Eggs have one of the lowest energy to nutrient density ratios of any food, and contain a quality of protein that is superior to beef steak and similar to dairy. From a nutritional perspective, this must qualify eggs as 'good'. The greater burden of proof has been to establish that eggs are not 'bad', by increasing awareness of the difference between dietary and blood cholesterol, and accumulating sufficient evidence to exonerate eggs from their associations with CVD and diabetes. After 60 years of research, a general consensus has now been reached that dietary cholesterol, chiefly from eggs, exerts a relatively small effect on serum LDL-cholesterol and CVD risk, in comparison with other diet and lifestyle factors. While dietary guidelines have been revised worldwide to reflect this view, associations between egg intake and the incidence of diabetes, and increased CVD risk in diabetes, prevail. These associations may be explained, in part, by residual confounding produced by other dietary components. The strength of evidence that links egg intake to increased CVD risk in diabetes is also complicated by variation in the response of serum LDL-cholesterol to eggs and dietary cholesterol in types 1 and 2 diabetes. On balance, the answer to the question as to whether eggs are 'bad', is probably 'no', but we do need to gain a better understanding of the effects of dietary cholesterol and its association with CVD risk in diabetes.
Eggs: Dietary: Cholesterol: CVD: DiabetesAn egg is equipped to support life, with a profile of essential micronutrients that is unparalleled by any other food. Eggs are relatively low in energy (326·35 kJ (78 kcal)/medium egg) and saturated fat (1·7 g/medium egg) in comparison with other animal products, and can boast the highest quality of dietary protein, with certain dairy foods (1) . Eggs also represent the principal source of dietary cholesterol, which has been a major barrier to egg consumption, primarily because of the outdated, but popular misconception that egg cholesterol converts directly into serum cholesterol, and thus increased risk of CVD. While dietary and serum cholesterol are the same chemical entity, the concentration of serum cholesterol (LDL-cholesterol) falls under the physiological control of whole-body cholesterol homeostasis. This process can be influenced by numerous dietary factors, including dietary cholesterol and fatty acids, but depends ultimately on the essential requirement of cells for cholesterol, and reciprocal interplay between the biosynthesis of cholesterol in tissues, and absorption of cholesterol and bile acids in the gut.A growing body of evidence from prospective cohort studies (2)(3)(4) , systematic reviews and meta-analyses (5)(6)(7)(8) have culminated in a consensus that eggs, and dietary cholesterol derived from eggs, exert a relatively small and clinically insignificant effect on serum LDL-cholesterol in comparison with other lifestyle factors. In one study, modifiable lifestyle factors accounted for <40 % of CHD mortality, to which eating one eg...