From this 2020 systematic review

on the effects of egg consumption on cholesterol,

here are the results of more than 50 randomized controlled trials,

nearly all of which pointing in the direction

of greater LDL blood cholesterol with greater egg intake.

And that's just looking at fasting cholesterol taken in the morning,

which is how much your liver is churning out,

which is like the baseline on top of which the effects

of diet can be assessed.

We live most of our lives in a postprandial state,

meaning an after-meal state, not a fasting state.

And this is what eating more and more dietary cholesterol can do

to your blood cholesterol levels immediately after eating,

shooting your levels up for hours after a meal.

And then what happens after four hours?

Lunchtime! And you can whack your arteries

with another surge of cholesterol on top

of your elevated fasting levels.

Of course, the only reason we care about cholesterol

is because we care about heart disease,

our #1 killer of men and women.

And you do see, for example, significantly higher coronary artery

calcium scores in those who eat more eggs,

which is a sign of atherosclerotic plaque buildup in the arteries.

But does this translate into a higher risk of heart attacks and death?

Apparently so.

Based on a half-dozen population studies

in the U.S., following tens of thousands

of people for up to 30 years,

each additional half of an egg consumed per day

was significantly associated with higher risk

of developing cardiovascular disease and dying from

all causes put together— in other words,

living a significantly shorter lifespan.

But wait a second.

Egg consumption commonly correlates

with unhealthy behaviors such as inactivity, smoking,

and eating all sorts of other bad stuff.

How do we know it's not the saturated fat and animal protein

as opposed to the cholesterol?

Failure to consider all these factors

could lead to different conclusions,

but this study comprehensively accounted for all these factors.

Also, the study had longer follow-up than the majority

of the previous studies, and therefore,

it may have provided more power to detect associations

with even single food products, such as eggs in this case.

And the study found that the significant associations

of dietary cholesterol and death were independent

of the quality of the diet.

Meaning, if you eat, let's say, two eggs a day,

but the rest of your diet is all vegetables and low sodium,

do those eggs portend any higher level of cardiovascular disease risk?

The effect of egg and dietary cholesterol in general

remained even after considering an

otherwise heart-healthy dietary pattern.

So, that significantly increased risk of death tied

to just half an egg a day persisted even after

taking overall diet quality into account.

So, it's not just like they're eating more bacon with their eggs.

When we adjust for overall diet quality

and the consumption of specific types of food

like red meat or processed meat, like bacon,

the association persisted,

which suggests that the entire association

is not driven by bacon or other foods eaten with eggs.

Considering the negative consequences of egg consumption

and dietary cholesterol, even in the setting

of heart-healthy dietary patterns, the importance of following

evidence-based dietary recommendations,

such as limiting intake of cholesterol-rich foods,

should not be dismissed.

But that's exactly what the 2015 Dietary Guidelines

Advisory Committee appeared to try to do,

declaring cholesterol not a nutrient of concern

for overconsumption, because available evidence shows

no appreciable relationship between consumption of dietary cholesterol

and blood cholesterol, consistent with the conclusion

of an American Heart Association/ American College of Cardiology report.

Wait, what?

Here's a meta-analysis of literally hundreds of studies

published like 25 years ago conclusively showing

that you can decrease blood cholesterol

by decreasing dietary cholesterol intake.

An interesting thing has since happened

with cholesterol research, though.

Industry funding of studies increased from zero to now,

most cholesterol studies are bought and paid for by the egg industry.

And studies funded by the Egg Board tend to use

specific design characteristics to minimize

the reported negative health effects.

So now, anyone limiting their reviews to studies

published in recent years—

when nearly all studies were industry-funded

and specifically designed to bring about

certain predetermined outcomes— you can make eggs look

more favorable than if you included more objectively designed research.

The American Heart Association/ American College of Cardiology report,

for example, limited their evidence review from 1998 to 2009.

They knew about meta-analyses like this one, published in 1997,

but didn't give it full consideration because these studies

predated their search time frame.

Dr. Kim Williams was President

of the American College of Cardiology

around the time of this saga.

Let's hear it straight from the horse's mouth.

Despite research studies over several decades

indicating that dietary cholesterol increases serum cholesterol levels,

their 2013 report stated that there was insufficient evidence

to determine whether lowering dietary cholesterol helps,

but this was based on that limited time search.

People didn't understand that,

but that's what the Dietary Guidelines Advisory Committee cited.

After clarification by the American College of Cardiology,

of which he was President,

the final, official 2015 - 2020 Dietary Guidelines for Americans

that was published followed the position

of the Institute of Medicine and told people

to “eat as little dietary cholesterol as possible.”

And here they are.

Here are the Dietary Guidelines.

As recommended by the Institute of Medicine,

individuals should eat as little dietary cholesterol as possible.

This was reiterated in the 2020 - 2025 Guidelines:

dietary cholesterol consumption should be as low as possible.

The National Academy's Institute of Medicine

is who determines the Recommended Daily Allowances.

And they're very explicit that based on all the evidence—

not just a sliver in time—

when it comes to dietary cholesterol,

which is found in all meat, dairy, and eggs,

intake should be as low as possible,

because any intake level above zero

increases LDL cholesterol concentration in the blood

and therefore carries increased risk

of coronary heart disease, our #1 killer.

After conviction for false advertising,

suggesting eggs were healthy,

which I detailed in one of my videos,

the egg industry has spent hundreds of millions of dollars

trying to convince the public, physicians, and policy makers

that dietary cholesterol and egg yolks are harmless.

But in reality, regular consumption of egg yolks should be avoided

by people at risk for cardiovascular disease,

which essentially means all North Americans

who expect to live past middle age.