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Despite the fact that the Dietary Guidelines for Americans 2015–2020 no longer emphasize limiting dietary cholesterol intake, confusion remains regarding egg consumption, a rich source of dietary cholesterol, which has historically been linked to increased risk of cardiovascular disease (CVD). In addition, eggs are a rich source of phosphatidylcholine, a form of choline and a precursor of TMAO (trimethylamine N-oxide), an emerging risk factor for CVD. The purpose of this book chapter is to review the existing literature regarding egg consumption and its relationship with CVD risk factors in both healthy and individuals at risk of CVD, and to determine whether eggs should be considered as part of a healthy dietary pattern. The available evidence so far suggests that egg consumption (between 1–3 eggs per day) has little effect on most traditional and non-traditional CVD risk factors, including inflammation, endothelial function, and plasma TMAO and low-density lipoprotein-cholesterol (LDL-C) concentrations. However, egg consumption seems to improve LDL particle phenotype by increasing the number of large LDL particles. Moreover, increases in HDL-C concentrations were consistently observed with egg consumption in both healthy individuals and those at risk of CVD. Despite the lack of evidence that relates egg consumption with CVD, the variability of study designs and populations included makes further investigations necessary.

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