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Going the ‘eggs’tra mile: How healthy is a meal containing eggs?

Rich in nutrients or high in cholesterol? A healthy snack or a guilty pleasure? As research continues to fuel confusion, HT attempts to decode the egg conundrum

health Updated: May 18, 2019 19:54 IST
Poulomi Banerjee
Poulomi Banerjee
Hindustan Times
egg,cholesterol,heart diseases
Eggs are a chief source of dietary cholesterol, but the association between regular egg consumption and risk of coronary heart disease and stroke are uncertain.(Shutterstock )

Why is Taron Egerton’s character in the 2014 release Kingsman (also starring Colin Firth) nicknamed Eggsy? Sadly, the film doesn’t ever explain. But wouldn’t it be the perfect nickname for many around us, simply because of their love for eggs?

Take Delhi resident Prithvi, for example. Last month the 38-year-old returned to the treadmill after a gap of 10 years. What prompted him was not his weight – which was touching 100 kg – or any real concern over the fact that he was beginning to pant every time he negotiated the flight of stairs to his second-floor apartment in south Delhi. Nor was it with any idea to lose the growing paunch that his wife had been cribbing about for years. “I had a routine medical check-up and my blood cholesterol level was high. Considering my weight issues, the doctor put all kinds of dietary restrictions on me, including cutting down my meat and eggs intake,” says Prithvi. “I don’t eat meat daily. But not having eggs was like a punishment. So I thought maybe if I lost some weight and became healthier, I could continue to have eggs,” he adds with a laugh.

Medical journals define cholesterol as a waxy substance in the blood, needed to build cells, among other things. It is of two kinds – high-density lipid (HDL) and low-density lipid (LDL). The problem arises when there is too much cholesterol in the blood (especially of the sticky LDL kind called bad cholesterol), which can then accumulate on the artery walls, choking them and increasing risks of heart attacks and other cardiac problems.

Root Of The Evil

In his 1906 novel Love Among The Chickens, PG Wodehouse asks, “Have you ever seen a man, woman, or child who wasn’t eating an egg or just going to eat an egg or just coming away from eating an egg? I tell you, the good old egg is the foundation of daily life.” For years, however, this ‘nature’s multivitamin’ as it is often referred to, for its rich store of nutrients, has been maligned because of its association with that dirty, scary ‘C’ word – cholesterol. A big egg (weighing about 50 gm) has about 184 mg of cholesterol, which is concentrated in the yolk.

“The simplistic reasoning was that cholesterol is not good for health, it gets deposited in the arteries, egg yolk contains a high level of cholesterol, so avoid eggs,” explains Dr Vikram Jaggi, director, Asthma, Chest & Allergy Centre, Delhi.

Scientists in America began researching the links between lifestyle, diet and cardiovascular diseases in humans from the 1940s. The Framingham Heart Study, under the direction of the National Heart, Lung and Blood Institute (formerly known as the National Heart Institute) is considered as one of the pioneering researches in this field. It began in 1948 in Massachusetts to identify factors that contribute to cardiovascular disease and is still on. In 1968, the American Heart Association (AHA) announced a dietary recommendation that all individuals should consume less than 300 mg of dietary cholesterol per day and not more than three whole eggs in a week. This American apprehension then spread to the rest of the world, depriving many an egg-lover of their favoured source of nourishment.

In a 2015 article, The 50 Year Rehabilitation of the Egg, available on the National Center for Biotechnology Information website, Donald J McNamara (former director of the Egg Nutrition Center) recalls the effect the AHA guideline had on consumption. “The egg industry was faced with a difficult situation... fight back and be accused of putting profits ahead of public health or simply give in to the dietary cholesterol phobia...” he writes. The decline in egg consumption finally “prompted the egg industry to establish the Egg Nutrition Center to promote research and initiate health education ...”.

According to a 2017 article on the National Public Radio website, Walter Willett of the Harvard TH Chan School of Public Health was one of the first physicians to realise that while cholesterol is associated with higher risks of heart disease, there was no proof that cholesterol consumption increased its levels in the blood. “Willett and his colleagues have since studied thousands of patients for years and have found no evidence that moderate dietary cholesterol or egg consumption increases the risk for heart disease and stroke, except in people with a strong genetic risk for high cholesterol and possibly people with diabetes,” said the article.

A 2017 article in Harvard Health Publishing pointed out that only about 20 per cent of the cholesterol in our blood comes from the food we eat. Agrees nutritionist and author, Kavita Devgan, “A large percentage of the cholesterol in our body is manufactured in the body. It has little relation to what we eat.”

