The humble egg is an example of what’s wrong with nutrition studies (2019)

Nutrition Science is broken because of the financial incentives of companies to fund sham research to get their products sold.

I strongly recommend going to https://nutritionfacts.org/ for your information -- a nonprofit that never sells anything or promotes any products, just tries to distill research on nutrition in easy-to-understand videos and posts.

Here's an example: "How the Egg Board Designs Misleading Studies" https://www.youtube.com/watch?v=2s25RaOZsFM

Imagine how rigorous nutritional science can be when state-of-the-art double-blind scientific tests are pretty much impossible or extremely expensive to do, and when there is a lot of $$$ interest and lobbying in presenting one outcome or the other.

Nutrition is not rocket science, we are all expert in eating and especially in how our body reacts to certain food types, yet we take studies of abysmal quality for granted and preach them to our fellow human as if they were the ultimate truth.

I can say I'm going to run a marathon naked in Antarctica and everyone would cheer me, but if I mention I'm going vegan, carnivore or adding some butter or tofu to my cheeseburger, everyone, from both camps, is ready to point out why I am killing myself and on the way to premature death. Yet they are not speaking from experience, but mostly from hearsay from their favourite echo chamber.

I've stopped caring what common wisdom around nutrition is, and since I've started listening to how my body reacts I feel much better, healthier, and I roll my eyes every time I read the latest "nutrition" article or comment thread posted on here or anywhere else.

We're still in the middle ages of nutritional sciences.

“the study tracked participants’ health outcomes over periods ranging from 13 to more than 30 years, and participants were queried about their diet only once, at the beginning of the study. Can we assume that the participants gave a reliable depiction of their diet at the outset, and then that they maintained that same diet for the years — in many cases, decades — that followed?”

That seems like an awful way to design an experiment.

Eggs could easily be replaced with salt. Consuming too much salt (more than 2g a day) is heavily discouraged by some because it is said to increase the risks of cardiovascular diseases as well as increase blood pressure to a dangerous level, but others repudiate these claims and assert they are untrue, and that salt has positive health benefits above this limit.

Even if we take a group of people, put them in a closed place and strictly control what they eat, it is extremely difficult to say if a certain food has had a particular impact on X or not. There are some many elements which are unrelated to nutrition at play that X could decrease or increase for any reason other than what one ate: stress, tiredness, physical activity, mood...

Now, I reckon the wisest thing to do is to follow what the author concludes with: eat moderately and have a balanced nutrition. I doubt we'll ever get concrete and truthful research on nutrition soon enough. We first need to learn more about the extremely complex system that is the human body.

So... I think I have 3 points.

First is worst. Looking back over a few generations, standard nutritional advice informing doctors, institutions and the public have been poor. Not only inaccurate, but de facto pushing people down bad paths. Low fat & low cholesterol labels led to foods, with processed foods with high sugar & many additives. Cereal instead of a boiled egg.

Second is that many norms, like the food pyramid hanging in classrooms during the 80s & 90s were based on long forgotten, often arbitrary decisions. Self correction was fatally weak. Challenging norms had a higher burden for proof than the norm had faced. Proof is really hard, it turns out.

Third is that "what's a healthy diet?" was never answered better by science than book gurus or old cultural understandings of nutrition. That is, a practicable, science based understanding of nutrition wasn't achieved. Lots of things about nutrition have been learned but it doesn't really add up to a Big Theory.

I think the real issue here is "what to do when we bust." Science doesn't predictably produce answers to questions we think it should answer. We discover what we discover. But, what do you do when hospitals, health ministries and such need scientific guidelines? IDK is not an acceptable answer. I do know is not a scientific one. "Lets not do science " doesn't (didn't?) work either. The only choice left is between a lie and a delusion. Postmodernism is inevitable.

We were told for decades that saturated fat was really bad for us.

Now it turns out (as some pointed out even back when it started) that saturated fat is absolutely fine. All the people dropping dead from heart disease were being poisoned by trans fats, which were being added to everything (as e.g. Crisco, and margerine).

There is something wrong in (American) beef, but it's not the saturated fat. We lost decades, blaming the fat, and still don't know what it is.

