Are eggs bad for your cholesterol?
For most healthy people, one or two eggs a day poses no problem for their cholesterol, as long as they are not also consuming a lot of saturated fat. Do you have diabetes or a high cardiovascular risk? If so, discuss it with your doctor.
The popular idea that eggs automatically drive your cholesterol up is not correct. A study with 61 participants showed that the cholesterol in eggs does not measurably raise LDL, the 'bad' cholesterol. The real culprit is the saturated fat in your overall diet. People who ate two eggs a day and kept their saturated fat intake low actually had a slightly lower LDL than the control group1,2.
There is one small caveat. That same egg-based diet did lead to more small, dense LDL particles. These are considered more harmful to your blood vessels than large LDL particles. Whether that actually makes a difference in practice is something current studies cannot yet answer1.
How your body responds to dietary cholesterol varies considerably from person to person. Roughly two out of three people are 'hypo-responders': their blood cholesterol barely rises. One in three does see an increase in LDL, but at the same time also an increase in HDL, the 'good' cholesterol, so the ratio often stays the same3,2. For most people, an egg at breakfast is therefore no threat to their blood values, as long as the rest of their diet is in order.
Large population studies paint a somewhat more cautious picture. An analysis of more than 3.6 million participants found that each additional egg per day was associated with a four percent higher risk of cardiovascular disease, and every additional 300 mg of dietary cholesterol per day with an eighteen percent higher mortality4,5. These are associations, not proof of causality; overall diet quality plays a role here. Notably, this increased risk did not appear at all in Asian population groups5.
For people with diabetes, extra caution is warranted: there are indications that they are more sensitive to the effects of eggs on cardiovascular risk, but the evidence is still too limited for firm advice2. The American Heart Association recommends taking your overall diet as the starting point, rather than one isolated nutrient6. Eggs also provide high-quality protein that is good for muscle maintenance, especially as you get older, and keeps you feeling full for longer7.
The cholesterol claims are based on a single randomised crossover study with 61 participants, which is limited in size. The claims about cardiovascular risk come from large population studies and an analysis of more than 3.6 million participants, but there is considerable variation between studies and the outcomes are strongly influenced by overall diet quality. None of the sources used is an overarching review of reviews.