Limit cholesterol intake from eggs to prevent CVD and death: JAMA Study

USA: If you find eggs to be a healthy option for breakfast, think again. A new study published in the journal JAMA has found that higher consumption of dietary cholesterol or eggs is associated with heightened risk of cardiovascular disease CVD and death.

The findings suggest it may be time to re-evaluate the current 2015-2020 Dietary Guidelines for Americans that no longer limit cholesterol or eggs, the researcher. Eating less than 300 milligrams of dietary cholesterol per day was the guideline recommendation before 2015. However, the most recent dietary guidelines omitted a daily limit for dietary cholesterol. The guidelines also include weekly egg consumption as part of a healthy diet.

Cholesterol is a common nutrient in the human diet and eggs are a major source of dietary cholesterol. Egg yolks are one of the richest sources of dietary cholesterol among all commonly consumed foods. One large egg has 186 milligrams of dietary cholesterol in the yolk. However, whether dietary cholesterol or egg consumption is associated with CVD and mortality remains controversial.

Victor W. Zhong, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, and colleagues conducted this large study involving about 30,000 adults studied for up to 31 years, to To determine the associations of dietary cholesterol or egg consumption with incident CVD and all-cause mortality.

"The take-home message is really about cholesterol, which happens to be high in eggs and specifically yolks," said co-corresponding study author Norrina Allen, associate professor of preventive medicine at Northwestern University Feinberg School of Medicine. "As part of a healthy diet, people need to consume lower amounts of cholesterol. People who consume less cholesterol have a lower risk of heart disease."

The new study looked at pooled data on 29,615 U.S. racially and ethnically diverse adults from six prospective cohort studies for up to 31 years of follow up.

Diet data were collected using food frequency questionnaires or by taking a diet history. Each participant was asked a long list of what they'd eaten for the previous year or month. The data were collected during a single visit. The study had up to 31 years of follow up (median: 17.5 years), during which 5,400 cardiovascular events and 6,132 all-cause deaths were diagnosed.

The study found that:

• During a median follow-up of 17.5 years, there were 5400 incident CVD events and 6132 all-cause deaths.


• The associations of dietary cholesterol or egg consumption with incident CVD and all-cause mortality were monotonic.


• Eating 300 mg of dietary cholesterol per day was associated with a 17 percent higher risk of incident cardiovascular disease and 18 percent higher risk of all-cause deaths. The cholesterol was the driving factor independent of saturated fat consumption and other dietary fat.


• Each additional half an egg consumed per day was significantly associated with higher risk of incident CVD and all-cause mortality.


• The associations between egg consumption and incident CVD and all-cause mortality were no longer significant after adjusting for dietary cholesterol consumption.


• Eating three to four eggs per week was associated with a 6 percent higher risk of cardiovascular disease and 8 percent higher risk of any cause of death.

Based on the study, people should keep dietary cholesterol intake low by reducing cholesterol-rich foods such as eggs and red meat in their diet.

But don't completely banish eggs and other cholesterol-rich foods from meals, Zhong said, because eggs and red meat are good sources of important nutrients such as essential amino acids, iron, and choline. Instead, choose egg whites instead of whole eggs or eat whole eggs in moderation.

For further reference log on to 10.1001/jama.2019.1572