In recent years, there has been a growing perception that eggs and dietary cholesterol aren’t as bad as we once thought. But a large new study calls this into question.

The study, published on March 15 by renowned medical journal JAMA, included 29,615 people who were followed for a median 17.5 years. The authors evaluated whether egg intake or dietary cholesterol was linked to a higher risk of cardiovascular disease or death from any cause.

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Their findings? The more eggs or cholesterol that participants consumed, the higher their risk of cardiovascular disease or death from any cause; there was a clear dose-response.

Specifically, each additional half of an egg per day was associated with a 6 percent increased risk of cardiovascular disease and an 8 percent increased risk of death over the course of the study. The risks were even more dramatic in women—13 percent higher risk of cardiovascular disease and 16 percent higher risk of death for each additional half an egg per day.

Each additional 300 milligrams of dietary cholesterol per day (1 egg contains about 186 milligrams of cholesterol) was linked to a 17 percent increased risk of cardiovascular disease and an 18 percent increased risk of death from any cause (not to mention a 14 percent higher risk of heart failure and a 26 percent higher risk of stroke). Again, the risk was magnified in women (28 percent higher risk of death from any cause).

What about people eating a diet that was healthy overall, with lots of fruits and vegetables? Notably, even these participants experienced a significantly higher risk of cardiovascular disease when they had an additional half an egg per day.

Of course, correlation does not equal causation, but these findings include adjustment for many variables and potential confounders, including age, sex, race, education, smoking, physical activity, and other dietary choices, and remained significant even after authors controlled for diabetes, body mass index, blood pressure, blood cholesterol, and other cardiovascular risk factors.

Bottom line: We have no biological requirement to consume cholesterol or eggs; indeed, this large study (among others) suggests that we are better off when we avoid them. Our bodies can make all the cholesterol we need, and we can get other nutrients found in eggs from healthier sources.

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about the author

Michelle McMacken, MD

Michelle McMacken, MD, is a board-certified internal medicine physician and an assistant professor of medicine at NYU School of Medicine. An honors graduate of Yale University and Columbia University College of Physicians and Surgeons, she has more than 14 years of experience practicing primary care, directing a medical weight-loss program, and teaching doctors-in-training at NYC Health + Hospitals/Bellevue. An enthusiastic supporter of plant-based nutrition, she is committed to educating patients, medical students, and doctors about the power of healthy eating and lifestyle modification. All opinions expressed by Dr. McMacken are her own and do not necessarily represent those of her hospital affiliations; neither she nor her affiliated hospitals have a financial relationship with Forks Over Knives.

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