Q. What is the story on the recommendations about eggs and cholesterol? I understand a new study has given eggs a clean bill of health.
A. Like an errant politician, the egg has been rehabilitated, somewhat. But it is not back to its once lofty dietary position. Here is the story with current dietary recommendations.
Once upon a time, eggs were considered the perfect food. They are an excellent source of protein, iron, and phosphorus, and eggs are high in important nutrients, such as vitamins B12, D, E, riboflavin, and folate. In addition, they are inexpensive and low in calories (70 per egg). But they have an Achilles Heel. The yolk has more cholesterol per ounce, by far, than any other food. So, in the 1960's, when the cholesterol/ heart disease connection became a public health concern, we were advised to restrict our egg consumption to one egg a week.
This weekly limit of one egg was later increased to three eggs by the America Heart Association (AHA), mainly because the restriction was considered to difficult to maintain and perhaps over cautious. Then in the late 1980's, it was determined that eggs actually have 25% less cholesterol than previously thought. So, the limit was raised to four eggs a week. The "less than thought revelation" was followed in 1991 by a strange New England Journal of Medicine case study of an 88-year-old man who ate 25 eggs a day and had normal cholesterol and no clinically significant heart disease. "Egg lovers can eat two dozen eggs a day and stay healthy," headlined the tabloids. Although this did not increase the daily egg limit, it did add to the confusion about recommendations.
The latest chapter, which probably gave rise to your question, comes from two large Harvard University studies, published last April in the Journal of the American Medical Association (JAMA), that looked at the egg consumption of almost 40,000 men and about 80,000 women over an eight to fourteen-year period. After taking into consideration other dietary patterns and risk factors, the researchers found that folks who ate one egg a day, or more, were no more likely to develop heart disease, or stroke, than those who consume one egg a week, or less.
So, where are we? The cholesterol/ heart disease connection has been weakened over the years. It is far from dead, however. The AHA and other national scientific bodies still maintain their stand on eggs and cholesterol. There is no question that high-cholesterol foods can raise artery-clogging, blood-cholesterol levels, says the AHA. And whether from cholesterol packed eggs yolks or from the less potent shell fish, meat, cheese, or other animal products, high cholesterol is a very serious threat to many people.
Still, there are perplexing things about cholesterol that make establishing dietary recommendations difficult and sometimes suspect. For example, healthy individuals respond quite differently to cholesterol in their diets. Some sources estimate that most Americans, 75% or more, have little trouble physiologically adjusting to the cholesterol they eat. There are also exceptional people, like the two-dozen-eggs-a-day-guy, who seem to be totally unaffected by dietary cholesterol. But on the other side of the coin, some have a very difficult time handling cholesterol. Diabetics in the Harvard study, for instance, who ate one or more eggs a day had a much higher rate of heart disease (twice as high in men) compared to those who consumed one egg or less per week.
An additional complication is that most of the cholesterol circulating in our blood is not from our diets. It is manufactured by our livers, which have a prodigious output of about 1000 milligrams a day. Because of these and other complexities, Dr. Frank Hu of the Harvard School of Public Health and lead author of the JAMA study makes the important point that: "... people should (not) go back to the typical Western diet -- a breakfast with two eggs, bacon, sausage, butter and toast. This kind of diet is very unhealthy."
Recommendations. The AHA nutrition committee is reviewing the guidelines for eggs and cholesterol. Their recommendations are expected to be released early next year. In the meantime, there is no change in the general cholesterol recommendations. That is, no more than four eggs a week. Limit total cholesterol consumption to 300 milligrams a day. (A single egg, averaging 215 milligrams, would account for most of this.) Exercise and maintain a healthy body weight. This can positively affect blood cholesterol levels. And if your doctor has prescribed cholesterol lowering medication, take it religiously. Remember, too, that saturated fats (found in butter, cheeses and meat products) and transfats (found in margarine and other products including crackers, cookies, pastries, cakes, doughnuts, french fries, potato chips, and puddings) have been conclusively shown to increase the "bad" LDL-cholesterol in our blood.
Eggs and Cholesterol
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dus ik zal jullie vertellen hoe met mijn cholesterol zit.
dus de eitjes hadden geen nadelig effect op mij 
