by

Charles A. Bertrand, M.D., FACP, DIM-CD (Ret.)
Associate Clinical Professor of Medicine at New York Medical College
and at the Medical University of South Carolina

AN EGG A DAY?

On occasion there appears an article in the medical literature that represents a major surprise. This is what occurred in the current issue of the Journal of the American Medical Association of April 21, 1999. The article is about eggs and caught my attention and the title is "A Prospective Study of Egg Consumption and Risk of Cardiovascular Disease in Men and Women."

The design of the study is excellent and basically represents two very large groups of people. The first group consists a total of 37,851men. These men were between the ages of 40 to 75 years at onset of the study. Over a period of eight years there were 866 who had heart attacks and 258 who had strokes.

The second group consisted of 80,082 females who were followed over a fourteen year span of time. There were 939 women who had sustained a heart attack and 563 who had a stroke during this time period. Both male and female groups were studied mainly by the technique of periodic questionnaires.

The follow-up questionnaires in the male group were done initially in the year 1988 and every two years thereafter. The female group also had questionnaires every two years but were followed for a longer period of time. In both groups all strokes were included as well as all heart attacks, both fatal and nonfatal.

The average size egg weighs about 50 grams and contains about 213 mg of cholesterol. For many years it has been assumed that eating eggs would elevate the cholesterol level and therefore contribute to heart attacks and strokes. But the big surprise was that such was not the finding in the study. Indeed, those who consumed up to one egg per day had no increase in the incidence of heart attacks or strokes. This was the limit of the study - one egg per day.

As the authors state, "We have limited power to examine the effect of high egg consumption. For example, two eggs per day or more." In conclusion, the authors state that, "Our data suggest that consumption of up to one egg per day is unlikely to have substantial overall impact on the risk of cardiovascular disease among healthy men and women. The apparent increased risk of heart attacks associated with higher consumption among diabetics warrants further research."

In the months ahead, and likely years, this article will be subject to scrutiny. This is particularly so because it seems to go against one's instincts and prior experience. Yet there had been some suggestion in the literature that eggs have a beneficial effect on HDL cholesterol (the good cholesterol) as well as triglycerides, and perhaps there may be other significant factors of which we are unaware at this point in time. If this article is corroborated by future studies, then one has to rethink our advice with regard to egg consumption. I await the publication of more research on the subject of eating an egg on a daily basis - and admit to a sense of dietary uncertainty.



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