Associations of egg consumption with cardiovascular disease
heart.bmj.com
heart.bmj.com
People that aren't consuming eggs might do so because of health issues. Meaning that they are more prone to feel the side effects.
Similar effect happened in the alcohol study, where moderate consumption had a lower mortality than those consuming nothing. It turned out that those abstaining from alcohol were more prone to get side effects immediately. After adjusting for these errors in data reporting, the u-curve disappeared and the relationship was linear (more alcohol you consumed higher the mortality).
I was also, embarrassingly, citing the alcohol study, since then I've realized the first reaction to a paper should be doubt and I'll definitely abstain from acknowledging epidemiological diet studies in the future. Even meta-analyses taking them into account.
One of the best examples is that many meta-analyses conclude that dietary cholesterol does not increase serum cholesterol (proven risk in CVD). Disregarding the fact that many of the aggregated studies do not measure baseline cholesterol, and it is assumed that there's a linear response on serum cholesterol to dietary cholesterol when it's a 20 year old information that response is non-linear.
The authors are aware of this, and excluded people suffering from several common health problems for this reason:
"In the present study, we excluded individuals reporting medical histories of cancer (n=2577), heart disease (n=15 472) or stroke (n=8884), or having prevalent diabetes (n=30 300) defined by self-reported diabetes or on-site plasma glucose testing (fasting blood glucose ≥7.0 mmol/L or random blood glucose ≥11.1 mmol/L). We made these exclusions to avoid a prevalence–incidence bias and minimise the effect of reverse causality led by potential confounders such as lifestyle factors."
This isn't all possible sources of reverse causality, but it does at least make it less likely.
The link between diet and cholesterol seems to be indirect.
Take for example coffee. Non-filtered coffee increases serum cholesterol even when it does not contain cholesterol. Coffee oils (diterpenes like cafestol and kahweol) mess up body’s ability to metabolize and regulate cholesterol.
Coffee contains 1% of diterpenes. Fortunately normal paper filter removes most of the oils. French press and Turkish style are the worst.
appreciating the reminder
The results are probably real, but maybe not for the reasons the author suggests.
Not the first one of its kind but pretty large sample.
https://www.ncbi.nlm.nih.gov/pubmed/20636661
Here's a study showing that drinking a little alcohol lowers your chance of having liver cirrhosis compared to drinking no alcohol.
https://sci-hub.tw/10.1111/add.13627
Here's the criticism.
> We would like to add to her discussion of the significance of former and occasional drinker biases in this literature and highlight how they can cause both overestimation of cardioprotection and underestimation of cancer risks across the whole drinking continuum. The underlying theory here is that, as a population ages, a selection bias operates whereby individuals with poorer health are more likely to cut down or stop drinking completely. Such individuals are often still classified as ‘abstainers’ and used as a reference against which all current drinkers are compared. In simple terms, they make drinkers at all levels of consumption ‘look good’ by comparison.
https://www.ncbi.nlm.nih.gov/pubmed/26997174
Guys above then adjust for the mistake. The benefits disappear. Mortality risk grows as alcohol consumption increases. Yeah, there are people with protective genes, but on a population scale, recommending to go from 0 to N glasses of alcoholic beverage a day is insane.
I have personally increased my alcohol consumption, which was obviously dumb, given that the data was flawed. After this study I don't think I'll have more than couple of drinks per year.
I'm assuming that first sentence is pointing out a negative association, rather than an intake greater than the slightly confusingly worded 'up to <1 egg a day' line.
Later they write:
> Lacking participants with consumption of more than one egg per day restricted us to assess the association between higher egg consumption (>1 egg/day) and the risk of CVD; but the usual amount of the highest frequency level in the present study was approximate to the recommended amount of the guidelines (0.76 egg vs 0.8–1.0 egg), indicating that adherence to the dietary guidelines with regard to egg consumption could result in a lower risk of CVD.
As someone who regularly has 2-3 eggs a day, I'm much more interested in risks - and indeed whether there are even greater benefits - associated with higher consumption rates.
