The Relationship between Egg Consumption and Blood Cholesterol Level

Abstract

Hypercholesterolemia as well as prevalence and mortality from ischemic heart disease is an important issue among Thai people.  Until recently the recommendations to control blood cholesterol level usually involve controlling cholesterol in the diet especially the amount of eggs consumed. In 2015, the United States Department of Agriculture has released the latest dietary recommendation on optimizing blood cholesterol which has been surprisingly changed. It is reported that dietary cholesterol has no effect on blood cholesterol level. This poses a critical question on how this recommendation applies to Thai setting. This narrative review on the effect of egg consumption on blood cholesterol includes various research designs i.e. intervention studies including randomized controlled trial in healthy subjects and in the patients, meta-analysis in the patients, and clinical studies in Thai patients. Observational studies include cohorts, mixed cohorts and cross-sectional studies, case-control studies as well as expert opinions, whose conclusions being various i.e. no need to control, safe at the intake of no more than one egg per day, or concern on the danger of the uncontrolled intake of eggs.  The review addresses these following 7 issues: how to interpret the communication about the result of egg consumption from various research, the maximum level of egg intakes from observational studies, the difference in response to dietary cholesterol consumption by age and gender, the difference in response by healthy or diseased subjects, comparison of the results from different research designs, and lastly the issue on conflict of interest. In conclusion, egg consumption may be recommended not to exceed an average of 1 egg per day in healthy Thai population whereas diabetic and/or dyslipidemic patients should consult their physicians on egg consumption and the intake preferably should not be greater than 1 egg per day or 7 eggs per week.