Now we are being poisoned by the fructose in sugar that is added to everything. It is really hard to buy things made in the US without a phenomenal amount of sugar dumped in. Bread, pickles, salad dressing, soy milk, you name it.

The US massively subsidizes production of corn, to the point there is so much more than the market wants that they have to turn it into sugar and pump that into everything. That's not enough, so they also have to feed cows, pigs, and chicken on it, which makes them sick. That's not enough, so they have to make it into ethanol and add it to gasoline.

What is ironic is that actual corn sugar, glucose, is fine.

But they catalyze corn into fructose because it is sweeter when cold. And, incidentally, toxic. Your liver can neutralize a strictly limited amount of almost any toxin, including fructose, but most Americans take in much more than that.

So, before you eat/drink sugar, think: how much sugar do I expect to need to neutralize today?

For more actionable information, consult Robert Lustig lectures on Youtube.

And the egg and cholesterol example is even more complex.

Because the cholesterol that is ingested does not necessarily increase amount of cholesterol in your body. Because body produces cholesterol on its own and when you ingest cholesterol -- it just produces less of it.

At least assuming you are healthy person. If you are not and your body already has problems regulating cholesterol - adding more cholesterol might actually be a bad idea.

This shows how important it is to actually understand processes and relations and not just rely on correlations.

Studies are flawed because we are looking for correlations and then immediately try to look at study result as a general rule to guide our decision process.

What we should do instead, we should still do these studies, but then we need to follow with more research to actually understand where these correlations come from exactly. Like understand actual biochemistry of what is going on.

I eat astonishing numbers of eggs, and salt nearly everything heavily. My N=1 study shows its all good for you, letting you stay active for life with low cholesterol and no health issues.

It reminds me of the 100+ year old lady asked "What do you attribute your advanced age?" and she replied "Whisky and a cigar every day!" I wonder if she was in this study?

My experience with this is that you have to take a n=1 approach to nutrition. You need to figure out what works for you by experimenting.

Do researchers even get taught about the difference between correlation and causation? People who eat large numbers of eggs probably also eat large amounts of bacon (compared to others), and bacon as a highly cured meat with high levels of salt and other toxic compounds, could easily explain the results. And then there is this:

> But on the other hand, the study tracked participants’ health outcomes over periods ranging from 13 to more than 30 years, and participants were queried about their diet only once, at the beginning of the study.

Wow I don't know what to say.

Even if eggs are somewhat unhealthy you also have to balance that with the fact that they have every possible nutrient and micronutrient needed to create a living animal.

You could be getting trace nutrients we don’t even know we need.

I think these types of takes are too harsh on nutrition. Nutrition are not only observational studies, you know? For example, we know that LDL is causally connected to our killer number one (atheroschlerosis). We are pretty pretty pretty sure that it is true (both clinical interventions with statins as well and mendelian studies confirm that). So, if that is the case, we can just split people into groups that consume one pattern of food and another one that acts like control. What happens to their LDL after some weeks? See, not that hard. There are a bunch of other biomarkers as well that can be used to do experiments like that. There are of course always a possibility that these changes on biomarkers don't mean anything at all, but this is something that will eventually show up on data. So... I don't really understand all these skepticism about nutrition as a field. People are too dramatic and react weirdly with all this "omg they are lying to me! I can't trust anyone" and go on to trust bro science. Grow up. Obesity epidemic is very real and somewhat there is this idea that we don't know anything about what a healthy diet is. This is ridiculous and shouldn't be that hard to discredit. Tribalism perpetuates that shit.

> Most experts recommend avoiding processed foods as much as possible and sticking with a Mediterranean-like diet because it makes intuitive sense. It is not too restrictive. It is heavy in fruits and vegetables. It has the right kinds of fats and some grains. It includes fish and generally lean proteins.

But that’s the point of the article, who’s to say what the right kind of fats are? Or if grains should be part of your diet, etc?

Part of the problem is that nutrition is incredibly nuanced and unknown, but people want simple, absolute answers.

Different people have much different bodies: they react to foods differently, have different metabolisms (at least based on sex/age/height/weight/bodyfat/exercise), and different preferences. Bodies are also complex, and there are 500 different causes that can all lead to you feeling like garbage.

