They have the highest quality of protein of all foods, and the yolk has a high nutrient density, rich in vitamins and minerals that support strength and health.
A 2018 review of evidence reported that the “link” between egg consumption and cardiovascular disease reported in large scale epidemiological studies is “only tenuous.”1
Moreover, all epidemiological studies all rely on dietary recall questionnaires, which do not constitute empirical evidence. Consequently, studies asserting “links” of this sort are pseudo-science and create a fictional narrative regarding nutrition and health. 2, 3
Dietary cholesterol and eggs in particular have little effect on serum cholesterol and cardiovascular disease risk in most people.4
Elevated serum cholesterol is actually a common sign of subclinical or clinical hypothyroidism, whereas high normal thyroid hormone level is linked to reduced triglycerides and increased HDL.5, 6 If your cholesterol is elevated, you may be able to reduce it by modifying your diet and taking supplements to promote better thyroid function. Eggs might help because they are a good source of selenium, which is needed for thyroid function, as discussed below.
The nutrients supplied by eggs, including cholesterol, support good health and may enhance results from resistance training,
Whole egg protein (white+yolk) has the highest protein efficiency ratio, biological value, net protein utilization, and protein digestibility corrected amino ratio of all whole foods (Table 1).7
Moreover, whole eggs supply nonprotein nutrients that enhance protein synthesis, so whole eggs support protein synthesis more effectively than egg whites when consumed after resistance training.8, 9
Egg yolks provide more cholesterol than any other commonly consumed food. Cholesterol is an intrinsic part of muscle cell membranes and therefore very important for muscle health and strength. Heavy resistance exercise depletes blood cholesterol needed for muscle cell membrane repair while supplementing cholesterol accelerates recovery from such exercise.10 Riechman et al found a dose-response relationship between dietary and serum cholesterol and gains in lean mass among men and women 60- to 69- years of age.11 A placebo-controlled study found greater strength gains among subjects supplemented with 800 mg/d (3 egg yolks) of cholesterol compared to 400 or 200 mg/d.12 Another study found that subjects assigned to eating a high cholesterol diet containing 3 eggs daily gained more muscle mass and strength than those who consumed 0 or 1 egg daily.13 A final study found that healthy, young (20-28 y) adults who consumed 800 mg/d cholesterol had nearly 3 times greater post-resistance training myofibrillar protein synthesis rate 22 h after training than the low cholesterol group.14
We need dietary choline for a number of functions including neurotransmitter synthesis, cell structure, methylation and proper liver function including metabolism of fats and sugars. Requirements are increased during pregnancy and lactation to support neurological development in children. Choline deficiency plays a role in liver disease, poor offspring cognitive function and neurological disorders. A 2019 study provided evidence that a lifelong high intake of choline (4.5 times the recommended adequate intake) might prevent Alzheimer’s disease.15
The Institute of Medicine recommends a daily choline intake of 425 mg for adult women and 550 mg for adult men.16 According to data from the 2009-2012 National Health and Nutrition Examination Survey (NHANES) of nearly 17,000 people in the U.S.A., only about 11% of people achieved the recommended adequate intakes.17 In Canada one study showed that only 23% of pregnant women and 10% of lactating mothers consumed adequate choline; women consuming at least one whole egg daily were 8 times more likely to meet choline intake recommendations compared with pregnant egg yolk-avoiders.18
Usual choline intakes are associated with egg and animal protein intake. Plant foods are poor sources of choline, and people who avoid animal products have difficulty obtaining an adequate intake. Liver, egg yolks, and beef are the best dietary choline sources (Figure 1).20
An adult needs the amount of choline found in 2 egg yolks daily to obtain the recommended adequate intake (425-550 mg/d).
The egg yolk is a good dietary source of other critical nutrients, including folic acid, vitamin B12, and vitamins A, D, and E.
Folate and vitamin B12 help control homocysteine levels to prevent cardiovascular disease. Vitamin A is needed for protein synthesis and immune function, vitamin D for calcium absorption and innate immunity, and vitamin E for fertility and protecting fats from oxidation.
Whole eggs are good sources of phosphorus, sulfur, and selenium.
We need phosphorus to produce ATP (energy) from macronutrients. Phosphorus supplementation has been shown to improve glucose tolerance and increase diet-induced thermogenesis and satiety in overweight and obese humans.21 A high phosphorus diet has also been shown to reduce insulin levels, formation of fat, and body fat levels in a rodent model.22
We need sulfur to maintain and repair connective tissue, such as cartilage in joints, and also to produce the hormone insulin.