Eggs are a fantastic food source. Even herbivores will often deign to eat them, albeit opportunistically.
E.g.: "Observational studies in middle-aged Japanese people and in people on a Mediterranean diet found no association between egg consumption and risk of cardiovascular disease. Another observational study found no increase in the risk of stroke or coronary artery disease in people consuming 1–6 eggs per week, whereas “greater than 6 eggs per week” appeared to increase the risk of coronary artery disease only in diabetics."
Well, according to this study, eggs do not do anything for diabetics.
I'm pretty sure all of those observational studies (including the one I cite) are severely flawed.
[1] An egg a day might reduce your risk of heart disease, study says - https://edition.cnn.com/2018/05/21/health/eggs-heart-disease...
http://www.dailymail.co.uk/femail/article-2644251/Un-scrambl...
Not all eggs are treated the same. I don't see how this study accounts for what kind of eggs or how they have been processed. It matters, a lot, if your eggs are bleached or how they have been stored.
I eat between 4 and 6 eggs per day. We'll see what happens in 50 years, but I bet CAD won't be a significant problem because of my good genetics.
My doctor, who is otherwise good, still parrots the usual “don’t eat eggs” and I just nod my head. I think it’s a script the medical group makes her ramble off because I’ve given her all of the relevant info to how I changed my diet.
My understanding from a lot of reading is that for most people, save for genetic black swans and diabetics, dietary cholesterol doesn’t matter. My guess is that for my own case, my family just has a gene that makes us metabolize saturated fats into syrum cholesterol more than people who can eat whatever without affecting it.
Now, it seems that cholesterol in isolation is not a very good indicator of CVD anyway (HDL/TG seems better). We are even considering that it's not the cause of atherosclerosis, but a correlation (just like cavities don't cause diabetes).
The best part is my HDL to total cholesterol ratio which is well into the very healthy range.
The key is good genetics in addition to exercise and eating lots of fresh foods and fish, and avoiding excessive red meat.
Ingredients of food in cuisines are clustered. They cannot be treated as if they were independent. For example egg consumption might be highly correlated with bacon consumption in one population, and spinach in another: the recommendation to eat more eggs based on studies of the latter population might have unintended consequences if adopted by the former.
It's unlikely that any reputable study is going to show them as a surprise miracle superfood, and if you're consuming them as a major part of your diet that's not "in moderation" and this study is not relevant to you.
Don that mean that it's best to eat a lot or less eggs ?
I would be interested to know, for the people not eating at least one egg a day, what were those meals instead? It could be a case of "an egg is healthier than [Unknown]" instead of "an egg makes you healthier."
An even simpler paraphrase is "eating less than 1 egg a day is associated with lower CVD".
To answer your question directly, one can reasonably infer from the quote you provide that it is best to eat fewer eggs.
EDIT: change quantifying adjective from "less" to "fewer"
In my partial defense, concluding something like "eating up to but less than one egg per day is inversely associated with CVD risk" is odd and somewhat defies common sense.
My incorrect translation is a good reminder for me that scientific language doesn't always easily translate into conversational language.
EDIT: remove repeated word
Try comparing an egg from the cheapest dozen you can buy at the cheapest supermarket in your area against an egg from someone who raises chickens. In my experience the cheap egg will have watery whites and a pale yoke that breaks if you look at it funny. Fry it up and it will basically taste like nothing. The other egg will have a much thicker white, and a yolk that stands up in the bowl, takes considerable work with a fork to really break apart, and is somewhere between orange and bright vivid orange. This egg almost certainly tastes a lot better.
Is one healthier than the other? I don't know. But you can tell just by looking at them that they have substantially different compositions.
People are just that clueless.
Great fun, and about as hard to look after as a rabbit. Plus the best eggs you will have ever tasted.
It's also why I don't agree with the moral argument for veganism - happy hens lay eggs too and eggs gotta be eaten!
