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"Itís not the cholesterol in foods that cause health problems, but the amount of saturated fat and eggs have little fat.... In addition, eggs are one of the least expensive and most balanced proteins." ĖNikki Goldbeck, co-author of American Wholefoods Cuisine (Plume)
Eggs Are Back Ė in a New and Improved Form
Q: Whatís the story on eggs? Iíve heard that a new study says eggs are okay after all. What happened to the concern about the cholesterol and saturated fat in eggs?
A: Youíre correct, there has been some changes on the egg front. Many -- certainly not all Ė doctors are now telling their healthy patients itís okay to eat up to four eggs a week. In addition, a special form of eggs which may be especially good for us is now available.
In view of these developments, Iíve modified my opinion on eggs -- again.
As those who have read my books know, Iíve eaten more than my share of eggs. The truth is, I love eggs. Poached or over easy are my favorites, but I like eggs in any form. In my Olympic lifting days and my early years of law practice, I was usually in a hurry and had a protein malt with two raw eggs for breakfast almost every morning. Actually, I can remember cracking up to a half-dozen eggs into my blender from time to time. I stopped eating raw eggs when I learned about the dangers of food poisoning. (For a complete explanation, see The Lean Advantage 2.)
As related in Ripped, I ate a dozen or more soft boiled eggs a day as part of a low-carbohydrate, high-protein diet in preparation for the Past-40 Mr. America contest. When I got smarter and switched to a whole foods diet a short time later, I dropped back to four eggs or less a day. Later, I cut back to having only an occasional egg when I became concerned about the connection between cholesterol and heart disease. For all practical purposes, I stopped eating eggs.
Now, Iíve changed again. But not because of study to which you refer (it was published in the April 21, 1999, Journal of the American Medical Association). Researchers from Harvard Medical School and Brigham and Womenís Hospital in Boston looked at egg consumption among 120,000 nurses and other health professionals with normal cholesterol levels and found no link between eggs and heart disease or stroke. The study did find an increase in coronary heart disease among people with diabetes who ate one or more eggs a day.
The other exception is a small percentage of people who produce large amounts of cholesterol when they eat eggs. Most people compensate when they consume more cholesterol; their liver makes less cholesterol and their total cholesterol is not significantly changed.
I wrote about this compensatory mechanism in The Lean Advantage 3, published in 1994. Some people are genetically predisposed to high cholesterol levels Ė and high rates of heart attack and stroke Ė but a large percentage have good genes that allow them to consume high amounts of cholesterol and still maintain relatively low levels of cholesterol in their blood.
As explained in The Lean Advantage 3, the most common cause of high cholesterol is unhealthy lifestyle: consuming too many calories, too much fat and not getting enough exercise. Too much fat, especially saturated fat, will cause your liver to produce far more cholesterol then youíre likely to get in your diet.
How your eggs are cooked is also important. To keep your cholesterol down, boiling or poaching is best. Frying in butter or lard, adding cheese, or eating your eggs with bacon or sausage adds saturated fat and is almost guaranteed to up your cholesterol level.
Some Doctors Not Convinced
Nevertheless, many doctors were not persuaded by the 1999 study and continued to urge their patients to stick to the 300 mg limit on daily cholesterol intake. Dr. Kenneth Cooper wrote in Impact, The Cooper Institutes Guidelines for Healthy Living, "We simply need more information before we can justify a major change in diet Ė especially for those at high risk for cardiovascular disease." He noted that the study was based on mailed questionnaires. "The researchers apparently conducted no regular monitoring of blood-lipid levels," says Cooper, "so we donít really know what effect the eggs were having on blood cholesterol."
If you are low risk (donít smoke, exercise regularly, eat healthy and have no family history of heart disease or stroke) and decide to begin eating eggs, Cooper suggests that you have a blood test in four to six weeks to see what the impact is on your total cholesterol and especially your "bad" LDL cholesterol. "An increase of only one percent in your total cholesterol translates over time into a 3% increase in your risk of getting coronary heart disease," Cooper cautioned.
Heart researcher Ernest Schaefer, MD, also criticized the methodology of the egg study in the Tufts University Health & Nutrition Letter: "They were studied with a questionnaire sent through the mail -- which amounts to many people studied poorly." Schaefer says "more carefully controlled research" has found that eating one egg a day "raises LDL-cholesterol by 5 to 10 percent -- and subsequent heart disease risk by anywhere from five to15 percent."
I got the message. My father had high cholesterol and died as a result of a stroke. I decided to continue eating only an occasional egg.