We need selenium to produce the anti-oxidant glutathione and to produce thyroid hormone. Low selenium intake has been linked to subclinical hypothyroidism.23, 24 Organically bound selenium supplementation improves thyroid function in individuals with auto-immune thyroiditis.25
Eggs are a good source of organically bound selenium; a large whole egg provides about 15 µg of selenium, about 25% of the recommended daily intake for a healthy individual. The selenium is in the yolk, so don’t throw it out!
Chinese medicine recognizes the high value of eggs but also notes that because eggs are such a nutritionally rich food, consuming too many eggs can result in intake more of protein and fat than the body can efficiently use. This will result in excess body fat, excess blood fat, excess cholesterol, liver and gall bladder congestion, kidney stones, and so on.
Dr. Bob Flaws, author of the Tao of Healthy Eating, explains
"Highly nutritious foods have more flavor (wei) than qi. In this context, qi means the light, airy, aromatic and yang part of a food, whereas wei,literally meaning taste, refers to a food's heavier, more substantial, more nourishing, yin aspects. All foods are a combination of qi and wei. Here again we see Chinese medicine's emphasis on balance. Highly nutritious foods, such as dairy products, meats, nuts, eggs, oils, and fats are strongly capable of supplementing the body's yin fluids and substances; however, in excess they generate a super-abundance of body fluids [and substances] which become pathogenic dampness. Although this may appear to be a paradox, it has to do with healthy yin in excess becoming evil or pathological yin or dampness, phlegm and turbidity."
This exemplifies one of the principles of Chinese science: everything in extreme turns into its opposite. Thus, food that is highly nourishing in moderation, turns into poison when consumed excessively. Because meat, eggs, and milk are so easily digested and strongly nourishing, animal products have what we call a narrow therapeutic range. Consumption below the range –– too little animal food –– results in deficiency conditions (common among vegans), such as vitamin B12 deficiency; while too much animal food (above the therapeutic range) results in excess conditions.
A 2022 study reported that when young Chinese adults consumed two eggs daily for 11 weeks, there was no change in their cholesterol balance, and those consuming two eggs at breakfast felt less hungry and more satisfied.26 Studies in Japan and China have found no significant correlation between egg consumption and risk of CVDs, stroke or type 2 diabetes.26 This indicates that when your diet is primarily plant based (as in Asia) and overall low in total fat, it is likely safe and beneficial to consume up to two eggs daily, without promoting disorders of excess.
1. Blesso CN, Fernandez ML. Dietary Cholesterol, Serum Lipids, and Heart Disease: Are Eggs Working for or Against You?. Nutrients. 2018;10(4):426. Published 2018 Mar 29. doi:10.3390/nu10040426
2. Archer E, Pavela G, Lavie CJ. The Inadmissibility of What We Eat in America and NHANES Dietary Data in Nutrition and Obesity Research and the Scientific Formulation of National Dietary Guidelines. Mayo Clin Proc. 2015;90(7):911–926. doi:10.1016/j.mayocp.2015.04.009
3. Archer E, Lavie CJ, Hill JO. The Failure to Measure Dietary Intake Engendered a Fictional Discourse on Diet-Disease Relations. Front Nutr. 2018;5:105. Published 2018 Nov 13. doi:10.3389/fnut.2018.00105
4. Eilat-Adar S, Sinai T, Yosefy C, Henkin Y. Nutritional recommendations for cardiovascular disease prevention. Nutrients. 2013;5(9):3646–3683. Published 2013 Sep 17. doi:10.3390/nu5093646
5. Rizos CV, Elisaf MS, Liberopoulos EN. Effects of thyroid dysfunction on lipid profile. Open Cardiovasc Med J. 2011;5:76–84. doi:10.2174/1874192401105010076 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109527/>
6. Lee J, Ha J, Jo K, et al. High Normal Range of Free Thyroxine is Associated with Decreased Triglycerides and with Increased High-Density Lipoprotein Cholesterol Based on Population Representative Data. J Clin Med. 2019;8(6):758. Published 2019 May 28. doi:10.3390/jcm8060758 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6616420/>
7. Hoffman JR, Falvo MJ. Protein - Which is Best?. J Sports Sci Med. 2004;3(3):118–130. Published 2004 Sep 1.
8. van Vliet S, Shy EL, Abou Sawan S, et al. Consumption of whole eggs promotes greater stimulation of postexercise muscle protein synthesis than consumption of isonitrogenous amounts of egg whites in young men. Am J Clin Nutr. 2017 Dec;106(6):1401-1412. doi: 10.3945/ajcn.117.159855. Epub 2017 Oct 4. PubMed PMID: 28978542. <https://academic.oup.com/ajcn/article/106/6/1401/4823156>
9. Abou Sawan S, van Vliet S, West DWD, et al. Whole egg, but not egg white, ingestion induces mTOR colocalization with the lysosome after resistance exercise. Am J Physiol Cell Physiol. 2018;315(4):C537–C543. doi:10.1152/ajpcell.00225.2018 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6230681/>
10. Riechman SE, Woock Lee C, Chikani G, et al. Cholesterol and Skeletal Muscle Health. World Review of nutrition and dietetics 2009 Feb;100:71-9.
