Eggs are a nutritious and inexpensive staple of diets around the world. However, they have long been controversial because of their cholesterol-packed yolks.

The relationship between cholesterol from eggs and cholesterol levels in the body is complicated. Understanding how cholesterol works and its relationship with egg consumption may help a person follow a healthy diet.

This article reviews the growing body of evidence suggesting that eggs are actually healthy to include in the diet and do not raise cholesterol for most people.

It also looks at cholesterol levels in eggs and presents a few egg alternatives to consider.

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The liver naturally produces cholesterol. It is a fatty compound in every cell, and the body needs it to stay healthy.

The body needs cholesterol for several processes. It is a structural molecule in cell membranes, and the body needs it to produce bile for digestion, vitamin D, and steroid hormones, such as estrogens and testosterone.

The liver produces enough cholesterol to supply the body’s needs. However, a person can also consume cholesterol in their diet. If someone consumes foods high in cholesterol, their liver responds by slowing down cholesterol production.

This balances out cholesterol levels and keeps them constant, meaning that dietary sources of cholesterol, including eggs, typically have minimal impact on blood cholesterol.

Nevertheless, this waxy compound has a bad reputation because of its links to coronary heart disease and stroke.

The story behind cholesterol and its effects on human health is complex, partly because there are different versions of this molecule that act differently in the body. These may lead to healthy or unhealthy effects when their levels change.

As part of normal body processes, molecules called lipoproteins combine with cholesterol to carry it in the blood.

There are two general types of cholesterol, depending on the type of lipoprotein they are attached to. These are low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol.

LDL cholesterol

When people talk about the negative health effects of cholesterol, they are often referring to total cholesterol levels and the levels of a type generally known as LDL cholesterol.

This is what people consider to be the “bad” type of cholesterol.

If there is too much LDL cholesterol in a person’s blood, it can stick to their blood vessel walls. Over time, this buildup of cholesterol can form plaques that narrow the arteries. This makes it harder for blood to flow through, increasing the risk of heart attack and stroke.

HDL cholesterol

People consider HDL cholesterol to be the “good” cholesterol. It helps keep bad cholesterol levels in check by transporting it to the liver, which recycles or removes it from the body.

A large body of recent research has suggested that consuming cholesterol in the diet, such as by eating eggs, is not associated with an increased risk of cardiovascular disease.

Research has suggested that elevated levels of total cholesterol and LDL cholesterol in the blood are associated with negative health effects, including cardiovascular disease. However, some studies have indicated that eating eggs does not significantly impact cholesterol levels in most people.

In fact, some studies have found that even though consuming eggs on a daily basis may lead to marginal increases in LDL, it also increases HDL. This means that the total cholesterol to HDL ratio, an important predictor of heart disease, remains steady.

In the past, healthcare professionals advised people to limit the number of eggs or egg yolks they ate to no more than three per week. The rationale behind this recommendation was that egg yolks are high in cholesterol.

Early researchers misunderstood the data and mistakenly concluded that dietary cholesterol directly contributed to raised blood cholesterol levels. Later researchers found this to be false.

Now, in light of recent evidence, health experts are changing their stances on eggs. In their 2015–2020 publication, the Dietary Guidelines for Americans removed the recommendation for people to limit their consumption of dietary cholesterol to under 300 milligrams (mg) per day.

A number of recent studies have confirmed that eating eggs as part of a healthy diet does not increase the risk of heart problems.

One of these studies looked at 177,000 people in 50 countries. It found no significant associations between egg intake and cholesterol levels, death rates, or major cardiovascular disease events. The study also found no significant link between how many eggs someone ate and their cholesterol levels.

A 2019 study in the journal Circulation found that eating eggs was not associated with ischemic heart disease. Moreover, the researchers found that substituting red and processed meats with fish, dairy, or eggs was associated with a 20% lower risk of ischemic heart disease.

The American Heart Association (AHA) published a scientific advisory in 2020 that concluded that healthy people could safely eat a whole egg daily. They also approved two eggs daily for healthy older adults because of the overall nutritional benefits and convenience of eggs.

There is a lack of information regarding high egg consumption levels, as research tends to focus on consuming one or two eggs daily.

However, one case study reported that an 88-year-old man ate 25 eggs daily. His cholesterol levels were normal, and he was in good health. Bear in mind that these findings do not demonstrate that eating a large number of eggs per day is healthy for everyone.

Around 25% of people are hyper-responders, or non-compensators. These people have bodies that are more sensitive to dietary cholesterol, and consuming cholesterol-rich foods can significantly impact their blood cholesterol levels.

However, studies show that the LDL to HDL ratio remains steady after cholesterol intake in hyper-responders. This means that even though cholesterol levels may increase in response to dietary cholesterol in hyper-responders, these changes are unlikely to increase heart disease risk.

Also, it is important to note that even though most people can enjoy cholesterol-rich foods, everyone is different. People with certain genetic mutations that affect their cholesterol levels may need to follow a reduced cholesterol diet in order to maintain healthy blood levels.

Overall, it seems that eating eggs is safe for most people. However, as with all foods, people should consume eggs in moderation and as part of a balanced diet.

The AHA state that one large egg contains around 186 mg of cholesterol. An article in the journal Nutrition expands on this figure, explaining that eggs may contain 141–234 mg each.

The United States Department of Agriculture (USDA) classify eggs by size. Peewee eggs, for example, weigh around 15 ounces (oz) (425 grams [g]) per dozen, whereas jumbo eggs weigh around 30 oz (850 g) per dozen. That is around 1.25 oz (35 g) per peewee egg and 2.5 oz (70 g) per jumbo egg.

The USDA FoodData Central database lists that 3.5 oz (100 g) of whole egg contains 372 mg of cholesterol. Logically, the larger the egg, the more cholesterol it contains.

The database also confirms that egg whites do not contain cholesterol. This means that people who do not want to consume cholesterol in eggs can still add egg whites to their diet.

Some people may want to replace eggs with substitutes in their baking and cooking, perhaps because they follow a vegan diet or have an egg allergy or intolerance.

The sections below will describe some alternatives.

Cholesterol-free egg substitutes

This commercial, processed preparation usually comes in cartons and resembles beaten eggs. Because it usually contains egg whites, it is not suitable for vegans.

These substitute products also tend to contain either natural or artificial colorings and flavorings, plus thickeners, such as xanthan and guar gum.

Egg whites

For non-vegans, egg whites can substitute whole eggs. There are dried, commercial versions available, or people can use fresh egg whites after removing the yolk.

Homemade substitutes

For vegans and those who would prefer to use a homemade egg substitute, there are various options available.

For example, a person can use tofu in quiches or “scrambled eggs,” bananas work well in sweet, baked products, and ground flaxseed can act as a thickener in place of eggs.

Historically, people have debated whether the cholesterol in eggs leads to unhealthy consequences.

However, a large body of recent research has suggested that a healthy diet can include eggs. For most people, eggs will not have an impact on their blood cholesterol levels or overall health.

People who do not want to include eggs in their diet can use a range of egg alternatives. These include egg white substitutes, whole egg substitutes, and vegan options.