Articles written by me on Self-care and Palliative Medicine
On Self-Care & Palliative Medicine

The Good Egg

Eggs have been associated with Easter for centuries. Symbolizing both fertility and new life, they have been decorated and celebrated in a variety of ways in diverse cultures. Originally, Easter eggs were painted with bright colors to celebrate the sunlight of spring. Most commonly, Easter eggs were either given as gifts or used in egg-rolling contests. One early tradition was the exchange of lovingly decorated eggs between sweethearts–as valentines are exchanged today. Medieval masters traditionally gave their servants Easter eggs. The tradition of giving Easter eggs to children made its way to us from Europe, and, of course, these days the Easter Bunny magically provides the colorful baskets that await our children on Easter morning. Too, the Easter Egg Hunts are ubiquitous each year as children across America search for the coveted golden egg. Clearly, the Egg has a celebrated spot in Easter tradition. But what about its place in our diets? Let’s crack that topic briefly this week.

Eggs are low in cost and easily digested by most individuals. They are rich in protein, essential amino acids, some vitamins and other minerals. They can be prepared as simply as boiling in hot water or can become elaborate omelettes or souffles. However, each egg does contain, on average 215 mg of cholesterol. Since the American Heart Association recommends that healthy/health-conscious individuals consume no more than 300 mg of dietary cholesterol per day, the egg has been in a frying pan of controversy since the 1960s. Around that time, eggs were yoked to a variety of public statements linking them to blood cholesterol elevations and increased heart disease risk. As a result, there was a clear downward trend in egg consumption. Several researchers scrambled to examine the scientific evidence of such health risk. . .and the results are reassuring.

A total of 37,851 men aged 40–75 years at study onset and 80,082 women aged 34–59 years at study onset were enrolled in two prospective cohort studies spanning up to 15 years in length. Results of the studies were published in April of 1999. At the outset, all participants were free of cardiovascular disease, diabetes, cholesterol elevations, and cancer. At the end of the studies, after adjusting for age, smoking, and other potential cardiovascular disease variables, there was no evidence of an overall significant association between egg consumption and the risk of either heart disease or stroke. Consuming less than one egg per week or up to one egg per day did not change the relative risk of heart disease or stroke in healthy people. Only in diabetic men and women did there appear to be an increased risk of heart disease when egg consumption increased from one per week to seven per week, and this apparent association is still unclear. One hypothesis is that diabetics have abnormal cholesterol transport as part of the disease itself, so any cholesterol intake would have greater negative impact.

The researchers looked at other factors that might influence the study results as well. For example, in men, egg eating was associated with smoking, lower physical activity and generally less healthy eating patterns. Both men and women who ate eggs were more likely to eat bacon, and men were more likely to consume whole milk, red meat, and less likely to consume skimmed milk, fruits and vegetables. Even after these factors were considered, there was still no significant association between egg consumption and risk of coronary heart disease and stroke. So, can we place eggs on the sunny side of healthful foods again?

The researchers in these two large studies do speculate that there may be nutrients in eggs that are actually beneficial in preventing coronary heart disease, thus counteracting the effects of the cholesterol. Additionally, they comment that consumption of eggs instead of carbohydrate-rich foods may raise HDL levels and decrease blood glucose and insulin responses as well. These conclusions are far from hardboiled evidence, but they definitely take eggs out of the ‘devil’s food’ category! And, remember that consumption of one egg per day does not conflict with the American Heart Association’s recommendations that healthy individuals consume no more than 300 milligrams of dietary cholesterol per day. New data indicate that restricting the consumption of saturated fats (such as butter, lard and palm oil) and trans fat (vegetable oil that has been made solid by a manufacturing process called hydrogenation) is the more effective strategy to help individuals lower blood cholesterol levels compared with restricting dietary cholesterol.

Additionally, the President’s Council on Food Safety initiated an Egg Safety Action Plan at the end of 1999. The goal is total elimination of Salmonella associated illness from egg consumption by 2010 and an interim 50% reduction in Salmonella associated illness by 2005. With all of this week’s information, you can see I’m not just giving you half-baked arguments here! The Good Egg is back, and as a part of your healthy diet, you can’t beat it.

Stephen L. Hines, M.D.
April 2001

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