11. Riechman SE, Andrews RD, Maclean DA, et al. Statins and dietary and serum cholesterol are associated with increased lean mass following resistance training. J Gerontol A Biol Sci Med Sci 2007 Oct;62(10):1164-71. <https://www.ncbi.nlm.nih.gov/pubmed/17921432>
12. Riechman SE, Woock Lee C, Gasier HG, Chikani G. Dietary Cholesterol and Skeletal Muscle Hypertrophy with Resistance Training: A Randomized Placebo-Controlled Trial. The FASEB Journal 2008 March;22:962.13.<http://www.fasebj.org/cgi/content/meeting_abstract/22/1_MeetingAbstracts/962.13>
13. Riechman SE, Gasier HG. Effect of Dietary Cholesterol on Muscle Hypertrophy with Resistance Training: Randomized Double Blind Placebo-Controlled Trial. Med Sci Sports Exer 2007 May;39(5):S291-S292. http://journals.lww.com/acsm-msse/Fulltext/2007/05001/Effect_of_Dietary_Cholesterol_on_Muscle.1949.aspx
14. Lee CW, Lee TV, Chen VCW, et al. Dietary Cholesterol Affects Skeletal Muscle Protein Synthesis Following Acute Resistance Exercise. FASEB J 2011 April;25(1):Supplementlb563. http://www.fasebj.org/content/25/1_Supplement/lb563.short
15. Arizona State University. "Common nutrient supplementation may hold the answers to combating Alzheimer's disease." ScienceDaily. ScienceDaily, 27 September 2019. <www.sciencedaily.com/releases/2019/09/190927122526.htm>.
16. Institute of Medicine. Food and Nutrition Board (1998) Dietary Reference Intakes: Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. In: . Washington, DC: National Academies Press, 1998.
17. Taylor & Francis. "Assessment of total choline intakes in the United States." ScienceDaily. ScienceDaily, 3 May 2016. <www.sciencedaily.com/releases/2016/05/160503131652.htm>.
18. Derbyshire E. Could we be overlooking a potential choline crisis in the United Kingdom? BMJ Nutr Prev Health 2019;bmjnph-2019-000037. <https://nutrition.bmj.com/content/early/2019/08/30/bmjnph-2019-000037>
19. Wallace T , Fulgoni V . Usual choline intakes are associated with egg and protein food consumption in the United States. Nutrients 2017;9:839.doi:10.3390/nu9080839
20. “Strict vegetarians, who consume no meat, milk, or eggs, may be at risk for inadequate choline intake.” Linus Pauling Institute Micronutrient Information Center, Oregon State University, “Choline,” <http://lpi.oregonstate.edu/mic/other-nutrients/choline>
21. Bassil MS, Obeid OA. Phosphorus Supplementation Recovers the Blunted Diet-Induced Thermogenesis of Overweight and Obese Adults: A Pilot Study. Nutrients. 2016;8(12):801. Published 2016 Dec 9. doi:10.3390/nu8120801 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5188456/>
22. Imi Y, Yabiki N, Abuduli M, Masuda M, Yamanaka-Okumura H, Taketani Y. High phosphate diet suppresses lipogenesis in white adipose tissue. J Clin Biochem Nutr. 2018;63(3):181–191. doi:10.3164/jcbn.17-141 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252294/>
23. Imi Y, Yabiki N, Abuduli M, Masuda M, Yamanaka-Okumura H, Taketani Y. High phosphate diet suppresses lipogenesis in white adipose tissue. J Clin Biochem Nutr. 2018;63(3):181–191. doi:10.3164/jcbn.17-141 <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252294/>
24. Wu Q, Rayman MP, Lv H, Schomburg L, et al. Low Population Selenium Status Is Associated With Increased Prevalence of Thyroid Disease. J Clin Endocrinol Metab. 2015 Nov;100(11):4037-47. doi: 10.1210/jc.2015-2222. Epub 2015 Aug 25. PubMed PMID: 26305620.
25. Ventura M, Melo M, Carrilho F. Selenium and Thyroid Disease: From Pathophysiology to Treatment. Int J Endocrinol. 2017;2017:1297658. doi:10.1155/2017/1297658
26. Ma Z, Wu W, Zhang D, et al. Daily intake of up to two eggs for 11 weeks does not affect the cholesterol balance of Chinese young adults. Food Science & Nutrition 17 January 2022.<https://onlinelibrary.wiley.com/doi/10.1002/fsn3.2734>
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