Eggs and cholesterol : Do Eggs Raise Cholesterol? Dr Chan answers.

“Do eggs raise cholesterol? The short answer is: Yes, for most people, but it depends.

”What is the impact of eggs on cholesterol?" is a question I get asked often, especially from people who are confused because they have heard conflicting views from scientists and doctors about the whether eggs are OK or not OK for people with high cholesterol. 

I made this video to help bring some clarity on these very common questions, "Do Eggs Raise Cholesterol?"

Synopsis of this 10 min video:

Eggs and Cholesterol: Do Eggs Raise Blood Cholesterol Levels?

Do Eggs Raise Blood Cholesterol?

Eggs and cholesterol is a common concern, especially for people managing their health. The answer is that eating eggs will likely raise blood cholesterol levels to some degree for most people, but the extent of the increase is not the same for everyone.

How Much Do Eggs Affect Cholesterol?

Studies show that adding eggs to the diet can lead to an increase in LDL cholesterol levels in many individuals, although the degree of increase varies. Some people may experience only a small rise, while others may have a much larger increase.

Why the Effect of Eggs on Cholesterol Varies

The impact of eggs and cholesterol is not uniform because individuals respond differently. Two key factors influence how much blood cholesterol rises:

• Baseline dietary cholesterol intake — People who start with a low intake of cholesterol may see a larger increase when they add eggs to their diet
• Cholesterol absorber status — Some people absorb more cholesterol from food, while others absorb less

Individual Differences Matter

Because of these differences, not everyone will respond to eating eggs in the same way. Some individuals may eat eggs regularly without significant changes in cholesterol levels, while others may see a noticeable increase.

A Real-World Example

In practice, dietary changes can make a meaningful difference for some individuals. One example described is a patient whose cholesterol levels increased after consuming more eggs and high-cholesterol foods, and later improved after adjusting his diet.

Eggs and Cholesterol: The Bottom Line

• Eggs can raise blood cholesterol levels in most people
• The degree of increase varies from person to person
• The response depends on dietary habits and individual biology

Understanding how your own body responds is important when considering eggs and cholesterol as part of your diet.

The relationship between dietary cholesterol and blood cholesterol is clear - that consumption of high cholesterol foods would likely raise the blood cholesterol, both LDL and Total Cholesterol for most people to varying degrees. The individual variability of the impact of egg consumption on blood cholesterol depends on a few factors, especially (1) whether one is already on a high cholesterol diet or not as well as (2) One's Cholesterol Absorber status - whether one is a hypoabsorber, hyperabsorber or normal absorber of dietary cholesterol. 

To learn more, check out this video that I made on the impact of consumption of high cholesterol foods such as eggs on blood cholesterol levels. 

Full transcript of this video is provided below, some might find it useful.

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Eggs and Cholesterol - are they related?

 ”Doctor, do eggs raise cholesterol?”. “Does eating eggs raise my blood cholesterol levels?” are questions I get asked often.

Hi, I'm Dr. Chan. I'm a medical doctor from Singapore, and today I would like to tackle this question: “Does eating eggs raise one's blood cholesterol levels?” My answer, “Yes. For most people it does.”

Egg consumption will likely raise blood cholesterol to some degree for most people, but the degree of increase is not the same for everybody, it varies from person to person,

Eggs and Cholesterol - the impact varies from person to person

The degree of increase depends on:
(1) the person's existing baseline level of dietary cholesterol intake:
that is how much cholesterol is a person already eating, whether that the person is eating very little cholesterol or already have a very high level of cholesterol in his or her diet.

(2) It also depends on the person's cholesterol absorber status.

Let me elaborate. Starting with sharing some studies that shows that egg consumption will likely raise blood cholesterol to some degree for most people.

In this study:
17 college students were given an additional egg to add to the diet every day for three weeks, and then given an isocaloric egg-less food to add to their diet every day for another three weeks, and this was what they found: Their mean LDL cholesterol levels were 12% higher during the three weeks when they were consuming an extra egg every day compared to the three weeks when they were not.
And this increase in LDL cholesterol levels when eating an extra egg a day was found in 13 out of the 17 college students in the study. That is the majority of them showed an increase in LDL cholesterol when eating and extra egg a day.

Okay. This was a small trial involving only 17 study subjects.

So let's look at bigger studies.
In this 2020 meta-analysis of 66 randomized controlled clinical trials with more than 3000 participants, the authors of this paper concluded that egg consumption can significantly increase LDL cholesterol.

That was why I said egg consumption will likely raise blood cholesterol to some degree for most people, not all, but most people.

Now, let me elaborate on the second part that the degree by which egg consumption raises blood cholesterol varies from person to person.

Eggs and Cholesterol studies

Let's refer back to the first study that I shared with you about the 17 college students.

They found that 13 out of the 17 study subjects had their blood cholesterol levels raised when eating an extra egg a day. The degree by which their LDL cholesterol levels increased varies.

Some of them had their LDL cholesterol levels raised by only a few percentage points, while others had their LDL cholesterol levels raised by as much as 42%. The impact of eating an extra egg a day on the LDL cholesterol levels varied very significantly.

Eggs and Cholesterol - the impact varies : Why?

The reason for this individual variation can be due to a few different factors:

Number one: the person's existing baseline level of dietary cholesterol intake.
Scientists have found that the degree by which a person's blood cholesterol increases from eating high cholesterol foods is affected by a person's baseline dietary cholesterol intake levels.

