The study, published in February 2021 in PLoS Medicine, found that every additional half egg participants ate per day was associated with a 7 percent higher risk of premature death from all causes. Also, every extra 300 milligrams (mg) of cholesterol per day was linked to a 19 percent higher risk of dying early. On the other hand, researchers estimated that replacing half an egg each day with egg whites or egg substitutes would reduce the risk of premature death from all causes by 6 percent. They furthermore reported that swapping in other protein sources, like poultry, fish, nuts, and legumes, could curb the risk of dying early by 8 to 13 percent. Nearly two-thirds of the increased risk of premature death associated with eggs is due to cholesterol in the eggs, researchers estimated. The study wasn’t a controlled experiment designed to prove whether or how eggs might directly prevent or cause health problems. And because researchers relied on study participants to accurately recall and report on their eating habits, it’s possible that some people provided inaccurate information about their own egg consumption. Results from this study mirror findings from a study published in March 2019 in the Journal of the American Medical Association that also examined the risks of eggs and cholesterol. This earlier research found each additional half egg consumed per day was tied to an 8 percent greater risk of death from all causes, and each extra 300 mg of cholesterol was linked to an 18 percent higher risk of premature death. “You simply should not eat a lot of eggs, particularly egg yolks, where most of the cholesterol is located,” says Michael Hill, MD, a professor of neuroscience at the Cumming School of Medicine at the University of Calgary in Canada. “This is particularly true if you have an elevated risk of cardiovascular disease because of other risk factors, such as family history or hypertension,” says Dr. Hill, who wasn’t involved in the study.
Conflicting Research — and Advice — About Eggs
If this advice and these latest study results go against what you thought you knew about eggs, don’t fret. It’s true that a large body of research about the potential benefits and harms of egg consumption has produced inconsistent and conflicting results, says Jean-Philippe Drouin-Chartier, PhD, RD, a researcher at the Institute of Nutrition and Functional Foods at Laval University in Quebec, who wasn’t involved in the latest study. For the latest study, researchers asked 521,120 adults to complete dietary questionnaires when they were 62 years old on average, then followed them for up to about 16 years. During this time, 129,328 people died, including 38,747 deaths from cardiovascular disease. The upside to this approach is that it includes a large number of people, and focuses on older adults who are at increased risk for developing cardiovascular disease, cancer, and other conditions that can hasten death, making it easier to detect meaningful differences in death rates associated with different eating habits, the study team notes. But the downside to this study is that people only shared their eating habits one time, and it’s possible their diets changed over the years, Dr. Drouin-Chartier says. And, the people in the study who ate more eggs were also more likely to have other risk factors for an early death, such as obesity, smoking, and unhealthy eating patterns. RELATED: Why Are Healthy Eating Habits Important?
Some Studies Found Eggs Harmless, Or Even Helpful
One large study, published in January 2020 in the American Journal of Clinical Nutrition found that eating an egg every day wasn’t associated with an increased risk of heart attacks, strokes, or premature death. Most of the participants were around 50 years old — about a decade younger on average than the people in the current study. Another study, published in May 2018 in Heart, also looked at people in their early fifties and found that individuals who ate about one egg each day were 11 percent less likely to develop cardiovascular diseases and 18 percent less likely to die from these diseases than people who never ate eggs. These studies may have found eggs harmless because they were done in people who were too young to have a high risk of heart attacks and strokes, says David Spence, MD, director of the Stroke Prevention and Atherosclerosis Research Centre at Robarts Research Institute in London, Ontario, Canada. The current study offers a better picture of how eggs impact disease and longevity because the participants were older and more at risk for diseases hastened by high cholesterol like heart disease and certain cancers, says Dr. Spence, who wasn’t involved in this study. “The clinically relevant question is not how long a teenager can get away with eating eggs; it is whether people at risk of heart attacks and strokes should limit their intake of eggs and cholesterol,” Spence says. RELATED: Study Says Eggs Don’t Increase Heart Risk for People With Type 2 Diabetes
Focus on Your Whole Diet, Not Just Eggs
While the science from eggs may not be settled, many experts agree that the best way to live a long and healthy life is not by focusing on whether a single food is good or bad for you, says Andrew Odegaard, PhD, MPH, an associate professor in health sciences at the University of California in Irvine. “Focus on the overall dietary pattern,” says Dr. Odegaard. Eggs as part of an overall heart-healthy diet, for example, may not necessarily increase your risk of dying young or make you more likely to have a heart attack or stroke, Odegaard says. Eating one egg a day is reasonable as part of a heart-healthy diet, according to 2019 recommendations from the American Heart Association. Eggs were not associated with an increased risk of cardiovascular disease in research reviewed by the AHA to draft these guidelines. Eggs in moderation are a healthy part of a variety of diets, such as the Dietary Approaches to Stop Hypertension (DASH) diet or a Mediterranean-style diet. These are both diets that emphasize consuming fruits, vegetables, whole grains, vegetable oils, nuts, fish, and poultry, and limiting red meat, added sugars, and salt. Many studies over the years have linked the heart-healthy Mediterranean and DASH diets to a longer life. One 2015 study in the British Journal of Nutrition, for example, followed elderly people for almost a decade and found they were less likely to die of all causes or from heart attacks or strokes when they followed a Mediterranean diet. Another study, published in 2017 in The New England Journal of Medicine, followed older adults over more than a decade and found people who changed their eating habits to more closely resemble a Mediterranean or DASH diets associated had a lower risk of death from all causes and from cardiovascular causes in particular. But if you have eggs every morning with a generous helping of fried potatoes and bacon, you might indeed have an increased risk of cardiovascular disease and premature death due to your eating habits, Odegaard says. And in this case, lowering egg consumption isn’t as important as making overall changes to make your whole diet healthier. For example, enjoying an egg or two next to a bed of greens and a side of fresh fruit could be a move in the right direction. “If frequent egg consumption is occurring in the context of a typical Western dietary pattern with high levels of refined grains, added sugars, red and processed meats, and ultraprocessed foods, then the best evidence for cardiovascular health is shifting one’s overall dietary pattern to a more healthful pattern, such as the DASH or Mediterranean diet, not focusing on eggs,” Odegaard says.