Omega-3 Enriched Eggs
I didnít start eating eggs again on a regular basis until I discovered the new omega-3 enriched eggs. We buy ours at Wild Oats; I donít believe they are generally available in regular supermarkets. The carton says the hens are raised on a "cage-free farm" and fed an omega-3 enriched diet especially designed to produce this "special nutritionally enhanced egg." Wild Oats Omega-3 Eggs contain 100 milligrams of omega-3 fatty acids, compared to only 40 for an ordinary large egg. The calories (70) and cholesterol (215 mg) are the same.
Omega-3 fatty acids, of course, are the "good fats" weíve been hearing so much about recently. (See Challenge Yourself and the articles on this site.) They are found in fatty fish such as salmon and sardines, and in plant sources such as flax seeds, soybeans and walnuts. No one knows exactly how omega-3 fats work. But many experts believe they help prevent heart disease and stroke. Some believe they help prevent fatty build-up along the arterial walls. Another theory is that they help stabilize the heartbeat. Omega-3s also appear to make platelets less sticky, which decreases the risk of clotting.
Normally, I would be skeptical of a product such as Omega-3 eggs, but people I respect say they are nutritionally superior to ordinary eggs.
Andrew Weil, MD, who the New York Times Magazine has called "arguably Americaís best-known doctor" is a supporter. Currently Clinical Professor of Medicine at the University of Arizona and director of the Foundation for Integrative Medicine at that institution, Weil wrote in Eating Well for Optimal Health (Knopf, 2000): "I strongly recommend using the new omega-3 fortified eggs from range-free chickens. The essential fatty acids in the yolks are very protective of the heart and arteries."
Michael F. Roizen, MD, author of the number one New York Times best-seller RealAge (discussed elsewhere on this site), calls this new product "Eggs-ceptionally good" in The RealAge Diet (HarperCollins, 2001). Referring to omega-3 enhanced eggs, he wrote: "Not only are eggs a lot better for you then they were once thought to be, but a special group of them may be exceptionally good for you."
Dr. Weil says eggs have gotten a bad rap for years. "Egg yolks contain cholesterol, but their inclusion in the diet makes an insignificant contribution to serum cholesterol; besides, they can be an important source of scarce essential fatty acids." In this connection, he answered an important question that needs to be understood in order to appreciate omega-3 enhanced eggs. How do essential fatty acids end up in eggs and fatty fish? Animals lack the enzymes needed to produce both omega-3 and omega-6 fatty acids, and chickens and fish are members of the animal kingdom. So, how do they make essential fatty acids?
Weil says they don't. "But they can eat them and store them." This, of course, explains the importance of the special diet fed to the hens that produce the new omega-3 eggs. Salmon and sardines, Dr. Weil explains, get essential fats by eating algae and other forms of plant life that make omega-3, and then store them in their body fat. "Chickens in the wild can find plant sources of omega-3s to put in the yoke of their eggs," says Weil. "Chickens confined to cages eating standard feed will not produce eggs that have anywhere near the omega-3 content of eggs of free-range chickens that scratch and peck the ground for food."
Farmers produce the new and improved eggs by letting their chickens range free and feeding them a diet rich in omega-3 fatty acids. Dr. Roizen says, "The hens that lay these enriched eggs are fed a diet that includes fish oil, fish meal, or flax, all sources of omega-3s." Dr. Weil says the egg farmers get this result by "fortifying chicken feed with a meal made from algae." I suppose both are correct. The important thing to understand is that raising the chickens outside of cages and feeding them the special diet is what makes the eggs heart healthy and worth the extra cost.
Makes sense to me. But that doesnít mean Iím going to eat eggs indiscriminately. The American Heart Association recommends eating no more than four egg yolks a week, and that still seems prudent. Remember, the especially enhanced eggs still contain 215 mg of cholesterol, which is pretty close to the recommended daily allotment of 300 mg. According to the latest computer analysis of my diet made by the Cooper Clinic, I am now consuming about 186 mg of cholesterol per day. Eating three or four eggs a week puts me at about the recommended limit Ė and satisfies my taste for eggs.
Finally, I should mention the other good stuff in eggs. As I have written before, except for the cholesterol, an egg is about the best thing you can put in your mouth. I still believe that. Doctors Weil and Roizen might not go that far, but they certainly extol the benefits of eggs.
Dr. Roizen points out that eggs are low in fat (only 4.5 grams) and calories (70), and high in quality protein (6 gm.). Eggs contain all of the essential amino acids your body needs for cell growth and repair. Eggs are also a good source of bone-building vitamin D, plus B12 and iron. Dr. Weil notes that eggs are low in saturated fat (1.5 grams). Most of the fat in eggs is the healthy, unsaturated variety. Dr. Cooper adds to the list protective antioxidants (vitamin E and carotenoids), folate (which helps to lower homocysteine) and says eggs may help raise the level of "good" HDL- cholesterol. And, of course, the good news is that the new enhanced eggs are an even better source of scarce essential fatty acids.
Yes, eaten in moderation, eggs can be a good thing.
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