Pedigree hens lay about once every other day, and can live up to eight years.
Think about how different this could look: https://xkcd.com/1338/
1. Those particular animals would not be alive. I was replying to a comment about the quality of life of those particular animals.
2. Regarding the point that other animals would take their place: isn’t this an argument against veganism? Life in a state of nature is brutal and not at all what I would classify as clearly better than life under domestication.
That being said, I still believe that we have some kind of a moral obligation to provide the animals in our care with a decent quality of life.
Consider:
* The modern chicken is quite different to its wild ancestors, and lays eggs about 20 times more frequently (the eggs are also larger). I'd call it genetic exploitation.
* The male chickens are (most likely) killed after hatching in preference of the females you'll keep.
* They may be safe from predators, but is the loss of freedom, a natural environment and normal biological functions a price worth paying?
I've raised chickens since I was a kid. We kept males and females. When the chickens stopped laying, we ate them too.
This idea that something "isn't natural" so it's wrong is ridiculous. Human technology has drastically altered the planet and we need to focus on how to work in it as opposed to fantasizing about how nice it would be if we could go back to the stone age.
So by all means, be vegan. Refuse to consume farm animals. 99.9% of the world will not. Your efforts are drowned out. Hopefully the moral superiority you gain will be an acceptable consolation prize.
I guess plant life, bacteria and fungi don't count?
Not really relevant. It's already done, and the alternative is chicken extinction. We can live symbiotically with chickens, or we can let them go extinct for vegan ideals.
> They may be safe from predators, but is the loss of freedom, a natural environment and normal biological functions a price worth paying?
Humans did this in forming societies, so clearly we by and large think the answer is yes.
https://www.manitobacooperator.ca/livestock/new-technology-d...
Great news!
Aside from that. What is the rest of the diet, eating patterns, exercise, environment, stress levels, etc. Yeah sure egg or <insert random food item here> will make a world of a difference on its own /endsarcasm. It is like taking a car to the mechanic for a checkup and he just check if front lights are working and try to conclude the state of the whole car.
Unless the nugget is, “less overall, and especially less refined sugar.”
I think the singular thing we can be certain of is nutritionists won’t wake up 20 years from now and say, “Oh man, we all should have been recommending a higher sugar intake!”
Replace a deli sandwich with two eggs or replace a bowl of sugar cereal with two eggs or a slice of pizza with a nice omelette
For the high caloric price of admission you get very little vitamins, minerals, and protein. Just look at their nutrient profile for proof: 1 egg nets you 10+% of your daily saturated fat recommendation, 14% riboflavin, 11% vitamin b12, and all other vitamins less than 8%. For the minerals, 23% of your selenium (really not something you need in abundance - google selenium overdose), 10% phosphorus, and the rest 5% or below. All of that for only about 1/9th of your daily suggested protein.
So to get your daily protein from eggs you would need to overdose on cholesterol by almost 9 times the recommendation, consume 90+% of your saturated fat, and overdose on selenium, and so on.
And if that weren’t enough, you would be eating more fat (by weight) than protein.
Edit-fixed saturated fat content to 10%
Edit 2-The ratio of omega3 to omega6 is about 1:12. That should be more like 1:1 (preferably) or at least 1:4. So to correct that you would need to eat even more fats to correct that ratio intake.
Your body is likely manufacturing 70-80% of your actual cholesterol content. I think cholesterol concerns have been debunked, or at least severely downgraded, since they became a big deal in the 1980's.
> Just look at their nutrient profile for proof: 1 egg nets you 70+% of your daily saturated fat recommendation ...
The fat recommendations you're citing are presumably coming from places like the USA's FDA -- which famously pushed the 'fat makes you fat' lie for many decades, directing citizens to consume increasing amounts of sugar instead, resulting in one of the most spectacular, and depressing, natural experiments that has proven this thinking to be literally fatally flawed.
