For most healthy adults, the cholesterol in eggs has a smaller effect on blood cholesterol than was believed for decades. Large studies find no link between eating up to one egg a day and heart disease, and the American Heart Association says healthy people can include about one egg a day in a heart-healthy diet. Three eggs every day is a different question: the evidence there is thinner, and if you have high cholesterol, diabetes or heart disease, it is worth asking your doctor first.
How much cholesterol is in an egg?
A medium to large egg has roughly 185–200 mg of cholesterol, almost all of it in the yolk. Three eggs therefore bring 550–600 mg. For years, many guidelines advised staying under 300 mg a day, which made eggs look like a problem food.
That limit has since been dropped in several places. When the European Food Safety Authority (EFSA) set its reference values for fats in 2010, it chose not to set a separate value for dietary cholesterol. The focus moved to saturated and trans fats, which have a bigger effect on blood cholesterol. The World Health Organization advises keeping saturated fat below 10% of daily energy.
An egg itself contains a modest amount of saturated fat. What often matters more is what comes with it: butter, bacon, sausages, halloumi fried in oil.
Does eating cholesterol raise your blood cholesterol?
A little, and less than most people expect. Most of the cholesterol in your blood is made by your own liver and cells, not taken from food. When you eat more cholesterol, the body usually absorbs a smaller share and makes less of its own.
The effect is not zero, though. A science advisory from the American Heart Association (Carson and colleagues, 2020) pooled controlled feeding trials and found a dose-response: on average, every extra 100 mg of dietary cholesterol a day raised LDL ("bad") cholesterol by roughly 2 to 4.5 mg/dL, depending on the model. That is a small average change, but people differ.
The European Food Information Council (EUFIC) notes that about 3 in 10 people absorb more cholesterol from food because of their genes. In these "hyper-responders", eggs can raise LDL more. You cannot tell which group you are in without a blood test.
What do large studies find about eggs and heart disease?
The results are mixed, which is part of why the topic keeps returning to the news.
- Up to one egg a day: no clear link. A 2020 analysis in the BMJ (Drouin-Chartier and colleagues) followed more than 200,000 US health professionals for up to 32 years, then combined the results with other studies covering up to 1.7 million people. Eating at least one egg a day was not linked to a higher risk of heart disease or stroke. An earlier 2013 BMJ meta-analysis (Rong and colleagues) reached a similar conclusion.
- One analysis did find a link. A 2019 study in JAMA (Zhong and colleagues) pooled six US cohorts and found that each extra half egg a day was associated with about a 6% higher risk of cardiovascular disease.
- People with diabetes. In the 2013 BMJ meta-analysis, people with diabetes who ate the most eggs had a higher risk of coronary heart disease than those who ate the fewest. The 2020 analysis did not see this. The question is open.
All of these are observational studies. They show associations, not cause and effect. People who eat many eggs may also eat more processed meat or fewer vegetables, and researchers can only partly adjust for that.
And three eggs a day specifically?
Here the evidence is small. A 2017 study in the Journal of Nutrition (DiMarco and colleagues) gave 38 healthy adults aged 18 to 30 zero, then one, two and three eggs a day, for four weeks at each step. Compared with no eggs, LDL did not rise and HDL ("good") cholesterol went up slightly.
That sounds reassuring, but keep the limits in mind: 38 young, healthy people, a few weeks at each level, no random order of the doses, and funding from the egg industry's Egg Nutrition Center. It tells us little about older adults, people with high cholesterol, or decades of eating three eggs a day.
So how many eggs are fine?
The American Heart Association's 2020 advisory gives a practical guide:
- Healthy adults: up to about one whole egg a day (or the equivalent) within a heart-healthy diet.
- Older adults with normal cholesterol: up to two eggs a day, again within a healthy diet, since eggs are an easy, affordable source of protein.
EUFIC suggests that most healthy adults can fit one to two eggs a day into a balanced diet.
If you enjoy three eggs a day, a sensible step is to check your cholesterol before you start and again a few months later. Your own numbers tell you more than any average.
Talk to your doctor first if you have high LDL cholesterol (including familial hypercholesterolaemia), diabetes, or heart disease, or if you take cholesterol-lowering medication.
How can I eat eggs in a heart-friendlier way?
- Boil, poach or scramble with a little olive oil instead of frying in butter.
- Pair them with vegetables, tomatoes, greens or wholegrain bread rather than bacon, sausages or processed meat.
- If you want a bigger portion, mix one whole egg with extra egg whites, which contain almost no cholesterol.
- Look at the whole week: eggs in cakes, pies and pastries count too.
FAQ
Should I only eat egg whites?
Not necessarily. The yolk holds the cholesterol, but also most of the egg's vitamins and other nutrients. For most healthy people, whole eggs in moderate amounts are fine. If your doctor has asked you to lower your cholesterol, mixing whole eggs with whites is a simple compromise.
Do eggs raise "good" HDL cholesterol?
Some small trials have seen a slight rise in HDL with eggs. That alone does not make eggs good for the heart, because a higher HDL number on its own is no longer seen as proof of protection. Look at the full blood test with your doctor.
I have type 2 diabetes. Can I eat eggs?
Many people with diabetes do eat eggs, but the studies are mixed, and one meta-analysis linked high egg intake to higher heart risk in this group. Agree on an amount with your doctor or dietitian, especially if you also have high cholesterol.
Sources: EFSA, Scientific Opinion on Dietary Reference Values for fats, including cholesterol (EFSA Journal 2010, 8(3):1461), Carson JAS et al., Dietary Cholesterol and Cardiovascular Risk: A Science Advisory From the American Heart Association, Circulation 2020, 141:e39–e53, Drouin-Chartier JP et al., Egg consumption and risk of cardiovascular disease: three large prospective US cohort studies, systematic review, and updated meta-analysis, BMJ 2020, 368:m513, Rong Y et al., Egg consumption and risk of coronary heart disease and stroke: dose-response meta-analysis of prospective cohort studies, BMJ 2013, 346:e8539, Zhong VW et al., Associations of Dietary Cholesterol or Egg Consumption With Incident Cardiovascular Disease and Mortality, JAMA 2019, 321(11):1081, DiMarco DM et al., Intake of up to 3 Eggs per Day Is Associated with Changes in HDL Function and Increased Plasma Antioxidants in Healthy, Young Adults, Journal of Nutrition 2017, 147(3):323, EUFIC, Should you avoid eggs because they're high in cholesterol?