To Eat Or Not To Eat

But the confusion – and contradictory opinion – about eggs persists. In the past one year two studies came up with very different findings. In March this year, various publications quoted a study published in The Journal of the American Medical Association “that for each additional 300 milligrams a day of cholesterol in the diet, there was a 17 per cent increased risk of cardiovascular disease and an 18 per cent increased risk of premature death from any cause.” The study had been conducted among almost 30,000 participants, over a period of 17 years. Eggs – because of their rich cholesterol content – “had the same more-is-worse effect”, wrote the New York Times (NYT) while reporting on the study. Norrina B Allen, lead author of the study and associate professor of epidemiology at Northwestern University, however, was quoted by the NYT as saying, “eggs have some advantages – amino acids and minerals... You do want to reduce the number of eggs, especially egg yolks, as part of a healthy diet. But we don’t want people to walk away thinking they shouldn’t eat any eggs.” Earlier, in May last year, CNN had reported on research by Canqing Yu, associate professor in the Peking University School of Public Health in Beijing and his colleagues, which found that “daily egg-eaters had an 18 per cent lower risk of dying from cardiovascular disease”.

Meanwhile, Jaggi’s patients continue to ask him about whether they should have eggs and how many is too many.

In the US, the 2015-2020 Dietary Guidelines published by the government, removed the earlier limit on dietary cholesterol, but cautioned that “individuals should eat as little dietary cholesterol as possible” because “foods that are higher in dietary cholesterol... are also higher in saturated fats.” Eggs should be safe, because they contain relatively little saturated fat. Since about 2000 all major UK health organisations, including the British Heart Foundation, have also lifted earlier restrictions on egg consumption. “One reason for this [confusion] is that we doctors are taught more about diseases and medicines than about good health and diets,” says Jaggi. “As a result, we do not have good scientific knowledge of what kind of food is good and what isn’t. Much of what we know about diets are hypothesis.”

An Egg A Day

The National Egg Coordination Committee (NECC) India, launched the campaign ‘Sunday ho ya Monday, roz khao ande’ in the 1980s. The campaign became an instant hit and enjoys recall even today. “That campaign was launched in response to prevalent religious beliefs which made people avoid eggs – as part of non-vegetarian – food on certain days of the week,” recalls national vice-chairman, NECC, Sandeep Mehta. But that does not mean that poultry farmers weren’t affected by the medical flip-flop over eggs. “About 20 years back the cholesterol worry was making many give up eggs. Our business had been seriously affected,” recalls Mehta.

Today most doctors in India are of the opinion that it’s all right to eat eggs – at least in moderation. “Healthy adults, till the age of 40, may have one to two eggs a day. Those with a more active lifestyle – sportsmen for example – may even have three-four eggs a day. After 40, as activity levels go down, one egg a day is good,” says Ritika Samaddar, chief clinical nutritionist at Max, Delhi. And by egg, she means a whole egg – not just the white. “Egg whites only are the biggest myth. It is true that most of the calories, as well as all the cholesterol, in an egg is in the yolk. But it is also rich in nutrients such as protein and vitamins. I always advise a whole egg for all my patients,” she says. Samaddar believes even vegetarians will benefit from eggs, even if they don’t eat meat. “Being an animal protein, it has 100 per cent absorption. Vegetable protein has fibres and other nutrient inhibitors present making it unavailable for absorption,” she says.

Those with a high cholesterol issue or with a history of heart ailments or diabetes, may also have eggs – but should restrict it to about two-three a week, says cardiologist Praveen Chandra, who practices at the Medanta hospital. “Dietary cholesterol raises the total serum cholesterol in the body, but is a less important contributor to coronary heart diseases than saturated fat. Eggs are a chief source of dietary cholesterol, but the association between regular egg consumption and risk of coronary heart disease and stroke are uncertain,” says cardiologist KK Aggarwal, president, Heart Care Foundation of India. “In patients with high cholesterol, it is more important to restrict trans fat and bad saturated fats.” So avoid making an omelette in hydrogenated oil, he cautions.

Check your diet for the real culprits – refined carbohydrates like sugar, maida, rice etc. As Anthony Komaroff (MD) writes in an article in the Harvard Health Publishing, “It matters greatly what you eat with your eggs. The saturated fat in butter, cheese, bacon, sausage, muffins, or scones, for example, raises your blood cholesterol much more than the cholesterol in your egg. And the highly refined “bad carbs” in white toast, pastries, home fries, and hash browns may also increase your risk of heart disease, stroke, and other cardiovascular diseases.” A balanced diet is important, insists Aggarwal. “And finally, what can be eaten and what can’t can vary on a case to case basis. There can’t be generalisations,” he says.

So here’s hope yet, for Prithvi. He may indulge in his egg a day, if he can curb his love for sweets and stop himself from sneaking to the kitchen for a few after-dinner deserts in the middle of the night. And has his morning egg with a bowl of sprouts or just a single slice of bread (preferably multigrain, unbuttered and not topped with sugar).

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First Published: May 18, 2019 00:13 IST