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Serum cholesterol concentration is clearly increased by adding dietary cholesterol. In other words, putting cholesterol in our mouth means putting cholesterol in our blood, and it may also potentiate the harmful effects of saturated fats, meaning when we eat sausage and eggs, the eggs may make the effects of the sausage even worse. If we ate the saturated fat and cholesterol found in two sausages and egg mcmuffins every day for two weeks, our cholesterol would shoot up nearly 30 points. If we ate about the same saturated fat without the cholesterol, some kind of cholesterol-free sausage mcmuffins without the egg, what would happen? Now the egg would have saturated fat too, so to even it out we have to add three strips of bacon to this side. Same saturated fat, but two eggs worth less cholesterol, would only bump us up to here. So yes, saturated fat may increase fasting cholesterol levels more than dietary cholesterol, but especially in the presence of dietary cholesterol.

And this is measuring fasting cholesterol, meaning the baseline from which all our meal-related cholesterol spikes would then shoot. Heart disease has been described as a postprandial phenomenon, meaning an after-meal phenomenon. Milky little droplets of fat and cholesterol straight from a meal called chylomicrons can build up in atherosclerotic plaques just like LDL cholesterol. So what happens after a meal that includes eggs?

Here’s what happens to the level of fat and cholesterol in our blood stream for the 7 hours after eating a meal with no-fat, no-cholesterol. Hardly changes at all. But now a meal with fat and more and more egg yolk. Triglycerides shoot up, and blood cholesterol shoots up.

That’s the kind of data that’s bad for egg sales, so how could you design a study to hide this fact?

What if you only measured fasting cholesterol levels in the morning, seven hours after supper, you wouldn’t see a big difference between those that ate eggs the night before and those that didn't. As the lead investigator of the smoking and egg study pointed out, measuring fasting cholesterol is appropriate for measuring the effects of drugs suppressing our liver’s cholesterol production, but not appropriate for measuring the effects of dietary cholesterol. After a cholesterol-laden supper, look what our arteries are being pummeled with all night long. And think about the day. How many hours are there between meals? Maybe four hours between breakfast and lunch? So if we had eggs for breakfast we’d get that big spike and by lunch start the whole cycle of fat and cholesterol in our arteries all over again. So most of our lives are lived in a postprandial state, in an after-meal state, and this shows that the amount of cholesterol in those meals—they actually used eggs in this study, so the amount of egg in our meals makes a big difference when it really matters—after we’ve eaten, which is where we spend most of our lives. So that’s why when the Egg Board funds a study they only measure fasting cholesterol levels way out here somewhere.