Eggs, dietary cholesterol and heart disease risk in US adults
What it found
In US adults, eating more dietary cholesterol or more eggs was linked to a higher risk of cardiovascular disease and death from any cause.
The link with eggs went away once dietary cholesterol was taken into account.
What they found
Studies in people
Cholesterol and heart risk
Each extra 300 mg of dietary cholesterol per day was linked to a higher risk of cardiovascular disease. Over the whole follow-up, the absolute risk difference was 3.24%.
Cholesterol and death
Each extra 300 mg of dietary cholesterol per day was also linked to a higher risk of death from any cause. The absolute risk difference over the follow-up was 4.43%.
Eggs and heart risk
Each extra half an egg per day was linked to a higher risk of cardiovascular disease. The absolute risk difference over the follow-up was 1.11%.
Eggs and death
Each extra half an egg per day was also linked to a higher risk of death from any cause. The absolute risk difference over the follow-up was 1.93%.
Eggs after cholesterol adjustment
After adjusting for dietary cholesterol, the links between egg consumption and cardiovascular disease and death were no longer significant.
What the authors conclude
“Among US adults, higher consumption of dietary cholesterol or eggs was significantly associated with higher risk of incident CVD and all-cause mortality in a dose-response manner.”
Also in their conclusions
- They conclude that among US adults, higher consumption of dietary cholesterol or eggs was significantly associated with higher risk of incident cardiovascular disease and all-cause mortality in a dose-response manner.
- They advise that these results should be considered in the development of dietary guidelines and updates.
How it was done
Cholesterol is a common nutrient in the diet and eggs are a major source of it. Whether dietary cholesterol or egg consumption is linked to cardiovascular disease and death was still controversial.
Researchers pooled individual data from 6 US studies that followed people over time, with data collected between March 25, 1985, and August 31, 2016. The analysis included 29 615 participants, with a median follow-up of 17.5 years.
What it can’t tell you
- We summarised it from the abstract only.
- This study followed people over time, so it can show a link but cannot prove that eating eggs or cholesterol causes heart disease or death.
- It cannot rule out that other lifestyle or health factors explain part of the link.
Who paid
- Funding
- Funded by NHLBI NIH HHS; NIDDK NIH HHS (from the PubMed record).
- Conflicts
- Conflict of Interest Disclosures: Dr Wilkins reported receiving consulting fees from NGM Biopharmaceuticals (Modest). Dr Mentz reported receiving research support from Akros, Amgen, AstraZeneca, Bayer, GlaxoSmithKline, Gilead, Luitpold, Medtronic, Merck, Novartis, Otsuka, and ResMed; honoraria from Abbott, Amgen, AstraZeneca, Bayer, Janssen, Luitpold Pharmaceuticals, Medtronic, Merck, Novartis, and ResMed; and serving on an advisory board for Amgen, AstraZeneca, Luitpold, Merck, Novartis and Boehringer Ingelheim. No other disclosures were reported.
- Authors work at
- Northwestern University Feinberg School of Medicine, Illinois; Duke University Medical Center, North Carolina; Duke Clinical Research Institute, North Carolina
The paper
- Title
- Associations of Dietary Cholesterol or Egg Consumption With Incident Cardiovascular Disease and Mortality
- Type
- Study
- Evidence
- Studies in people
- Summarised from
- Abstract only
- Cite
- Zhong VW, Van Horn L, Cornelis MC, et al (2019). Associations of Dietary Cholesterol or Egg Consumption With Incident Cardiovascular Disease and Mortality. JAMA. doi:10.1001/jama.2019.1572Free full textPubMed 30874756DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error