Are Eggs Good For You?

Written by Dr. Steve Chaney on . Posted in Eggs and Health

Do Eggs Reduce Heart Disease Risk?

Author: Dr. Stephen Chaney

Are eggs good for you?

are eggs good for youIf you are like most Americans, you are probably confused about whether you should eat eggs or not. It’s no wonder. The story about eggs keeps changing.

Just a few years ago we were told that eggs were full of cholesterol. They would increase our risk of heart disease. We should avoid them. If we did eat eggs, it should just be the egg whites because all the cholesterol was in the yolk.

Then we were told that the latest science showed that dietary cholesterol didn’t have much of an effect on serum cholesterol levels. It was saturated fats, trans fats, and obesity that raised serum cholesterol levels. Several major studies found that eggs didn’t increase heart disease risk. But we were told not to overdo it. Two to three eggs a week were probably OK, but more might be risky.

Now the headlines proclaim that eggs are good for our heart. They decrease heart disease risk. You can eat an egg every day and actually reduce your risk of heart disease. What is the truth? Let’s start by looking at the study (C. Qin et al, Heart, doi: 10.1136/heartjnl-2017-312651 ).

How Was The Study Done?

are eggs good for you and your heartThe study was performed in China. 500,000 adults (aged 30-79 years) from 10 diverse sites in China were enrolled in the study between 2004 and 2008. At the beginning of the study, the participants were asked about the frequency of egg consumption. A subset of the participants was asked about egg consumption at regular intervals during the first year to assess whether egg consumption was constant. The participants were followed for 8.9 years and cardiovascular incidents were determined from multiple health registries in China.

In terms of egg consumption:

  • 9% of the population never consumed eggs or consumed them very infrequently.
  • 20% of the population consumed eggs 1-3 days/month.
  • 47% of the population consumed eggs 1-3 days/week.
  • 11% of the population consumed eggs 4-6 days/week.
  • 13% of the population consumed eggs daily (average = 0.76 eggs/day).

 

Are Eggs Good For You?

 

are eggs good for you and reduce heart diseaseWhen the scientists conducting the study compared participants reporting daily egg consumption with those who never or rarely consumed eggs:

  • Overall risk of cardiovascular disease was lowered by 11%
  • Risk of heart attacks was lowered by 12%
  • Risk of major cardiovascular events was lowered by 12%.
  • Risk of hemorrhagic stroke (stroke caused by bleeding in the brain) was lowered by 26%
  • Risk of ischemic stroke (stroke caused by a blood clot) was lowered by 10%.

In addition, daily egg consumers lowered their risk of:

  • Cardiovascular death by 18%.
  • Hemorrhagic stroke death by 28%.

The reduction in hemorrhagic stroke risk is particularly significant for the Chinese. In China stroke is the leading cause of death and disability. The reasons for the high stroke risk in China are not well understood. However, the smoking rate and the incidence of high blood pressure are both higher in China than in the United States.

 

What Does This Study Mean For You?

There are some weaknesses to this study. For example, participants reporting daily egg consumption had a higher level of education and household income, were more likely to take a multivitamin supplement, and less likely to have high blood pressure than participants reporting little or no egg consumption. The authors did their best to compensate for these differences statistically, but there is always the concern that they might have introduced bias into the conclusions.

More to the point, diet and lifestyle are very different in China than in the United States. That also could have influenced the results. Thus, it is, perhaps, premature to claim the eggs reduce the risk of heart disease. However, several major studies performed in the United States have shown that eggs do not increase heart disease risk. That means eggs can be part of a heart healthy diet. According to the Mayo Clinic : “Most healthy adults can eat up to seven eggs a week with no increase in their risk of heart disease.”

That is fortunate because eggs are a very healthy food. According to the authors of this study:

  • Studies have shown that egg protein results in better blood sugar control, better satiety (feeling of fullness), and reduced subsequent food intake in healthy and overweight individuals. In layman’s terms that means egg protein can help you achieve and maintain a healthy weight.
  • Egg yolks are a good source of lutein and zeaxanthin. We think of lutein and zeaxanthin as good for eye health. But, they also play an important role in protecting against oxidation, inflammation, and atherosclerosis.
  • Egg yolks also contain choline. We think of choline as good for brain and nerves. But, choline and other phospholipids in the yolk also raise HDL levels and enhance HDL function.
  • Eggs are a good source of vitamin A, vitamin D, vitamin B12, riboflavin, selenium and iron.
  • Eggs contain almost twice as much monounsaturated and polyunsaturated fats as saturated fats.

are eggs good for you but not sausage and baconThere is one other possible takeaway from this study. Let’s return to the differences between the Chinese study and US studies. There is one other major study showing that daily egg consumption reduces heart disease risk, and it was performed in Japan. What is different between Japan, China, and the United States you might ask. The answer is simple. They consume primarily plant-based diets.

That suggests eggs may be healthier as part of a primarily plant-based diet than they are as part of the typical American diet. In short, eggs are healthy. It’s the sausage, bacon, ham, breakfast muffin, and biscuits that are the problem.

Are eggs good for you? Yes.

For more information on heart healthy diets, read my book “Slaying The Food Myths.”

