Egg consumption: to eat or not to eat?

Hypercholesterolemia has been recognized as a key risk factor for cardiovascular disease (CVD) (1). Up to 70% of circulating cholesterol is synthesized endogenously, while the remainder comes from dietary sources (2). Whether eating foods rich in cholesterol is independently associated with CVD and mortality has been the subject of intensive research for many years, with a plethora of observational studies reporting equivocal results (3-5). Several meta-analyses tried to shed light on this vexing topic, but were flawed by major methodological drawbacks, leading ultimately to inconsistent conclusions (6,7). The heterogeneous nature of the observational studies, which made the quantitative synthesis of their results problematic, and the potential for significant residual confounding (i.e., tobacco use, unhealthy dietary patterns) have rendered the results of those meta-analyses prone to bias. Therefore, the association between dietary cholesterol and CVD has been an open question.