By Nancy Clark MS RD CSSD — When it comes to eating eggs, nutrition advice has changed. In 1968, the American Heart Association (AHA) recommended Americans consume no more than three whole egg per week. The belief was eating cholesterol-rich egg yolks would elevate cholesterol in the blood, which would increase one’s risk of developing cardiovascular disease and having a heart attack or stroke. By 2015, that belief had changed. Today’s 2020-2025 US Dietary Guidelines no longer limit eggs. (As you can tell, nutrition is an evolving science. Research led to new understandings about eggs. Though confusing, the “system is working” when new knowledge leads to new recommendations about what’s best to eat to protect good health.)
Studying the role of eggs in our diet has been done by surveying thousands of egg-eaters from a cross-section of the general population. This led to the conclusion that eating eggs can increase one’s risk for elevated blood cholesterol and heart disease. But that conclusion applied best to the average American (overfat, underfit) who ate fried eggs + bacon + buttery white toast, i.e., a lot of saturated fat. Today’s heart-healthy dietary guidelines focus on saturated fat as the culprit (and even that is not clear-cut). Of the 5 grams of fat in an egg, only 1.5 g are saturated. (The recommended daily limit for saturated fat is about 15 grams per 2,000 calories.) Athletes who eat poached eggs + avocado + whole grain toast can likely enjoy that breakfast worry-free.
Overall, epidemiological evidence suggests enjoying 6 to 7 eggs/week does not increase heart disease risk. For most healthy athletes, cholesterol in eggs does not convert into artery-clogging cholesterol in the blood. That said, some people are hyper-responders to dietary cholesterol, meaning when they eat cholesterol-rich foods, their blood cholesterol level increases. If you have a family history of heart disease and/or diabetes, a worry-free choice is to enjoy more oatmeal breakfasts, made really yummy by stirring in a spoonful of peanut butter. (Both oatmeal and peanut butter are known to be heart-healthy choices.)
Heart-health is enhanced by far more than eliminating eggs from your menu. Rather than targeting eggs as a contributor to heart disease, I suggest you take a good look at your overall lifestyle as well as dietary intake. As an athlete, you get regular exercise, but do you get enough sleep? Drink alcohol only in moderation, if at all? Eat an overall well-balanced diet? You might want to focus less on whether or not an omelet for breakfast will ruin your health (doubtful!) and instead make other long-term dietary enhancements. That is, could you add more spinach and arugula to your salads? Munch on more nuts instead of chips? Enjoy more salmon and fewer burgers? There’s no question that whole grains, nuts, beans, fish, and colorful fruits and veggies promote heart-health.
Egg truths
- Eggs are nutrient dense. They contain all the nutrients needed to sustain life. The 150 calories in two eggs offers far more vitamins, minerals, protein, and other nutrients than you’d get from 150 calories of other breakfast foods (i.e., English muffin, energy bar, banana).
- Brown eggs are nutritionally similar to white eggs. The breed of hen determines the color of the eggs.
- Yolks contain nutrients that athletes can easily miss out on, including vitamin D, riboflavin, folate, and for vegans, B-12.
- One large egg has about 6 to 7 grams of high-quality protein that contains all the essential amino acids (such as BCAAs) that are needed to build muscles. Half of an egg’s protein is in the yolk (along with most of the vitamins, minerals, fat, and flavor). The white is primarily protein and water.
- Egg yolks contain the (once feared) cholesterol. One egg yolk has about 185 to 200 milligrams of dietary cholesterol. That’s more than half of the 300-milligram limit previously recommended by the American Heart Association (and has been dropped).
- Eggs are a rich in a well-absorbed source of lutein and zeaxanthin, two types of antioxidants that reduce risk of cataracts and age-related macular degeneration.
- For dieters, eggs are pre-portioned, which can be helpful. Eggs are also satiating. Research suggests people who eat eggs for breakfast tend to eat fewer calories later in the day.
- What about omega-3 eggs? Are they all they are cracked up to be? Yes and no. Omega-3 fats are thought to be protective against heart disease. Eggs from hens fed flaxseed, algae, and fish oils have a higher omega-3 fat content in their yolk, increasing it from about 50 mg in an ordinary egg to 125 mg in an Eggland’s Best egg. This small amount is tiny compared to the 3,000 mg. omega-3s in a standard portion of Atlantic salmon ( 4-5-oz.).Omega-3 eggs are more expensive than standard eggs: $6 vs $4/dozen. You’ll get a lot more omega-3s by spending more of your food budget on salmon and less on omega-3 eggs. That said, for non-fish eaters, any omega-3 fats are better than no omega-3s.
Stay tuned
Someday, we will have a 100%-clear answer to which foods contribute to high levels of blood cholesterol and if that even impact heart disease risk. That will put an end to the egg-cholesterol-heart health confusion. In addition, we’ll likely be able to benefit from genetic testing that offers personalized nutrition advice. Targeted research that looks at the genes of specific populations, will enable us to know, for example, which athletes can enjoy three-egg omelets (with or without buttered toast) day after day without any fear of impairing their heart-health.
Until then, if your family is predisposed to heart disease, you certainly want to talk with your doctor and ask about not just eggs but also the possibility of getting tested for biomarkers for heart disease, such as Coronary Artery Calcium score, C-Reactive Protein, and a type of blood lipid called Lp(a). You could also get personalized guidance about a heart-healthy diet from a registered dietitian who specializes in cardiovascular disease. The referral list at eatright.org can help you find that expert!
The bottom line
Heart-health is more than eliminating eggs from your menu. Lifestyle choices impact your risks for heart disease. In addition eating more fruits, veggies, whole grains, nuts, and beans, you want to get enough sleep, exercise regularly, consume alcohol only in moderation (if at all), and don’t smoke. Enjoying a three-egg spinach mushroom omelet with whole wheat toast twice a week seems like a satiating way to start a heart-healthy, high energy day—and undoubtedly is more health-promoting than a donut or scone with sweetened coffee!
Reference
- Zhong V., Eggs, dietary cholesterol, and cardiovascular disease: the debate continues. J Thorac Dis 2019; 11(9): E148-150