 

The Bottom Line:

A recent study looked at the effect of egg consumption on heart disease risk in China. It found that people who consumed one egg per day had significantly lower risk of heart disease risk than people who seldom or never consumed eggs.

This study has some shortcomings and may not be directly applicable to those of us in the United States. However, several major studies in the United States have concluded that egg consumption does not increase heart disease risk. That means eggs can be part of a heart healthy diet. According to the Mayo Clinic: “Most healthy adults can eat up to seven eggs a week with no increase in their risk of heart disease.” That is fortunate because eggs are a very healthy food.

There is one other major study showing that daily egg consumption reduces heart disease risk, and it was performed in Japan. What is different between Japan, China, and the United States you might ask. The answer is simple. They consume primarily plant-based diets.

That suggests eggs may be healthier as part of a primarily plant-based diet than they are as part of the typical American diet. Are eggs good for you? Yes, eggs are healthy. It’s the sausage, bacon, ham, breakfast muffin, and biscuits that are the problem.

For more information on heart healthy diets, read my book “Slaying The Food Myths.”

For more details on this study, read the article above:

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Comments (1)

  • Dr. Steve Chaney

    |

    Dear Geoff,

    I am not familiar with that study.

    Dr. Chaney

    Reply

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Latest Article

Are Pregnant Women and Children Dangerously Deficient in Omega-3s?

Posted August 13, 2019 by Dr. Steve Chaney

What Is The Omega-3 Status Of The American Population?

Author: Dr. Stephen Chaney

 

pregnant women omega 3 deficient fishIt is no secret that the American population is deficient in omega-3s. Numerous studies have documented that fact. There are many reasons for Americans’ low intake of omega-3s:

  • The high price of omega-3-rich fish.
  • Concerns about sustainability, heavy metal contamination, and/or PCB contamination of omega-3 rich fish.
  • Misleading headlines claiming that omega-3 supplements are worthless and may even do you harm.

Of course, the questions you are asking are probably?

  • How deficient are we?
  • Does it matter?

The latest study (M Thompson et al, Nutrients, 2019, 11: 177, doi: 10.3390/nu11010177) goes a long way towards answering those important questions.

How Was The Study Done?

scientific studyThis study used data on 45,347 Americans who participated in NHANES surveys between 2003 and 2014. (NHANES or National Health and Nutrition Examination Surveys is a program run by the CDC that is designed to assess the health and nutritional status of adults and children living in the United States).

EPA and DHA intake from foods was based on the average of two 24-hour dietary recall interviews. Trained dietary interviewers collected detailed information on all foods and beverages consumed during the past 24 hours.

To assess EPA and DHA intake from supplements study participants were asked what supplements they had taken in the past 30 days, how many days out of 30 they had taken it, and the amount that was taken on those days.

 

What Is The Omega-3 Status Of The American Population?

 

omega 3 statusThe results of the NHANES surveys were shocking.

In terms of total EPA+DHA intake:

  • EPA+DHA intake across all age groups was lower than recommended.
  • Toddlers (ages 1-5), children (ages 6-11), and adolescents (ages 12-19) had lower EPA+DHA intakes than adults (ages 20-55) and seniors (ages > 55).
  • Women had lower EPA+DHA intakes than men.
  • Pregnant women and women of childbearing age did not differ in their EPA+DHA.
  • Pregnant women consumed less fish than women of childbearing age (perhaps because of concerns about heavy metal contamination).
  • Pregnant women consumed more omega-3 supplements.

In terms of EPA+DHA from supplements:

  • Less than 1% of the American population reported using omega-3 supplements.
  • The one exception was pregnant women. 7.3% of pregnant women reported taking an omega-3 supplement.
  • People taking omega-3 supplements had significantly higher EPA+DHA intake than people not taking omega-3 supplements.
  • This was also true for pregnant women. Those taking omega-3 supplements had higher EPA+DHA intake.

Of course, like any clinical study, it has strengths and weaknesses.

The biggest weakness of this study is that omega-3 intake is based on the participants recall of what they ate. The strengths of the study are its size (45,347 participants) and the fact that its estimate of omega-3 intake is consistent with several smaller studies.

 

Are Americans Deficient In Omega-3s?

 

pregnant women omega 3 deficient questionsNow we are ready to answer the questions I posed at the beginning of this article. Let’s start with the first one: “How deficient are we?”

You would think the answer to that question would be easy. It is not. This study provides a precise estimate of American’s omega-3 intake. The problem is there is no consensus as to how much omega-3s we need. There is no RDA for omega-3s.

There are, in fact, three sets of guidelines for how much omega-3s we need, and they disagree.

  • The World Health Organization (WHO) recommendations for EPA+DHA intake range from 100-150 mg/day at ages 2-4 years to 200-500 mg/day for adults.
  • The US National Institute of Medicine (IOM) recommendations for EPA+DHA intake range from 70 mg/day for ages 1-3 to 110 mg/day for adult females and 160 mg/day for adult males.
  • As if that weren’t confusing enough, an international group of experts recently convened for a “Workshop on the Essentiality of and Recommended Dietary Intakes for Omega-6 and Omega-3 Fatty Acids” (Workshop). This group recommended an EPA+DHA intake of 440 mg/day for adults and 520 mg/day for pregnant and lactating women.

