Facts about cholesterol - in an eggshell

Dr. David Becker, a cardiologist with Chestnut Hill Temple Cardiology in Flourtown, wrote this for philly.com/health.

Lately, it seems advice on the benefits and risks of eating eggs is just plain scrambled. For years, physicians, nutritionists, and nurses have recommended avoiding eggs in one's diet, because the yolks are full of cholesterol. One little yolk has 200 mg of cholesterol in it, almost the entire amount we should eat in one day.

Yet recently, opposing recommendations grabbed media attention. The sudden acceptance of eggs and cholesterol has sparked a dietary debate that plainly misses the mark. A little history lesson is egg-sactly what is needed.

Thirty years ago, Americans started gaining weight. As our waistlines expanded, we attributed it to eating too much fat. In response, the advice was to reduce fat and cholesterol intake, including the egg. Soon, supermarket shelves were lined with products labeled "cholesterol free" and "reduced fat." Thinking this was the responsible choice, many people reached for those products and altered their cholesterol intake.

Yet despite that change, Americans are still overweight and wrestling with dietary-influenced chronic illnesses like heart disease.

This is because, to avoid fatty foods, we began ingesting the easy alternative of simple carbohydrates like breads, bagels, and pasta. These foods are no better, as the body treats these white-flour products just like sugar. It turns them into fat, causing weight gain and blood-vessel inflammation.

Which means one thing is certain; the buzz about eating eggs is not all it's cracked up to be. Avoid them if you can, and I still think egg whites are better.

People tell me all the time they are confused about dietary advice because it changes all the time. No one knows what to believe. The egg debate is merely a distraction from more valuable heart dietary information.

What we should eat is a more important concern. A nutrition plan like the Mediterranean diet - rich in omega-3 fatty acids, and other sources of polyunsaturated fats as well as monounsaturated fats - can lower our cholesterol values, reduce inflammation, and lessen heart attack risk. Examples of foods include lots of fruits and vegetables; lean chicken, turkey, or fish as sources of protein; low-fat or fat-free yogurt, cottage cheese, and skim or low-fat milk. A recent trial showed just how powerful this diet could be to prevent a heart problem. Spanish researchers found a Mediterranean diet supplemented with either olive oil or nuts cut the chance of having a heart attack or stroke by 30 percent in a group of adults, compared to a similar group on their usual diet.

As a cardiologist, my major concern is that my patients' focus be on the importance of diet, weight loss, and exercise, instead of relying on drugs like statins to lower cholesterol levels. Sometimes, they are medically indicated, but they should not be a replacement for dietary control and healthy lifestyle habits.

The famous egg Humpty Dumpty may be sitting pretty this week, but the reputation of the medical world for giving good advice has taken a great fall, and can only be repaired by advocating careful healthy living, exercise, and maybe egg white alternatives. That's no yolk!