Eggs aren't just for Easter -- eating them is no longer considered unhealthy

Many people hesitate to eat eggs due to concerns about their cholesterol levels and potential impact on heart health. However, a recent study challenges this notion, suggesting that consuming fortified eggs may not adversely affect cholesterol levels, even among those at high risk for cardiovascular disease.

Debunking the myth about eggs and cholesterol

The PROSPERITY trial, presented at the American College of Cardiology’s Annual Scientific Session, enrolled 140 patients with or at high risk for cardiovascular disease.

The study aimed to assess the effects of consuming 12 or more fortified eggs per week compared to a non-egg diet (less than two eggs per week) on HDL- and LDL-cholesterol, as well as other key markers of cardiovascular health over a four-month period.

“We know that cardiovascular disease is, to some extent, mediated through risk factors like high blood pressure, high cholesterol and increased BMI and diabetes,” explained Nina Nouhravesh, MD, a research fellow at the Duke Clinical Research Institute in Durham, North Carolina, and the study’s lead author.

“Dietary patterns and habits can have a notable influence on these and there’s been a lot of conflicting information about whether or not eggs are safe to eat, especially for people who have or are at risk for heart disease. This is a small study, but it gives us reassurance that eating fortified eggs is OK with regard to lipid effects over four months, even among a more high-risk population,” Nouhravesh added.

Benefits of eating fortified eggs

Eggs are a common and relatively inexpensive source of protein and dietary cholesterol. The researchers specifically focused on fortified eggs, which contain less saturated fat and additional vitamins and minerals, such as iodine, vitamin D, selenium, vitamin B2, 5 and 12, and omega-3 fatty acids.

Patients in the study were randomly assigned to either eat 12 fortified eggs a week (cooked in any manner) or to eat fewer than two eggs of any kind per week.

The participants were 50 years of age or older, half were female, and 27% were Black. All patients had experienced one prior cardiovascular event or had two cardiovascular risk factors, such as high blood pressure, high cholesterol, increased BMI, or diabetes.

Study results: No adverse effects on cholesterol levels

The study’s co-primary endpoints were LDL and HDL cholesterol levels at four months. Secondary endpoints included lipid, cardiometabolic, and inflammatory biomarkers, as well as levels of vitamins and minerals.

Results showed a -0.64 mg/dL and a -3.14 mg/dL reduction in HDL-cholesterol (“good” cholesterol) and LDL cholesterol (“bad” cholesterol), respectively, in the fortified egg group.

While these differences weren’t statistically significant, the researchers suggest that consuming 12 fortified eggs each week had no adverse effect on blood cholesterol.

Furthermore, the study observed numerical reductions in total cholesterol, LDL particle number, apoB (another lipid biomarker), high-sensitivity troponin (a marker of heart damage), and insulin resistance scores in the fortified egg group, while vitamin B levels increased.

“While this is a neutral study, we did not observe adverse effects on biomarkers of cardiovascular health and there were signals of potential benefits of eating fortified eggs that warrant further investigation in larger studies as they are more hypothesis generating here,” Nouhravesh explained.

Importance of a balanced diet

So why have eggs gotten a bad rap? Some of the confusion stems from the fact that egg yolks contain cholesterol.

However, experts suggest that a more important consideration might be what people are eating alongside their eggs, such as buttered toast, bacon, and other processed meats, which are not heart-healthy choices.

As always, Nouhravesh recommends that people with heart disease talk with their doctor about a heart-healthy diet.

While this single-center study is limited by its small size, reliance on patients’ self-reporting of egg consumption and other dietary patterns, and its unblinded nature, it provides valuable insights into the potential role of fortified eggs in a heart-healthy diet.

Reviving the egg eating debate

In summary, the PROSPERITY trial challenges the common misconception that eggs, particularly fortified eggs, adversely affect cholesterol levels and heart health.

The study found no significant differences in HDL- and LDL-cholesterol levels between those who consumed 12 or more fortified eggs per week and those who ate fewer than two eggs per week, even among individuals at high risk for cardiovascular disease.

While further research is needed to confirm these findings, the study suggests that fortified eggs may be a part of a heart-healthy diet when consumed in moderation and alongside other nutritious foods.

As always, individuals with heart disease should consult their doctor to develop a personalized, heart-healthy eating plan.

The full study was published by the American College of Cardiology.

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