While it’s true that just one egg yolk has 200 mg of cholesterol, eggs also contain additional nutrients that may help lower the risk for heart disease. In addition, the moderate amount of fat in an egg, about 5 grams, is mostly unsaturated (monounsaturated and polyunsaturated) fats. 

Unsaturated fats, are considered beneficial because they can improve blood cholesterol levels, stabilize heart rhythms, ease inflammation, among other beneficial roles. They are mostly found in foods from plants, such as vegetable oils, nuts, and seeds. Whereas saturated fats are mainly found in animal foods, but a few plant foods are also high in saturated fats, such as coconut, coconut oil, palm oil, and palm kernel oil.

What the research says:

• Moderate egg consumption in two large prospective cohort studies (nearly 40,000 men and over 80,000 women) found that up to 1 egg per day is not associated with increased heart disease risk in healthy individuals.
• For most people, cholesterol in food has a smaller effect on blood levels.
• Total saturated fat contributes more to LDL (bad) cholesterol than dietary cholesterol.
• People who have difficulty controlling their total and LDL cholesterol may want to be cautious about eating egg yolks and instead choose foods made with egg whites. The same is true for people with diabetes. Studies have shown that heart disease risk was increased among men and women with diabetes who ate 1 or more egg yolks a day. For people who have diabetes and heart disease, it may be best to limit egg consumption to no more than three yolks per week.

Recommendations:

• To lower your cholesterol, no more than 5-6% of your total calories should come from saturated fat. For example, if you need about 2,000 calories a day, a maximum of 120 calories (or 13 grams) should come from saturated fats.

• If you have heart disease or high cholesterol, consider all other forms of saturated fat (red meat, beef, pork, veal, lamb, chicken with the skin, whole-dairy, full-fat cheese and pastries) in your diet.

• You also need to pay attention to the “add-ons” that come with your eggs. Scrambled eggs, salsa, and a 100% whole-wheat English muffin is a much healthier option than scrambled eggs with cheese, sausages, home fries, and white toast.

• While eggs may be a much better choice than sugary, refined grain-based options like sweetened breakfast cereals, pancakes with syrup, bagels or muffins, they may fall short of other options. One cup of steel-cut oats (made with water) with nuts, chia seeds and berries, will be a much better choice for heart health than an egg-centric breakfast. Consumption of whole grains and fruit predict lower risk of heart disease, and when it comes to protein, plant sources like nuts and seeds are related to lower cardiovascular and overall mortality, especially when compared to red meat or eggs.

• Cutting back on saturated fat will likely have no benefit if it is replaced with refined carbohydrates. Eating refined carbohydrates in place of saturated fat does lower “bad” LDL cholesterol, but it also lowers the “good” HDL cholesterol and increases triglycerides.

• Reducing saturated fat consumption can be good for health if it is replaced with good fats like polyunsaturated fats (walnuts, flaxseeds and fatty fish).

Free-range? Farm-fresh? Brown or white eggs?

Cage-free: Chickens are not confined to cages and may wander freely indoors but not necessarily outdoors.

Free-range: Chickens can wander freely outdoors but the amount of time varies and they are not necessarily given access to a pasture setting.

Pasture-raised: Chickens roam outdoors in a pasture setting and feed on greens and insects, though the amount of time to roam varies.

Organic: This term is regulated by the USDA’s National Organic Program which states that “certified organic eggs are from uncaged hens that are allowed free range of their houses and access to outdoor spaces. They are fed an organic diet produced according to [National Organic Program] standards.” An updated rule on these standards was announced in January 2017, which specifies “daily access to outdoor areas” and “amount of space required indoors.”

Vegetarian-fed: Chickens are given vegetarian feed of corn and soy to reduce the risk of potential diseases from poultry or animal by-product feed. This creates some controversy as chickens are naturally omnivores, consuming seeds, grass, worms, insects, frogs, and snakes.  Vegetarian-fed chickens can develop nutrient deficiencies if the feed is not fortified with the missing nutrients. There is also no evidence that a vegetarian diet produces more nutritious eggs than using a standard feed.

Omega-3 enriched: Eggs from chickens that are fed a diet containing ingredients like flaxseed or fish oils, which is rich in alpha-linolenic acid (ALA), a type of omega-3 fatty acid.

Natural or Farm-Fresh: These terms are ambiguous and vary highly in meaning. They do not ensure that the chickens are raised a certain way or are fed a certain diet.

Brown eggs are equally as nutritious as white. The color and size of an egg are determined by the breed of hen, which can produce different egg colors. Also, the color of the yolk does not reflect the nutritional value rather the type of poultry feed. 

References

U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 – 2020 Dietary Guidelines for Americans; 2015.

Hu FB, Stampfer MJ, Rimm EB, et al. A prospective study of egg consumption and risk of cardiovascular disease in men and women. JAMA. 1999;281:1387-94.

Fernandez ML. Dietary cholesterol provided by eggs and plasma lipoproteins in healthy populations. Curr Opin Clin Nutr Metab Care. 2006;9:8-12.

Shin JY, Xun P, Nakamura Y, He K. Egg consumption in relation to risk of cardiovascular disease and diabetes: a systematic review and meta-analysis. Am J Clin Nutr. 2013;98:146-59.

The American Heart Association’s Diet and Lifestyle Recommendations. Accessed June 29, 2017: http://www.heart.org/HEARTORG/HealthyLiving/Diet-and-Lifestyle-Recommendations_UCM_305855_Article.jsp#.WVU6_8aZNsM