The Truth About Eggs and Cholesterol

Eggs are a high-cholesterol food, but the connection between egg intake and blood cholesterol is not that simple, said Janet Wei, MD, associate medical director of the Biomedical Imaging Research Institute at Cedars-Sinai.

Cholesterol is a waxy, fat-like substance that the human body needs to survive. The liver makes cholesterol, and we also get dietary cholesterol from food, such as eggs. Having too much cholesterol in your blood can cause heart health risks, such as heart attack and stroke—and for a long time, eggs were believed to be a part of the problem.

“The egg has been controversial, but it doesn’t need to be,” said Wei, the Erika J. Glazer Chair in Women's Cardiovascular Research, Education and Innovation. “When you adjust for other lifestyle factors like exercise and other dietary habits, there doesn’t seem to be a direct relationship between egg intake and cardiovascular disease.”

Does eating eggs raise blood cholesterol levels?

A healthy total blood cholesterol level ranges from 140 to 200mg/dl. Low-density lipoproteins (LDL), the so-called “bad” cholesterol, should be under 100mg/dl, while high-density lipoproteins (HDL) should be above 40mg/dl for men and above 50mg/dl for women.

Evidence from randomized controlled trials indicate that eating one to three eggs per day causes a mild increase in blood cholesterol levels in the general population, Wei said.  

“One egg per day is unlikely to significantly increase your cholesterol or your risk for cardiovascular disease,” she said.

That’s probably because blood cholesterol levels are more impacted by your saturated fat intake than by the cholesterol you consume. Processed foods and red meat are high in saturated fat, which reduces the liver’s ability to regulate blood cholesterol. Also, a person’s cholesterol response to dietary saturated fat varies due to genetics, liver function and gut microbiome health.

“There’s still more to be learned,” Wei said. “But, in general, we should focus on limiting saturated fat to achieve healthy cholesterol readings."

Eggs get a bad rap because they’re often served alongside other foods high in saturated fat, such as buttered toast, greasy bacon and rich hollandaise.

“It’s really not the eggs themselves that we should be worried about,” Wei said. “It’s the background saturated fat intake that seems to be driving the high cholesterol.”

One egg per day is unlikely to significantly increase your cholesterol or your risk for cardiovascular disease

Eat eggs the Heart-Healthy Way

Enjoy eggs as part of a heart-healthy diet that includes fruits, vegetables and whole grains, Wei said. A breakfast of two hardboiled eggs with whole-grain toast and fruit, for instance, is much less likely to raise your blood cholesterol than a meal of fried eggs and sausage.

Try boiling or poaching your eggs. Avoid preparation methods that add saturated fat, such as frying. If you plan to prepare the eggs in a pan, Wei said, avoid butter and use a small amount of a healthier fat, such as olive oil or canola oil.

Skip additions that are high in saturated fat, such as full-fat cheese, cream and red meat.

All of an egg’s cholesterol is contained in its yolk, Wei said, so consider swapping out whole eggs for egg whites if you’re concerned about cholesterol.

You don’t have to banish eggs from your diet for cholesterol concerns.

“Moderate egg consumption—one egg a day—seems to be safe, particularly when you have a diet that’s low in saturated fat,” Wei said.

If you’re concerned about cholesterol, heart disease risk or dietary choices, talk to your doctor, who can give you personalized guidance.

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