Systematic review and meta-analysis · Circulation · 2022Conflicts declared

Eggs, dietary cholesterol and death from heart disease

What it found

In a large group of Finnish men followed for up to 31 years, eating more eggs and dietary cholesterol was linked to a higher risk of death from heart disease and other causes.

A combined analysis of many studies also found a small rise in heart disease risk with each extra 50 g of egg eaten daily.

What they found

Studies in people

Eggs and death

Each extra 50 g of egg eaten daily was linked to a 6% higher risk of death from any cause and a 9% higher risk of death from heart disease. After accounting for dietary cholesterol, these links were no longer significant.

Dietary cholesterol and death

Each extra 300 mg of cholesterol eaten daily was linked to a 10% higher risk of death from any cause and a 13% higher risk of death from heart disease. The link with cancer and stroke deaths was weaker and not statistically significant after correction.

Blood cholesterol and death

Men with higher blood total cholesterol had a 14% higher risk of death from heart disease for each standard deviation increase. Higher blood cholesterol was linked to a lower risk of cancer death, but this finding was not statistically significant after correction.

Eggs and heart disease across studies

In the combined analysis, each extra 50 g of egg eaten daily was linked to a 4% higher risk of heart disease. The link was stronger in US studies (8% higher risk) and weaker in European studies, with no link in Asian studies.

Subgroup consistency

The links between eggs, cholesterol and death were similar across groups divided by age, smoking, body weight, heart disease history and other factors.

What the authors conclude

“In this prospective cohort study and updated meta-analysis, greater dietary cholesterol and egg consumption were associated with increased risk of overall and CVD-related mortality.”
Zhao B, Gan L, Graubard BI, Männistö S, Albanes D, Huang J, 2022

Also in their conclusions

  • They conclude that greater consumption of dietary cholesterol and eggs is associated with increased risk of overall, cardiovascular and heart disease mortality.
  • They state that their findings support restricted consumption of dietary cholesterol as a means to improve long-term health and longevity.
  • They say that the results from the updated meta-analysis provide compelling evidence for the association between increased egg consumption and elevated risk of cardiovascular disease, especially in the US and possibly Europe, but not in Asia.

How it was done

Dietary guidelines have gone back and forth on whether people need to limit cholesterol and eggs, and previous studies have given conflicting results. The authors wanted a clearer picture of how dietary cholesterol, blood cholesterol and egg consumption relate to death from heart disease and other causes.

They followed 27,078 Finnish male smokers aged 50 to 69 for up to 31 years, tracking their diets and deaths. They also combined 49 risk estimates from other studies, covering 3,601,401 participants and 255,479 heart disease events.

What it can’t tell you

  • This kind of study follows people over time and can show links, not cause and effect.
  • The main group was Finnish male smokers with high egg and cholesterol intake, so the results may not apply to other people.
  • Diet was measured only once at the start, so later changes in eating habits were not captured.

The paper

Title
Associations of Dietary Cholesterol, Serum Cholesterol, and Egg Consumption With Overall and Cause-Specific Mortality: Systematic Review and Updated Meta-Analysis
Type
Systematic review and meta-analysisThe authors follow a set, published method to find every relevant study, then combine the numbers from them into one result.
Evidence
Studies in people
Summarised from
Full text
Cite
Zhao B, Gan L, Graubard BI, Männistö S, Albanes D, Huang J (2022). Associations of Dietary Cholesterol, Serum Cholesterol, and Egg Consumption With Overall and Cause-Specific Mortality: Systematic Review and Updated Meta-Analysis. Circulation. doi:10.1161/CIRCULATIONAHA.121.057642Free full textPubMed 35360933DOI

Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error