For years, even decades, common wisdom was that if you wanted to eat a heart-healthy diet, you should avoid eating eggs, which are high in cholesterol. Actually, egg whites were given a pass, because the yolks contain all the cholesterol. The rationale was that dietary cholesterol would raise levels of cholesterol in the blood, especially LDL (“bad”) cholesterol, thus increasing the risk of cardiovascular disease, heart attack and stroke. Is there any truth to this?

Scientific evolution

Not only did the idea of avoiding eggs seem logical, but it’s what doctors were advising their patients, and what researchers, health organizations and the Dietary Guidelines for Americans were recommending. But eventually, scientists observed that most of the cholesterol in our bodies is made by our liver, and for most people, dietary cholesterol does little to affect the cholesterol in our blood.

Here’s what we know now — eating one egg per day does not increase the risk of cardiovascular disease in most people.

Why the confusion?

It’s possible that some of the observational studies that contributed to the original idea that eggs were bad for heart health didn’t adequately account for the types of foods people often eat with eggs, such as bacon, sausage or hashbrowns cooked in butter. These foods are high in saturated fat, which can raise LDL cholesterol, or refined carbohydrates such as added sugar and refined white flour, which can also contribute to cardiovascular disease risk. So, it could be that eggs were victims of “guilt by association.”

While one whole large egg contains 3.2 grams of saturated fat, a recent randomized controlled trial found that in the context of a diet that’s low in saturated fat overall, eggs may actually lower cholesterol. In this study, researchers assigned 61 healthy adults to three different diets for five weeks each.

Compared to control, the egg diet significantly reduced LDL cholesterol, but the low cholesterol egg-free diet did not. Higher saturated fat was associated with increases in LDL cholesterol. While this demonstrated that saturated fat, and not cholesterol, increases blood cholesterol, it is worth noting that while the two-egg-per-day diet reduced LDL cholesterol overall, it did slightly increase the small dense LDL particles that are more likely to contribute to plaque buildup in the arteries, while lowering levels of the large LDL particles that are less of a concern.

The bottom line

While eggs generally don’t raise cholesterol, it’s wise to eat them in moderation. Egg yolks contain many important nutrients that contribute to health, including choline, a nutrient that’s essential for brain, nerve, and cell health. Also, since a large egg contains six grams of protein and 72 calories, it could be a useful addition to a diet that includes fiber-rich plant foods and heart-healthy unsaturated fats.

(Environmental Nutrition is the award-winning independent newsletter written by nutrition experts dedicated to providing readers up-to-date, accurate information about health and nutrition in clear, concise English. For more information, visit www.environmentalnutrition.com.)

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