Cholesterol in Eggs – It May Not Be as Harmful as You Think

In 1988 the prestigious New England Journal of Medicine ran a clinical report on an 88-year-old man who was in good cardiovascular health and who had normal cholesterol levels, despite the fact he had eaten an average of 25 eggs a day, as few as 20 a day, as many as 30 a day, for the previous 15 years.

There was general agreement among this man’s doctors that a psychological compulsion to eat 25 eggs a day is not a good thing, however, there were no ill effects on cholesterol or heart health. His lab numbers were:

  • Total cholesterol, 200 mg/dl (5.18 mmol per liter),
  • LDL cholesterol, 142 mg/dl (3.68 mmol per liter), and
  • HDL cholesterol, 45 mg/dl (1.17 mmol per liter).

He also had normal apo-A and apo-B and triglycerides. The doctors calculated that this man’s body absorbed only about 20 per cent of the cholesterol he ate, and the reason why is not hard to understand.

Eggs are not just high in cholesterol. They are also high in lecithin. The lecithin in eggs keeps much of the cholesterol from reaching the bloodstream, especially when the liver generates large amounts of bile salts (which it makes from excess cholesterol) that keep cholesterol in the stool so that it is simply flushed away.

Was this man’s good health a fluke?

This man’s percent absorption of cholesterol was exceptionally low, but his consumption of cholesterol was exceptionally high. When there is a huge amount of cholesterol in the colon, the sheer bulk of fat keeps some of it from ever reaching the portal hepatic vein and reaching the body. And when the liver senses there is excess cholesterol, it sends waste cholesterol out into fecal contents, also keeping cholesterol from being absorbed.

Most modern research has found that eating up to three eggs per day has no detrimental effects on either inflammation in the lining of arteries or cholesterol levels, and that eating eggs is healthier than eating cured pork products or cheese. However, to improve cholesterol levels and increase the flexibility of blood vessels, egg substitutes are even better than eggs.

Selected References:

Kern, F. Normal Plasma Cholesterol in an 88-Year-Old Man Who Eats 25 Eggs a Day – Mechanisms of Adaptation. N Engl J Med. 324:896-899. 28 March 1991.

Njike V, Faridi Z, Dutta S, Gonzalez-Simon AL, Katz DL. Daily egg consumption in hyperlipidemic adults – effects on endothelial function and cardiovascular risk. Nutr J. 2010 Jul 2;9:28.