Eggs Raise Cholesterol but Do Not Increase Heart Disease Risk and May Actually Protect Heart Health

Our Summary

Eggs have long been viewed with suspicion in mainstream nutrition due to their high cholesterol content, yet they are also one of the most nutrient-dense foods available. This comprehensive 2025 review published in the Journal of Poultry Science examined evidence from clinical trials, observational studies, and large-scale global ecological studies to provide a thorough and updated picture of how egg consumption affects blood lipids, antioxidant status, and cardiovascular outcomes. The findings reveal a seemingly paradoxical but increasingly consistent pattern: while consuming eggs does raise total serum cholesterol in some studies, this rise does not translate into increased risk of atherosclerosis or cardiovascular disease, and in some cases appears to be actively protective. Adding one egg per day for four weeks was associated with higher HDL (good) cholesterol and lower levels of oxidized LDL (a more dangerous form of bad cholesterol directly linked to arterial damage), a combination that is generally favorable for heart health. Among patients not taking cholesterol-lowering medications, moderate egg intake of three to four eggs per week was associated with a lower prevalence of multi-vessel coronary artery disease, while worldwide ecological analyses found a significant negative association between egg consumption and both the incidence and mortality of ischemic heart disease, meaning that populations eating more eggs tended to have lower rates of heart disease death. Beyond cardiovascular effects, eggs are also rich in lutein and zeaxanthin, two carotenoids that support antioxidant defenses and eye health. The authors conclude that given their exceptional nutritional value, relatively low cost, and the weight of current evidence, eggs are a beneficial component of healthy diets across many populations globally.

PMCID: PMC12765572  

PMID: 41497962

Abstract

Eggs are a highly nutritious food and an excellent source of carotenoids, lutein and zeaxanthin, which contribute to antioxidant defenses and ocular health. However, eggs have been viewed skeptically because of their impact on serum cholesterol levels. This review summarizes the evidence from clinical trials, observational studies, and worldwide ecological studies relating egg consumption to serum lipid profiles, antioxidant status, and cardiovascular outcomes. Recent meta-analyses on egg consumption have reported an increase in serum cholesterol but limited or no impact on atherosclerosis and cardiovascular disease risk. Clinical studies have reported that the additional consumption of an egg per day for 4 weeks improved high-density lipoprotein-cholesterol levels and decreased oxidized low-density lipoprotein levels. Most recently, a cross-sectional study of Japanese patients who underwent coronary angiography reported no significant association between egg intake and the prevalence of coronary artery disease or multi-vessel disease. Among patients not receiving lipid-lowering drugs, moderate egg intake (3–4 eggs/week) was associated with a lower prevalence of multi-vessel disease. Furthermore, worldwide ecological analyses have identified a significant negative association between egg intake and the incidence and mortality of ischemic heart disease. Given their high nutritional value, relatively low cost, and the evidence presented, eggs could contribute to healthy diets in many countries worldwide.