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A small study finds that fortified eggs may not increase cholesterol levels. Gregory Adams/Getty Images
  • People who ate 12 fortified eggs per week had similar cholesterol levels after four months as people who ate fewer than two eggs per week.
  • The study was small, but suggests that fortified eggs may be a heart-healthy addition to the diet, even for people with or at risk of heart disease.
  • Experts recommend that eggs be eaten in moderation due to their high cholesterol content.

While eggs are a nutritious, lean source of protein, they contain high amounts of cholesterol. So do they fit in a heart-healthy diet?

A new study suggests that, yes, moderate consumption of eggs may be good for your heart. However, experts caution that people with existing heart disease or diabetes should talk to their doctor about what will work specifically for them.

In the preliminary study, researchers found that people who ate 12 fortified eggs per week had similar cholesterol levels after four months compared to those who ate fewer than two eggs of any kind per week.

“This is a small study, but it gives us reassurance that eating fortified eggs is okay with regard to lipid effects over four months, even among a more high-risk population,” study author Dr. Nina Nouhravesh, a research fellow at the Duke Clinical Research Institute in Durham, North Carolina, said in a news release.

The study, which will be presented April 6 at the American College of Cardiology’s Annual Scientific Session, involved 140 people 50 years of age or older who had cardiovascular disease or were at high risk for it.

Risk factors for cardiovascular disease include high blood pressure, high cholesterol, obesity, and diabetes.

The average age of participants was 66 years, around half were female, and just over one-quarter were Black. Almost one-quarter of participants had diabetes.

Researchers randomly assigned people to eat either 12 fortified eggs per week or to eat fewer than two eggs of any kind per week. People could cook the eggs however they liked.

Michelle Routhenstein, a preventive cardiology dietitian at EntirelyNourished.com, cautions that when eggs are cooked at high temperatures, it can result in higher levels of advanced glycation end products (AGEs), which may negatively impact heart health.

Fortified eggs contain less saturated fat and additional vitamins and minerals, such as iodine, vitamin D, selenium, vitamin B2, vitamin B5, vitamin B12, and omega-3 fatty acids. This is accomplished by feeding hens a special diet.

In the study, after following participants for four months, researchers did not see any adverse effects on cardiovascular health among people who ate 12 fortified eggs per week.

For example, blood cholesterol levels were similar between people who regularly ate fortified eggs and those who ate few or no eggs.

People in the fortified egg group also had a reduction in their total cholesterol level, insulin resistance scores, and high-sensitivity troponin (a marker of heart damage). They even saw an increase in their vitamin B levels.

In addition, “there were signals of potential benefits of eating fortified eggs that warrant further investigation in larger studies,” Nouhravesh said in the release.

In particular, there were possible benefits of eating fortified eggs among older adults and those with diabetes, including a rise in HDL (“good”) cholesterol and a decrease in LDL (“bad”) cholesterol.

The results of the study, which was funded by Eggland’s Best, have not been published yet in a peer-reviewed journal, so should be viewed with caution.

Dr. Yu-Ming Ni, cardiologist and lipidologist at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, Calif., is pleased that researchers carried out this kind of study.

Many earlier studies looking at the impact of egg consumption on cholesterol or cardiovascular disease risk were observational.

The new study was a randomized controlled trial — the “gold standard” for research — in which people were randomly assigned to eat more eggs or to limit their egg consumption, with ongoing follow-up of participants.

“We don’t commonly see clinical trials in the nutrition space,” Ni told Healthline. However, “there are enough issues with this study that it’s hard to make strong conclusions about whether eggs are healthy or not.”

One of these issues is the small number of participants. Ni said you would need a larger study to be able to see differences between the egg group and the low-egg group, such as changes in cholesterol levels.

Dr. Nieca Goldberg, a cardiologist and clinical associate professor of medicine at NYU Grossman School of Medicine in New York City, said a larger study would also be needed to know if the heart-related risks of egg consumption were different for people with diabetes versus those without diabetes.

Participants also knew which study group they were in, which could have influenced what they ate overall or their other health behaviors.

When it comes to egg consumption and risk of cardiovascular disease, past research has been mixed. This is due in part to how studies were carried out, including how well they took into account all the factors that can affect the outcomes.

For example, a 2022 review and meta-analysis of earlier studies found that eating one extra egg per day may significantly increase people’s risk of cardiovascular disease.

In contrast, a 2020 review and meta-analysis found that eating up to one egg per day was not associated with an increased risk of cardiovascular disease and might even decrease that risk in Asian populations.

Similarly, a 2020 study observed no significant connection between eating an extra half an egg per day and the risk of death overall or from heart disease.

So, it’s complicated — because people’s diets are complicated.

Our bodies are complex, too.

“In healthy individuals, when foods containing cholesterol are consumed, the liver decreases its own production of cholesterol,” Routhenstein told Healthline. “Therefore, eggs can be included in a heart-healthy diet without significant concern over their cholesterol content.”

Goldberg emphasizes that eggs are an excellent lean source of protein and contain many micronutrients such as B vitamins, choline, and omega-3 fatty acids.

“I wouldn’t eat five eggs a day, but an egg or two a day won’t necessarily increase one’s risk for heart disease,” she told Healthline.

However, people should keep in mind that one large egg contains 186 milligrams of cholesterol.

Previous federal dietary guidelines recommended eating no more than 300 milligrams of cholesterol per day, which is less than two eggs per day.

Current guidelines suggest keeping dietary cholesterol consumption “as low as possible without compromising the nutritional adequacy of the diet.”

“When I talk to my [heart disease] patients about their diet, I tell them to be careful with eggs because of the high cholesterol,” said Ni. “I do allow people to eat up to one egg a day, and they can lump them together on the weekend, if they want.”

Another option is to eat egg whites, he said, which have very little cholesterol because the yolk has been removed. Or you can scramble together one egg with one egg white, which will provide additional protein while keeping the cholesterol lower.

Goldberg also pointed out that “when it comes to the question of eggs, it’s not just about the egg, it’s what you pair them with.”

“People often combine eggs with bacon, sausage and croissants, which contain saturated fats,” she said. “Processed meats like bacon and sausages also contain lots of salt.”

Routhenstein agrees that “it’s important to focus on the big picture.” She suggests “combining eggs with other nutrient-rich, heart-healthy options like beans, vegetables and whole grains.”

In addition, the health risks of eggs — and how many eggs per week you can safely eat — may differ for people with diabetes or specific types of cardiovascular disease.

”So I think it’s really important for people to discuss [eating eggs] with their doctor,” said Goldberg.

Researchers randomly assigned people to eat 12 fortified eggs per week or fewer than two eggs of any kind per week. After four months, cholesterol levels were similar between the two groups.

This suggests that eggs may be a heart-healthy addition to the diet, even for people with cardiovascular disease or at risk for it. The study was small, so additional research will be needed to confirm the results.

While moderate consumption of eggs is safe for most healthy people, experts recommend that people with heart disease or diabetes talk to their doctor about whether eggs can be a healthy addition to their diet.