Does Dietary Cholesterol Increase Cancer Risk?

For years, we have known about the connection between increased cholesterol levels as it relates to heart disease. The higher the cholesterol level, the higher the risk for heart disease. 

However, there is a public debate regarding dietary cholesterol consumption. Overall, the medical community agrees the consumption of dietary cholesterol should be as little as possible. 

The Institute of Medicine (IOM) states “individuals should consume as little dietary cholesterol as possible while consuming a healthy eating pattern.” (1) 

What is the reason behind this recommendation? Most foods that contain dietary cholesterol are also high in saturated fats, such as fatty meats and high-fat dairy products. Furthermore, strong evidence from prospective cohort studies (following individuals for a long period of time and monitoring disease development) and randomized controlled trials show eating patterns lower in dietary cholesterol are associated with a reduction in heart disease risk (1). 

But what about cholesterol as it relates to cancer risk? 

Studies are not as widely available and don’t have as strong of evidence in cancer versus heart disease. However, the evidence continues to mount. 

This study, which looked at 19,732 people, found dietary cholesterol increased the risk of cancers of the stomach, colon, rectum, pancreatic, lung, breast, kidney, bladder, and Non-Hodgkin’s lymphoma. (2)

Further research focused on prostate cancer has found that men who consumed the equivalent of just ½ egg per day (the equivalent of 3.5 eggs a week) had a 14% increased risk of advanced prostate cancer (3). Whereas, men who consumed 5 eggs per week were found to have a 47% increased risk of fatal prostate cancer (4). Limitations to both of these studies include they were prospective cohort studies, rather than a randomized control trial. 

What do researchers believe is the reason for increased cancer risk? 

It has been found that “a large amount of cholesterol is required for malignant (cancerous) cells to support their rapid growth” (4). Meaning, cancer cells can use cholesterol to fuel its growth. 

As mentioned previously, foods that contain high amounts of cholesterol likely contain high amounts of saturated fat, but also choline and protein — all of which are believed to play a role in the development and/or growth of cancer cells. 

What should we do with this information? 

As always, the goal of Wholesome is to present research in an easy-to-understand manner allowing YOU to make the best decisions for you and your family. 

Consider focusing on limiting eggs within your diet and follow the IOM recommendation to limit the consumption of dietary cholesterol as little as possible. 

Furthermore, research demonstrates the relationship between egg consumption and cancer risk is a dose response relationship, especially among GI cancers (5). Meaning, the more eggs consumed, the higher the cancer risk. 

It doesn’t mean one needs to cut out eggs from the diet completely. Simply focus on limiting consumption to reduce your overall risk of cancer development or recurrence if complete elimination is daunting to you. 

Egg Replacement Recommendations

For many, cooking or baking without eggs is very different. 

For us, it was a gradual process to eliminate eggs from our home. Thankfully, here are a few simple replacements that help reduce your egg consumption! 

References: 

1. Chapter 1: Key Elements of Healthy Eating Patterns. (n.d.). Retrieved March 24, 2020, from https://health.gov/our-work/food-nutrition/2015-2020-dietary-guidelines/guidelines/chapter-1/a-closer-look-inside-healthy-eating-patterns
2. Hu J, La vecchia C, De groh M, et al. Dietary cholesterol intake and cancer. Ann Oncol. 2012;23(2):491-500.
3. Wu K, Spiegelman D, Hou T, et al. Associations between unprocessed red and processed meat, poultry, seafood and egg intake and the risk of prostate cancer: A pooled analysis of 15 prospective cohort studies. Int J Cancer. 2016;138(10):2368-82.
4. Keum N, Lee DH, Marchand N, et al. Egg intake and cancers of the breast, ovary and prostate: a dose-response meta-analysis of prospective observational studies. Br J Nutr. 2015;114(7):1099-107.
5. Tse G, Eslick GD. Egg consumption and risk of GI neoplasms: dose-response meta-analysis and systematic review. Eur J Nutr. 2014;53(7):1581-90.