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Fortified Eggs Did Not Raise Cholesterol in Modest-Sized Cardiology Study

Further study needed to investigate secondary findings. 

eggs in a yellow bowl

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Stephanie Lopez
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DURHAM, NC – There are often conflicting headlines about whether certain foods are good or bad for you, and the news about eggs has been especially confusing. Search the topic online and you’ll find a wealth of articles spanning back decades. 

A study presented at the American College of Cardiology’s Annual Scientific Session and led by researchers at Duke, offers new evidence on fortified eggs, which are eggs enriched with various vitamins or nutrients. In a modest-sized randomized trial, researchers found that fortified eggs did not have a negative impact on bad cholesterol (LDL cholesterol) or good cholesterol (HDL cholesterol) over the course of the four-month study.

The study was sponsored by Eggland’s Best, a company that makes and sells fortified eggs. It also provided the eggs used in the research.

The study had 140 participants, all people aged 50 or older, who had experienced at least one cardiac event in the past or had risk factors for cardiovascular disease such as diabetes. Researchers randomized participants into two groups, asking half to eat two or fewer eggs per week for four months. The other half were provided with fortified eggs and asked to eat 12 per week for the same period of time. 

While no significant changes in bad or good cholesterol were found, a secondary finding hinted there could be some benefit associated with fortified egg consumption for older patients and patients with diabetes.

That secondary finding was not statistically significant due to the number of study participants, but senior researcher, Robert Mentz, M.D., associate professor in the Department of Medicine at the Duke University School of Medicine, said it’s an interesting signal that the researchers would like to investigate in future work.

“If we can explore this area further, in a larger study, specifically focusing on the type of patients who appear to have potentially experienced some benefit, and over a longer period of time, we could see if it is possible for fortified eggs to improve cholesterol,” Mentz said.

The study’s first author, Nina Nouhravesh, M.D., a cardiology fellow at the Duke Clinical Research Institute, said the study can be viewed as a pilot study. 

“While it was modest in size, it did include a broadly generalized population,” Nouravesh said. “The average age of participants was 66 years, half were women, and more than 25% identified as Black.” 

Mentz said the enrollment was representative of the community, especially for a study aimed at cardiology patients. 

He said he would like to move forward with a larger study assessing clinical outcomes, particularly when considering the topic of equity and food access. 

“There are disparities around access to food,” Mentz said. “Individuals who are the most socially disadvantaged (and likely have more instances of high blood pressure and diabetes), often have less access to healthy foods. Often what we hear described in the community is access to fresh fruits and vegetables. Those are really time-limited foods that may go bad quickly. Fortified eggs can be safely stored in the refrigerator for longer periods of time. Investigating potential health benefits of an easily accessible and less time-limited food is something we should be doing.” 

“I think we are in this exciting time where people think of food as medicine,” Mentz said. “Some foods are fortified and nutritionally optimized before they’re disseminated, similar to medications, so it’s exciting to use the same rigor that’s applied in medication trials to food science.”

In addition to Mentz and Nouhravesh, study authors include Josephine Harrington, Laura H. Aberle, Cynthia L. Green, Kathleen Voss, Dave Holdsworth, Kurt Misialek, Bartel T. Slaugh, Mandee Wieand, William S. Yancy and Neha Pagidipati.

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