I would like to add something. I am from India and I am seeing the results of Fat makes you fat principle peddled by doctors on the population. Before the introduction of "Americanised" version of food and US FDA dietary regulations(Docs in India follow the US FDA regulations), we had animal fats like Ghee, Butter, Panner, cream made from milk. Now the docs told remove these and told everyone to eat more Carbs. Well people started more eating more Carbs. Guess what they choose more and more processed cereals rather than greens. Now we have Type 2 Diabetes epidemic in India. People are not as fat as Americans but are skinny fat and have belly fat and all metabolic diseases. And the bad advice continues.
"Back then, we knew that egg yolks had lots of cholesterol, and we knew that high levels of LDL (bad) cholesterol in the blood increased the risk of cardiovascular disease. So it seemed logical that avoiding cholesterol in the diet made sense.
Since then, however, research has shown that most of the cholesterol in our body is made by our liver-it doesn't come from cholesterol we eat. The liver is stimulated to make cholesterol primarily by saturated fat and trans fat in our diet, not dietary cholesterol. But a large egg contains little saturated fat-about 1.5 grams (g). And research has confirmed that eggs also contain many healthy nutrients: lutein and zeaxanthin, which are good for the eyes; choline, which is good for the brain and nerves; and various vitamins (A, B, and D). In fact, just one large egg contains 270 international units (IU) of vitamin A and 41 IU of vitamin D. One large egg also contains about 6 g of protein and 72 calories.
The evidence that eating an egg a day is safe for most people comes from huge studies-many conducted here at Harvard Medical School-that have followed hundreds of thousands of people over decades."
https://www.health.harvard.edu/heart-health/are-eggs-risky-f...
Not to mention:
https://www.dietdoctor.com/saturated-fat-completely-safe-acc...
https://thescienceofnutrition.wordpress.com/2014/08/10/the-b...
Considering eggs a problem for that (their cholesterol content) is like having a program that takes 20 minutes to run, and trying to optimize a routine that only accounts for 5 seconds of the overall time.
Most of the studies that have claimed to show that diet doesn't raise cholesterol have involved populations of people that already have abnormally high cholesterol from a bad diet (i.e. the typical American).
Important points summarized here:
Edit: You've now corrected this to 10%, but even that is based upon a very cautious RDA for saturated fat.
Also, consuming 9 eggs by themselves would not cause you overdose on selenium either - the RDA for selenium is between 55-135mg (again, depending on source), whilst the overdose threshold for it is believed to be around 400mg. However, an egg contains around 15mg of selenium - so whilst consuming 9 of them would put you over or at your RDA, it is not an overdose, since the RDA is a recommendation, not a limit.
https://www.ahealthiermichigan.org/2011/10/11/the-nurtional-...
A 920g container has 500 calories, 100g of protein, zero fat, zero saturated fat, zero trans fat, zero carbs, zero cholesterol.
Most people are not trying to minmax their nutrient intake. The numbers you give seem to make eggs a useful component of a healthy, varied diet.
Nitpick: eggs don't have mothers because eggs are not offspring.
Scientifically, healthy-unhealthy food does not exist. There's no health scale. Everything depends on the context.
If your blood results and other health information is stable, whatever you're eating isn't doing you any harm, then that's a healthy lifestyle.
Trying to divide foods into healthy and unhealthy is impossible.
E.g.
http://annals.org/aim/article-abstract/1846638/association-d...
>Trying to divide foods into healthy and unhealthy is impossible.
They don't try to "divide foods into healthy and unhealthy". They try to divide diets of food, including amounts and limits, into healthy and unhealthy.
You cannot say that strawberries are the healthiest food, just like you cannot say eggs are not healthy.
The study contradicts what you wrote in your comment above -- I never claimed it supports what I tell you in my comment below it, which touches on another aspect.
Unlike strawberries where relationship is linear, unlike many other vegetables. Put a healthy exercising population and the correlation disappears, I guess foods are no longer healthy in that case.
Eating 1 egg per day for the average member of the measured population seems to be healthy. It does not mean eggs by themselves are healthy or unhealthy.