Unscrambling the Egg: Are They Healthy?
March 31, 2002 -- Whether brightly colored and delivered by bunnies for Easter or served as part of a Passover Seder, eggs are spring holiday fixtures. But how do they fit into a healthy diet?
Advice on the subject is often confusing. After developing a bad reputation among some health advocates, the egg was given a bit of a reprieve in 2000 when new American Heart Association dietary guidelines upped the limit from three or four a week to one a day.
But the guidelines were recently clarified again amid concerns that people would believe they could eat them carte blanche. The AHA now says if you choose to eat an egg a day, you need to keep an eye on your total cholesterol intake. That's because the average large egg contributes a whopping 213 milligrams of cholesterol toward the total 300 milligrams recommended daily maximum.
While essential for some physiological functions, the body tends to produce all the cholesterol it needs. So extra cholesterol from the diet can be problematic. Having too much cholesterol is a risk factor for heart disease — the No. 1 killer in America.
But how does egg consumption fit into this picture — when estimates by the American Egg Board say that every person in the United States will eat 261 of them in one form or another this year?
Some research indicates that the egg may not contribute as much to heart disease as you may think, and others laud the egg for its numerous health benefits — even for those watching their cholesterol intake. Moderation, as always, is the key.
Cholesterol's Only Icon?
The egg has become a symbol of high cholesterol, unhealthy eating habits, and by extension — heart disease.
"For 30 years now, [the egg] has been the icon of dietary cholesterol," acknowledges Donald McNamara, executive director of the Egg Nutrition Center in Washington, D.C.
But recent research suggests that eggs might not be a major contributor to heart disease after all.
One study, conducted by Harvard researchers and published in the Journal of the American Medical Association in 1999 looked at the egg consumption of more than 100,000 men and women. It found that eating eggs on their own was unlikely to contribute to heart disease and stroke in healthy individuals.
Moreover, the study found that people who ate eggs were more likely to engage in certain heart-unfriendly behaviors like consuming bacon, high-fat whole milk, and smoking.
"Eggs often get a bad rap, perhaps because they are often paired with [artery-clogging foods like] bacon and sausage," adds Dr. Keith-Thomas Ayoob, associate professor of pediatrics at Albert Einstein College of Medicine in the Bronx, N.Y. and spokesperson for the American Dietetic Association. "I'd actually rather see people skip the bacon and sausage and keep the eggs."
But the fact remains that eggs are high in cholesterol and research has shown that going over the recommended daily limit of 300 milligrams can raise LDL or "bad" cholesterol levels — increasing heart disease risk.
"The best recommendation that we can make to the general public is that if you want to keep your LDL low, then there should be a reasonable limitation of cholesterol intake," says Alice Lichtenstein, vice-chair of the American Medical Association's Nutrition Committee and professor of nutrition at Tufts University in Boston, Mass.
Egg-cellent Benefits
Because all of an egg's cholesterol is confined to the yolk, many people avoid them altogether. But the yolk is also the most nutrient-dense part of the egg.
"There's more to eggs than cholesterol, much more," says Jackie Newgent, registered dietitian and culinary instructor at the Institute of Culinary Education in New York. "They're an inexpensive nutrition powerhouse containing high-quality protein, 13 essential vitamins and minerals including folate, vitamin B12 and vitamin D, and nutritive compounds — all within a 70-calorie package."
Among those nutritive compounds are lutein and zeaxanthine, which are thought to prevent macular degeneration — the leading cause of blindness in Americans age 65 and older.
Research also suggests that eggs are critical for women who are pregnant or nursing, as they are a rich dietary source of choline, which is depleted during these periods. Choline is thought to be essential for normal fetal brain development.
"It concerns me, as a pediatric nutritionist, when parents want to eliminate them from children's diets," says Ayoob. "They have a higher quality protein than even meat or fish, and they're fast food."
Working With What's Left
"The recommendation is to keep your cholesterol intake below 300 milligrams a day," says Lichtenstein. "Whether you do that by eating an egg a day and then limiting other sources of cholesterol, or you don't eat eggs — it's personal preference."
If you do opt for that egg a day, and want to stay within the recommended daily range for cholesterol — you're left with 87 milligrams before you're over the limit. That doesn't sound like much, but it might be easier than you think.
"Surprisingly, that's still a lot to play with," says Newgent. "The only foods that we need to keep a cholesterol check on are basically meat, fish, poultry, dairy, butter and some high-fat baked goods."
Foods that are plant-based like fruits, vegetables, beans and nuts are cholesterol free — and low-fat and fat-free dairy foods contain very little. And of course, there is always the option to skip the cholesterol-laden yolk and choose egg whites or egg substitutes.
And experts say, instead of counting cholesterol day to day, keeping track of your weekly average and staying below 2100 milligrams — might be easier to swallow. The bottom line is that the egg can be A-OK, as long as you keep your eye on the big picture.
"Don't eat 12 of them," adds Will Clower, research scientist at the University of Pittsburgh and author of The Fat Fallacy. "But a moderate level can actually be good for you."