Your Health Checkup: Should I Eat Eggs for Breakfast?

The latest study on eggs may have you rethinking your breakfast.

Pair of egg yolks

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“Your Health Checkup” is our online column by Dr. Douglas Zipes, an internationally acclaimed cardiologist, professor, author, inventor, and authority on pacing and electrophysiology. Dr. Zipes is also a contributor to The Saturday Evening Post print magazine. Subscribe to receive thoughtful articles, new fiction, health and wellness advice, and gems from our archive. 

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I like to eat two eggs sunny side up, with hash brown potatoes, rye toast, and a double espresso for breakfast sometimes. Those breakfasts may soon be a just a memory. A new study indicates I may have to substitute egg whites for those sunny siders.

According to a report of almost 30,000 U.S. adults (45 percent men; 31 percent black) collected from six prospective cohort studies and followed for 17.5 years, each additional 300 mg of dietary cholesterol consumed per day (about 187 mg cholesterol makes up a large egg) increased the risk of cardiovascular disease (CVD) and death, by 17 percent and 18 percent, respectively. Each additional half an egg consumed per day increased the risk in a dose dependent fashion. The conclusion was that eating eggs for breakfast was associated with higher risk of cardiovascular disease and death.

Other studies support these conclusions. For example, the Nurses’ Health Study included 73,710 women from 1984 to 2012 and 92,329 women from 1991 to 2013; while the Health Professionals Follow-up Study from 1986 to 2012 included 43,259 men. None had chronic diseases to start. The authors found in over 4,833,042 person-years of follow-up that higher intake of a plant-based diet rich in healthier plant foods (like whole grains, fruits/vegetables, nuts/legumes, oils, tea/coffee) was associated with substantially lower coronary heart disease (CHD) risk, whereas a diet that emphasized animal-derived foods was associated with higher CHD risk.

One can question the results of such observational studies for several confounding reasons, including the accuracy of reporting food intake, knowing people have fallible memories and might exaggerate or underestimate intake of certain foods. However, we now have a potential explanation why plant-based diets are beneficial: reduced inflammation.

Recent studies have firmly established the role of inflammation in promoting coronary artery disease (CAD), and that reducing such inflammation can reduce cardiovascular mortality by almost a third.

It turns out that a diet emphasizing plant-based foods reduces inflammation. Researchers randomized patients with CAD to eight weeks of a vegan diet compared with those randomized to an American Heart Association-recommended diet. The two diets differed by the absence of animal protein in the vegan diet. They found that a marker of inflammation was 1/3 lower in those on the vegan diet compared to the AHA diet, with no difference in body mass index, waist circumference or glycemic control. So the vegan diet reduces inflammation, which would be expected to reduce CAD.

The Mediterranean Diet (MD) also reduces inflammation. In a recent study, baseline MD was assessed in 25,994 initially healthy U.S. women in the Women’s Health Study who were followed up to 12 years. The investigators found that a higher MD intake was associated with approximately one-fourth relative risk reduction in cardiovascular (CV) events. The largest mediators of the CV risk reduction from MD intake were biomarkers of inflammation (accounting for 29.2 percent of the MD-CVD association), glucose metabolism and insulin resistance (27.9 percent), and body mass index (27.3 percent).

The MD can be made more “potent” by supplementing it with nuts or extra-virgin olive oil. In a multicenter trial in Spain, investigators assigned 7447 participants (55 to 80 years of age, 57 percent women) who were at high CV risk, but with no CV disease at enrollment, to one of three diets: a MD supplemented with extra-virgin olive oil, a MD supplemented with mixed nuts, or a control diet (reduced dietary fat). They found that the incidence of major CV events was lower among those assigned to a MD supplemented with extra-virgin olive oil or nuts than among those assigned to a reduced-fat diet.

Sadly, I guess I will have to do without my sunny siders in the future. Maybe if I cook them with extra-virgin olive oil and eat some walnuts on the side I can mitigate the harm. After all, as I’ve said before, moderation in all things, including moderation.

Featured image: Shutterstock

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  1. Like your other commenter, I’ve been driven nuts by the conflicting science about eggs. At least three times in my lifetime I’ve been told they’re unhealthy, only to be told a few years later, “never mind, false alarm, a better study tells us they’re good for you.” I used to read the science conscientiously and keep track of everything. Now I just get angry at every new contradiction. Either the egg lobby is playing havoc with “junk science” or nutritional science is so unreliable and immature that we are better off ignoring all these announcements.

  2. The hash browns are probably worse for you than the eggs. Still, I’d keep the cooked breakfasts for a Sunday treat, and eat some fruit or whole grain or smoothie thing the rest of the week.

  3. Dr Zipes, I’ve been hearing/reading conflicting info concerning eggs since the ’80s. Most of it advocates not eating them very often for the reasons stated here. It’s enough to have my head turning a full 360 (as seen in ‘The Exorcist’) and getting my brains all scrambled! That, and the even more contradicting studies on coffee.

    So ‘no’ on both for me. Breakfast is usually a bowl of Toasted Oats (Kroger’s reasonably priced version of Cheerios) in 9.5 alkaline water with a little blue agave organic syrup on top and a glass of Simply Orange. I’ll occasionally have a cup of de-caf with Coffee Mate’s hazelnut or French vanilla creams at work. God those are good.

    The traditional breakfast like yours Dr. Zipes, is a once or twice a year indulgence at Denny’s or Norm’s ‘Grand Slam’ breakfast. I do love bacon and hash browns; especially with ketchup, but they are rare treats. I can see how you’d want to have an indulgent breakfast. My cholesterol is a little below normal which it better be, considering what I’m giving up. But moderation is best. Life is never-ending trade-offs and compromises, but staying fit and slim is worth it even though it’s a drag doing so.

    Speaking of that, I don’t see how TV stars basically remain so slim. I don’t! I was invited to Paramount’s Valencia studios for an NCIS tour in 2007, and the catered food was out of this world. They’re on the set everyday too. That would really test my willpower. Yeah, I’d lose that battle–big time.


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