated fat, high sugar, and low fiber diets [7]. Similarly, CVD can result from a multitude of factors, with diet and nutrition being just two of them [3]. 

Now, let’s explore the relationship between eggs and cholesterol. 

A recent meta-analysis completed in 2021 investigated the relationship between egg consumption and cholesterol levels. The control groups were composed of individuals who either ate no eggs, only egg whites, or egg substitutes, whereas the experimental groups ate an additional amount of eggs. Using these guidelines, they reviewed several RCT’s that studied healthy individuals. They found that those who ate more eggs showed higher LDL cholesterol levels and higher LDL:HDL ratios than the control group [2]. 

This study considered RCT’s with a wide range of time intervals from 21-84 days. However, when they distinguished between studies that were conducted within 2 months versus studies conducted over 2 months, they found again that LDL:HDL ratios were higher in the experimental group that ate more eggs than the control group [2]. 

Additionally, this meta-analysis only studied healthy individuals, so factors such as genetic predisposition or family history were not considered. These can all play a role in influencing cholesterol levels. 

Another interesting facet of the conversation is that recent epidemiological studies show that dietary patterns can affect egg consumption and cholesterol levels. For instance, a 2021 paper found that although Japanese individuals consume relatively more eggs than Americans, they did not show a higher risk of CVD. This result could have stemmed from contrasting dietary patterns between the two nations that consequently influence how the egg nutrients are digested and interact within the body [4]. 

So, how many eggs should I be eating?

Thus, when considering how many eggs, whole eggs, or just egg yolks you should consume yourself, the exact number is very difficult to determine. Multiple factors such as your genetics, dietary patterns, family history, lifestyle, and more will influence how your body metabolizes eggs, how it will affect your cholesterol levels, and your risk for CVD.

Current research shows that if you do not have high cholesterol, eating 1-2 eggs per day won’t put you in harm’s way [5]. 

If your blood tests show that you already have higher cholesterol levels or you know that you have some risk of CVD, sticking to 1 egg per day or only 4-5 eggs per week may be better for you. 

Managing High Cholesterol

If you are diagnosed with higher cholesterol levels, this is not something that is irreversible. There are many ways in which you can manage high cholesterol levels and work to reverse it without depending on medications.

1. Increasing your HDL cholesterol levels will allow these molecules to bind to LDL cholesterol and transport it to your liver so that your body can properly remove it [1].  
2. Eating enough fiber performs a similar function as fiber helps bind to excess cholesterol and remove it from your body through regular bowel movements [6].

Nutrition Support For You

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References:

1. Cortes, V. A., Busso, D., Maiz, A., Arteaga, A., Nervi, F., & Rigotti, A. (2014). Physiological and pathological implications of cholesterol. Frontiers in bioscience (Landmark edition), 19, 416–428. https://doi.org/10.2741/4216
2. Li, M. Y., Chen, J. H., Chen, C., & Kang, Y. N. (2020). Association between Egg Consumption and Cholesterol Concentration: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Nutrients, 12(7), 1995. https://doi.org/10.3390/nu12071995
3. Huo, S., Sun, L., Zong, G., Song, B., Zheng, H., Jin, Q., Li, H., & Lin, X. (2020). Genetic susceptibility, dietary cholesterol intake, and plasma cholesterol levels in a Chinese population. Journal of lipid research, 61(11), 1504–1511. https://doi.org/10.1194/jlr.RA120001009
4. Sugano, M., & Matsuoka, R. (2021). Nutritional Viewpoints on Eggs and Cholesterol. Foods (Basel, Switzerland), 10(3), 494. https://doi.org/10.3390/foods10030494
5. Drouin-Chartier, J. P., Chen, S., Li, Y., Schwab, A. L., Stampfer, M. J., Sacks, F. M., Rosner, B., Willett, W. C., Hu, F. B., & Bhupathiraju, S. N. (2020). Egg consumption and risk of cardiovascular disease: three large prospective US cohort studies, systematic review, and updated meta-analysis. BMJ (Clinical research ed.), 368, m513. https://doi.org/10.1136/bmj.m513
6. Surampudi, P., Enkhmaa, B., Anuurad, E., & Berglund, L. (2016). Lipid Lowering with Soluble Dietary Fiber. Current atherosclerosis reports, 18(12), 75. https://doi.org/10.1007/s11883-016-0624-z
7. Temple N. J. (2018). Fat, Sugar, Whole Grains and Heart Disease: 50 Years of Confusion. Nutrients, 10(1), 39. https://doi.org/10.3390/nu10010039