35Evidence B

No need to quit eggs; within one per day is fine

Eating half an extra whole egg per day increases the risk of death by approximately 7%. Replacing this half egg with egg whites, fish, poultry, or nuts actually results in a lower risk of death. However, another set of studies found no apparent link to cardiovascular disease within the limit of one egg per day, so there is no need to abstain from eggs.

Cost

No cost involved, and it takes no extra time.

Benefit

A US follow-up study of 521,000 people, with a total of 129,000 deaths. Eating half an extra whole egg every d…

Cost

No cost involved, and it takes no extra time.

Benefit

A US follow-up study of 521,000 people, with a total of 129,000 deaths. Eating half an extra whole egg every day increases the risk of death by about 7% (Hazard Ratio 1.07, 95% CI 1.06–1.08, which is the confidence interval). Replacing this half whole egg with an equal amount of egg whites, poultry, fish, dairy products, or nuts and legumes results in an even lower risk of death, and the risks of death from cardiovascular, cancer, and respiratory systems are also lower. Opposing view: Three large US studies involving a total of 216,000 people, with the longest follow-up of 32 years. Compared to those eating less than one egg per month, people eating at least one egg per day showed no difference in cardiovascular disease risk (HR 0.93, 95% CI 0.82–1.05). Combining 33 sets of data from the same paper involving 1.72 million people, eating one extra egg per day also showed no change in cardiovascular disease risk (RR 0.98, 0.93–1.03). The authors' conclusion is that eating up to one egg per day has no association with cardiovascular disease.

Original sources

Zhuang P, Wu F, Mao L, et al. (2021). Egg and cholesterol consumption and mortality from cardiovascular and different causes in the United States: A population-based cohort study. PLoS Medicine, 18(2), e1003508. https://doi.org/10.1371/journal.pmed.1003508;Drouin-Chartier JP, Chen S, Li Y, et al. (2020). Egg consumption and risk of cardiovascular disease: three large prospective US cohort studies, systematic review, and updated meta-analysis. BMJ, 368, m513. https://doi.org/10.1136/bmj.m513;U.S. Department of Health and Human Services, U.S. Department of Agriculture (2015). 2015–2020 Dietary Guidelines for Americans, Chapter 1:「The Key Recommendation from the 2010 Dietary Guidelines to limit consumption of dietary cholesterol to 300 mg per day is not included in the 2015 edition, but this change does not suggest that dietary cholesterol is no longer important to consider」「individuals should eat as little dietary cholesterol as possible while consuming a healthy eating pattern」. https://www.dietaryguidelines.gov/sites/default/files/2019-05/2015-2020_Dietary_Guidelines.pdf

Open source link
Book note

There is great controversy: there are also long-term follow-up studies of large populations, as well as meta-analyses of multiple studies, which found no link between one egg per day and cardiovascular disease. The 2015 version of the US Dietary Guidelines removed the upper limit of 300 mg of cholesterol per day. However, it simultaneously states that this does not mean cholesterol is unimportant, and that one should eat as little as possible under the premise of eating healthily. One egg a day, as it currently appears, has no association with cardiovascular disease. The 'within one per day' in the title is based on this result; higher consumption has not been directly tested in the studies discussed here.

My note