That is if you get a group of people to start eating more cholesterol, for example, by eating more eggs, those who started off with a lower baseline intake of dietary cholesterol, if they increase their intake of dietary cholesterol from low levels to moderate levels, the degree of the increase in their blood cholesterol levels would likely be significantly greater than the increase in blood cholesterol levels of people who started off with a higher baseline dietary cholesterol intake before they started adding more cholesterol into the diet.

Let me put it another way. If you take two groups of people:
Group A : comprising of people who eat very little cholesterol in the diet. That is people who start off with a very low level of dietary cholesterol intake
and group B : people who eat a lot of cholesterol in the diet. That is people who start off with a high level of dietary cholesterol intake.
Then you make both groups add more eggs. The same amount for both groups to their diets every day.
You will find that the increase in blood cholesterol levels as a result of adding the same amount of eggs into their diet is likely to be greater for group A as compared to group B. That is the impact of additional egg consumption on raising blood cholesterol levels is likely to be more significant for people who started off with a low intake of cholesterol in their diets than for people who are already eating a lot of cholesterol in their diets.

So the degree by which a consumption raises blood cholesterol varies from person to person.
It can be affected by a person's baseline level of dietary cholesterol intake.
It can also be affected by a person's cholesterol absorber status.

Eggs and Cholesterol - A person's absorber status matters

Let me elaborate.
The ability to absorb dietary cholesterol varies from person to person, meaning the ability to absorb into our bodies the cholesterol that we eat varies from person to person.
Some people are genetically hyper-absorbers: they absorb a lot of the cholesterol that they eat whilst others are genetically hypo-absorbers: that is they absorb very little of the cholesterol that they eat.

For hypo-absorbers, their blood cholesterol levels are less affected by the increased intake of dietary cholesterol, such as by eating more eggs .
Whilst for hyper-absorbers, any increase in intake of dietary cholesterol such as by eating more eggs will raise their blood cholesterol levels a lot more in comparison.

So to this question, “Does eating eggs raise one's blood cholesterol levels?” My answer is yes, for most people it does. Egg consumption will likely raise blood cholesterol to some degree for most people. The degree of increase is not the same for everybody. It varies from person to person, and the degree of increase depends on the person's existing baseline level of dietary cholesterol intake, as well as that person’s cholesterol absorber status.

Eggs and Cholesterol - Many have strong views and suspicious of contrary ones.

When I was making this video, I was expecting, I was prepared to see many people reacting to this video, potentially leaving angry comments to say that they disagreed with my answer.
Some viewers will be angry and leave comments saying “Eggs are healthy!”

Whilst others would highlight that they read somewhere or learned from some YouTube videos, that it is perfectly okay, it is safe or even healthy to have high cholesterol levels.

I am not commenting on whether I agree or disagree with all these different statements. Because the goal of this video focuses only on tackling this question whether eating eggs will likely raise one's blood cholesterol levels. This video is not intended to tackle the questions of whether consumption is good for health or not, or about the impact of high cholesterol levels on cardiovascular diseases risk.

Another comment that I expect to get is this, “Doctor, you are wrong. I eat at least an egg a day, and my blood cholesterol levels, including my LDL cholesterols are all at very healthy levels”, to people who are likely to say this, let me refer you again to my full answer to the question: the impact of egg consumption on one's blood cholesterol levels varies from person to person, and the degree of increase also varies from person to person. So just because you have good blood cholesterol levels, even though you're eating quite a lot of eggs regularly, does not mean that it will be the same for everybody.

Eggs and Cholesterol - Reiterating individual variability and a story.

We must be mindful of individual variability. Not everybody react to egg consumption in the same way.
Let me share with you this real story. I do a lot of training and coaching, group coaching, or one-to-one coaching to help people review, change, and improve their lifestyle and diet to better improve their control of their diabetes, high blood pressure, high cholesterol, or other lifestyle and diet related chronic diseases.

A few years ago, I had this patient come to me for one-to-one coaching. He wanted me to coach him to make changes to his diet, to help him improve his high cholesterol levels.
And when I probed a little further into his dietary habits, he said, “Doctor, I used to be very mindful of my intake of foods that are high in cholesterol, but that was only until a few months ago when I read somewhere and also saw some YouTube videos that said that eating high cholesterol foods would not and does not raise blood cholesterol. So I began to be less mindful of the cholesterol that I eat. I began to more freely indulge in high cholesterol foods, including eggs, which I love a lot, thinking that it would not raise my blood cholesterol, but recently I had a blood test and I was shocked to find that my cholesterol levels, including my LDL cholesterol levels have all skyrocketed.”

Without going into details, after a few months of helping him holistically reviewing, changing and improving his diet through a series of one-to-one coaching sessions, including cutting down on his consumption of eggs, delighted to share that this particular patient had his blood cholesterol levels brought down to much healthier levels after he has made the necessary dietary changes and improvements.

At this point, I must emphasize that not everybody will be able to improve their blood cholesterol levels through dietary changes.

The patient in this story that I just told you was able to lower his blood cholesterol levels through changing his diet likely because he belongs to the group of people whose blood cholesterol levels are more impacted by the amount of cholesterol that they eat. We must be mindful of individual variability.

Regardless of whether one's blood cholesterol can be improved by dietary change or not, when it comes to preventing controlling and combating diabetes, hypertension, high cholesterol, cardiovascular disease, and other lifestyle and diet related chronic diseases, we must not be solely and overly dependent on medications alone. Improving our lifestyle and dietary habits must be the cornerstone in our efforts to optimally prevent control and combat lifestyle and diet related chronic diseases.

I am Dr Chan, let Habits be Thy Medicine. Eat well and be well.

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