On the one hand, the guidelines say that "cholesterol is not a nutrient of concern for overconsumption;" but on the other hand, the guidelines say that "individuals should eat as little dietary cholesterol as possible while consuming a healthy eating pattern".
Although previous studies on egg consumption found that eggs did not increase the risk of heart disease, the studies did not have a diverse sample and were short-term studies that did not adjust for other parts of the diet, Norrina Allen, co-author and associate professor of preventive medicine, said in a press release.
"The fact that studies outside the USA appear to show favorable relationships with egg intake and cardiovascular risk may speak to the importance of what other foods are consumed with eggs as part of the overall diet pattern, as recent research has demonstrated the importance of separating eggs from other foods to understand their independent impact on health outcomes", Rubin said in a statement.
Eggs are a leading source of dietary cholesterol, which once was thought to be strongly related to blood cholesterol levels and heart disease. However, the guidelines omit a daily limit for the substance.
The new research makes a strong case for bringing that limit back. Participants were asked about their dietary habits over the last month or year in an extensive questionnaire.
The study can not prove cause and effect and is unlikely to be the last word on the matter, but experts said moderation was probably the safest course, advising no more than three or four eggs a week.
The egg yolk is full of cholesterol.
The new data suggest that eating eggs increases the risk of heart attack or stroke, although the study does not establish a causal link.
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"Our study showed if two people had the exact same diet and the only difference in diet was eggs, then you could directly measure the effect of the egg consumption on heart disease", Allen said.
Why is there so much conflicting guidance on eggs?
"I can totally understand that people would be confused and frustrated", Dr. Leslie Cho, a preventive cardiologist at Cleveland Clinic, told CBS News. "They are not free from industry bias", she said. "Because I don't. It's the same thing with patients". That's because unlike a randomized controlled trial that tests the safety and efficacy of a drug, it's hard to randomly control what people eat over a long period of time, especially with a large sample size.
The researchers based their conclusions on what participants said they ate at the start of each study.
"In science, the way it works is we don't think of it as one study having the final word", she said.
Eggs in moderation is generally considered a good addition to a daily diet.
"A more appropriate recommendation would be eating egg whites instead of whole eggs or eating whole eggs in moderation, for the goal of reducing risk of cardiovascular disease and death", he said. One large egg yolk has 186 milligrams of cholesterol.
"The old advice still stands, eggs in moderation are absolutely fine as a useful source of protein. For example, poached eggs on whole-grain toast is a much healthier meal than a traditional fry up". "This is the diet we should be adopting".
"Time and time again, it's been shown to improve survival", Cho said.
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