Australia is famed for its poached eggs, and tucking into the yolky goodness is considered a breakfast staple – particularly on long, lazy Sundays.
Yet, for decades, eggs have carried a reputation they can’t quite seem to shake off: that they lead to high blood cholesterol and heart disease.
Keep enjoying your eggs and avocado on toast.Credit:iStock
It was once advised by health authorities that eating any more than two or three eggs a week was risky because of the cholesterol contained in the yolk and since then, the fear has lingered.
In 2017, a vegan film on Netflix even claimed, by distorting research findings, that eating an egg a day was the equivalent of smoking five cigarettes, showing images of a mother sautéing cigarettes in a frying pan to serve to her children for breakfast.
And only recently, a study published in February in PLOS Medicine made headlines around the world for finding that eating more eggs – as few as three a week – is linked to earlier death. Researchers had examined health data of more than 520,000 Americans, aged 50 to 71, who were recruited in the mid-90s and followed up about 16 years later, at which point almost 130,000 participants had died, with egg consumption thought to be associated.
But health experts are not convinced. Dr Evangeline Mantzioris, accredited practising dietitian and nutrition scientist at the University of South Australia, warns against getting carried away by the findings. “It is just an observational study and we have to treat those carefully,” Mantzioris says. “It is a big study, but only in the US, and only for people 50-71.”
Dr Alan Barclay, accredited practising dietitian and spokesperson for Dietitians Australia, adds: “They only assessed food intake at the start of the study and it’s highly unlikely what people were eating 16 years later was the same as what they were eating at the beginning.”
Barclay thinks eggs don’t deserve their bad rap and he worries that people are being “scared off”.
“It started with the very low-fat diet trends of the ’80s because of the fat and cholesterol content, up until the ’90s, and the fear of eggs has persisted,” he says. “[Observational] studies are interesting but should be considered as part of the overall body of evidence.”
In its totality, most modern, high-quality research actually shows that eating eggs as part of a healthy, balanced diet has little influence on our blood cholesterol.
First, a note on cholesterol: it’s a type of fat carried in the blood, and in small amounts, it’s a good thing, because it helps your body produce hormones, nerve cells and vitamins.
While it’s true that we don’t want too much of it, the biggest contributors to blood cholesterol do not come from sources of dietary cholesterol, like eggs. Rather, most of it is made in the liver from saturated and trans fats, which are rife in processed foods.
Mantzioris points to several large reviews and meta-analyses of randomised controlled trials (the highest quality research) which conclude that eating more eggs is not associated with a higher risk of cardiovascular disease in the general population – including a 2020 umbrella review that showed “a substantial no association between egg consumption and a number of health outcomes, including cancer, cardiovascular and metabolic disorders”.
Mantzioris says this evidence is convincing because they involve trials in which people are divided into two groups, where one eats increased eggs, and scientists observe what happens to their cholesterol levels and health outcomes.
Some research does tell another story. For example, a 2020 meta-analysis of 17 randomised controlled trials showed that healthy adults who ate more eggs had higher levels of “bad” cholesterol, known as LDL cholesterol. But Mantzioris says this research didn’t look at health outcomes.
Australia’s Heart Foundation examined the scientific literature and concluded that “eggs have a neutral relationship with heart health, neither remarkably increasing or decreasing risk in the general population”. A maximum egg limit was therefore removed for most people. But those with type 2 diabetes or high cholesterol are advised to eat no more than seven eggs per week (anyone who is concerned about their cholesterol levels can get a test done at their GP).
The other side to it is that eggs put more into your body than just cholesterol. Barclay says they’re rich in protein, vitamins A, B, D and E and minerals such as iron, zinc and iodine. Their moderate fat content is also mostly unsaturated.
Mantzioris’ advice for most people is to not stress and keep enjoying eggs as part of a healthy, balanced diet.
Eggs do contain cholesterol, so the key, she says, is to consider what you’re pairing eggs with (something some observational studies fail to do). “If it’s always with bacon, that’s a problem. If it’s with wholegrain toast, baked beans, tomatoes, then that’s a great meal,” she says.
Barclay also suggests boiling, poaching or frying in a non-stick pan with olive or canola oil. “How you prepare them matters so don’t put lots of saturated fat with them is the bottom line,” he says.
Also examine your dietary pattern as a whole. You want to limit processed foods and eat lots of fruit, vegetables and wholegrains. “The overall diet is important. Provided you’re eating well you won’t have a problem,” Barclay says.
And if you’re eating a lot of eggs, is there another food group you’re missing out on – for example protein from fish, lentils and beans, or fruit and cereals with good fibre content? The big rule is not to eat too much of one thing.
So don’t give up on your Sunday eggs. As Barclay, who has 12 chooks at home, says: “Eggs are a highly nutritious food and that’s why we have enjoyed them for thousands of years.”
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