Using these recommendations as guidelines, this study reported that:

  • EPA+DHA intake for children 1-5 years old was ~25% of the WHO recommendations and ~40% of IOM recommendations.
  • EPA+DHA intake for children 6-11 years old was ~27% of WHO recommendations and ~40% of IOM recommendations.
  • EPA+DHA intake for adolescents 12-19 years old was ~50% of IOM recommendations (The WHO did not have a separate category for adolescents.
  • EPA+DHA intake for adults 20-55 years old was ~30% of WHO recommendations, and ~65% of IOM recommendations.
  • EPA+DHA intake for seniors >55 years old was 38% of WHO recommendations and 82% of IOM recommendations.
  • EPA+DHA intake for pregnant women was ~20% of Workshop recommendations (The WHO and IOM did not have a separate category for pregnant women).

While the percentage deficiency varied according to the EPA+DHA guidelines used, it is clear from these results that Americans of all age groups are not getting enough omega-3s from their diet.

The authors concluded: “We found omega-3 intakes across all age groups was lower than recommended amounts.”

 

Are Pregnant Women and Young Children Dangerously Deficient In Omega-3s?

 

danger symbolWhile the authors concluded that all age groups were deficient in omega-3s, they were particularly concerned about the omega-3 deficiencies in pregnant women and young children.

The authors said: “Taken together, these findings demonstrate that low omega-3 fatty acid intake is consistent among the US population and could increase the risk for adverse health outcomes, particularly in vulnerable populations (e.g., young children and pregnant women).”

In part, the focus on young children and pregnant women was based on their very low omega-3 intake. With intakes at 20-27% of recommended levels, I would consider these groups to be dangerously deficient in omega-3s.

pregnant women omega 3 deficient pregnancyHowever, the focus on young children and pregnant women was also based on the seriousness of the adverse health outcomes associated with low omega-3 intake in these population groups. This answers the second question I posed at the beginning of this article: “Does it matter?”

According to the authors low intake of EPA and DHA during pregnancy and early childhood is associated with maternal depression, pre-term births, low birth-weight babies, increased risk of allergies and asthma, problems with learning and cognition, and other neurocognitive outcomes.

None of these associations between low omega-3 intake and adverse health outcomes have been proven beyond a shadow of a doubt, but the evidence is strong enough that we should be alarmed by the very low omega-3 intake in pregnant women and young children.

There is, however, a simple solution. The authors of this study concluded: “Individuals taking EPA/DHA containing supplements had significantly elevated intake compared to individuals not taking omega-3 fatty acid-containing supplements or not reporting any supplement use.”

omega 3 supplementsThey went on to say: “As supplement use is associated with increased omega-3 intake, supplementation could be an important source of EPA/DHA, particularly for pregnant women given their lower fish consumption compared to non-pregnant women of childbearing age.”

I agree. Given the low omega-3 intake in these population group and current guidelines for omega-3 intake. I recommend:

  • Pregnant & lactating women (and women of childbearing age who might become pregnant) take an omega-3 supplement providing around 520 mg of EPA+DHA/day.
  • Young children (ages 1-5) take an omega-3 supplement providing around 100 mg of DHA/day.

Of course, this study also confirmed that Americans of all age groups are not getting enough omega-3s from their diet, and low omega-3 intake may increase the risk of heart disease. Furthermore, recent studies have shown that high purity omega-3 supplements may reduce heart disease risk.

You will find my recommendations for omega-3 supplementation for adults in a previous issue of “Health Tips From the Professor.”

 

The Bottom Line

 

The largest study to date (45,347 participants) measured omega-3 intake for Americans of all ages and compared that to current recommendations for omega-3 intake.

The authors of the study concluded:

  • “We found omega-3 intakes across all age groups was lower than recommended amounts.”
  • “Low omega-3 fatty acid intake … could increase the risk for adverse health outcomes, particularly in vulnerable populations (e.g., young children and pregnant women.”

In part, the focus on young children and pregnant women was based on their very low omega-3 intake. With intakes at 20-27% of recommended levels, I would consider these groups to be dangerously deficient in omega-3s.

However, the focus on young children and pregnant women was also based on the seriousness of the adverse health outcomes associated with low omega-3 intake in these population groups.

  • According to the authors low intake of EPA and DHA during pregnancy and early childhood is associated with maternal depression, pre-term births, low birth-weight babies, increased risk of allergies and asthma, problems with learning and cognition, and other neurocognitive outcomes.

There is, however, a simple solution. The authors of this study also concluded:

  • “Individuals taking EPA/DHA containing supplements had significantly elevated intake compared to individuals not taking omega-3 fatty acid-containing supplements or not reporting any supplement use.”
  • “As supplement use is associated with increased omega-3 intake, supplementation could be an important source of EPA/DHA, particularly for pregnant women given their lower fish consumption compared to non-pregnant women of childbearing age.”

For more details on the study and my recommendations for omega-3 supplementation, read the article above.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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