Regarding eggs, dietary cholesterol, and health - from ironaddicts.com

A common question raised by weight lifting athletes concerns the relationship between dietary cholesterol and health. Whether it is from a friend, a family member, television, or a registered dietician, many of us have heard the warnings about eating too many eggs, too much meat, or the perils of a high fat diet.

Now, if you frequent this board, you’ve probably read views of others here who don’t buy into this perspective, but this often leads to debates centered on feelings and opinions rather than anything more objective.

So, let’s look at something more objective. What do the actual data tell us?

In this month’s issue of Current Atherosclerosis Reports (Volume 11, Number 6 / November, 2009, page 418-22), is a systematic review of the prospective studies addressing the relationship between dietary cholesterol and heart disease. Here is the key table from the article summarizing the data.

Study Patients, n Follow-up Outcome Adjusted RR (95% CI)
Shekelle and 1824 men 25years CHD death 1.38(1.00-1.90)
Stamler

Hu et al. 80,082 women 14 years CHD 1.17 (0.92–1.50) for 5th vs 1st
quintile of dietary cholesterol

Ascherio et al. 43,757 men 6 years Total CHD 1.03 (0.81–1.32)

Djousse and
Gaziano 21,327 men 20 years MI 0.90 (0.72–1.14) for ≥ 7 eggs/wk
vs < 1 egg/wk

Hu et al. 37,851 men 8 years CHD Men: 1.08 (0.79–1.48) for ≥ 7
eggs/wk vs < 1 egg/wk
80,082 women 14 years Women: 0.82 (0.60–1.13) for ≥ 7
eggs/wk vs < 1 egg/wk

Mann et al. 10,802 both 13.3 years CHD death 2.7 (1.2–6.0) for ≥ 6 eggs/wk
vs < 1 egg/wk
CHD=Coronary heart disease RR=Risk ratio MI=Myocardial infarction


What does the above mean?
• First, of the seven studies addressing this relationship, only one (Mann et al) found a significant relationship, a second (Shekelle) found a borderline relationship, and 5 found no evidence of a relationship at all.
• Second, in the four largest studies, each with more than 20,000 participants, none observed a significant relationship.
• Third, there is no consistent evidence in either men or women for a relationship between dietary cholesterol and heart disease.
• Finally, the comparisons in these studies were intentionally extreme, designed to find relationships if they existed. For example, comparing those who ate eggs everyday versus those who almost never did (Hue et al). Even with these extreme differences in dietary cholesterol intake, however, these studies still didn’t find differences in heart disease risk.

For the take home, I’ll quote the concluding paragraph from the article, which reads:

“It is reasonable to conclude that there is little evidence supporting a major association between dietary cholesterol and CHD risk in the general population.”