But that wouldn't sell papers, there wouldn't be much to write. So people make blunt statements. Most of what I see online seems to be geared towards the "average American". Which ironically means, the people reading these articles who actually care about their nutrition, most of it doesn't even apply to them.

And this isn't even getting into another factor, which is that people get particularly defensive about nutrition. So others take these blunt, over-generalized statements as fact and double down on them. I see this in-person by people who are otherwise really smart.

Examples: "eat less salt and more fiber" - you don't know how much salt / fiber I'm eating. "Almonds keep you full" - idk some people eat loads of almonds. "Keto changed my life / I hate keto" - that's your anecdote, it only applies to you.

Specifically, for eggs: if someone has high cholesterol, it will show up on bloodwork, and if the eggs raise their cholesterol, cutting / reintroducing them will show up too. If I eat 6 eggs a day and have great cholesterol, some study that says on average people who eat eggs die of a heart attack, that means nothing to me. If I eat 6 eggs a day and have terrible cholesterol, and after I stop eating eggs my cholesterol lowers, some study that says eggs usually don't spike cholesterol, that also means nothing.

Another article recommending Mediterranean diet. The healthy Greek and Italian people I know seem to have coffee and a cigarette for breakfast. It seems traditionally food was tight and often in the winter they'd skip meals and go hungry, so Med diet is probably closer to intermittent fasting.

Ya know, technically,...

"Nutrition research tends to be unreliable because nearly all of it is based on observational studies, which are imprecise, have no controls, and don’t follow an experimental method."

You could say the same things about astronomy.

The concept of sticking to one particular form of eating has always bothered me. It's always felt like an attempt to find a panacea that doesn't require much analysis by the person of what they input to their bodies. Realistic eating is a lifelong responsibility of paying attention to what you're eating and the effects it has on your body. Perhaps what we need is a faster feedback loop of what the current state of your body is so you can make an adjustment.

There are definitely some foods that are better than others, but choosing a diet because it'll solve all your problems is the wrong way to address health.

Most “science” that denies the reality of studying complex systems is broken. The concept of studying strength of correlations, even applied in the context of randomized controlled trials is only really effective in low dimensional spaces and linear dependences (I’m being very loose here, for brevity). But complex systems break all those assumptions.

To steal a quote, researchers use data/statistics like a drunkard uses a lamp post — for support, rather than illumination.

This applies to nutrition, medicine, ecology, economics, etc. I wouldn’t be surprised if their experimental arms run largely on confirmation bias.

Industrial egg production is bad for the chickens, especially male chicks. I consume egg alternatives such as Just Egg and use alternatives (e.g. tapioca starch) for baking and no one notices.

Complex synergistic systems are notoriously challenging to understand. They can have multiple moving parts, with various intertwined causes and effects. But with our limited tooling, we often have to isolate a part from the whole to get but a glimpse at how it works. The approach is scientific, often clean and elegant. It's quite tempting. It also gives the illusion of predictability. I wish scientists would realize that sometimes, all they've actually discovered is exactly that, how the part works in isolation, with no guarantee that the sum of the set can predict the outcome of the whole.

I'm having deja vu. We had a top story on HN recently where either the article or the consensus of the comments was "you pretty much cannot believe any studies about food or nutrition."

Eat food, not too much, mostly plants.

Side note: Why do we constantly cry about recommendations from the 1970s being different from today's recommendations? That's a lot of time. Over time we tend to figure things out. It doesn't mean that in 40 years today's recommendations will be overturned.

Honestly I expect diet doesn’t matter that much unless you are trying to lose weight, except that eating lots of sugar is probably not good for you. Exercise is probably more important for long term health than what particular kinds of animals or plants you eat.

N=1. I was eating eggs daily. My cholesterol was high and my doc wanted to put me on statins. I said let me try diet and exercise. I changed it what I was eating (no more daily eggs) and 6 months later I dropped 50 points in bad cholesterol.

I eat 3 eggs a day - I hadn't heard of that study that more than 2 would kill me!

In general I aim for lots of protein, a good bit of fat and less carbs.. with a specific aim to avoid carbs from bread, fries, cakes, chips/crisps

"Dr. Mehmet Oz even touted it on his television show." Yeah, no.

The venal, profit-driven corruption in academic nutrition science is exactly why we should stop paying attention to it and start paying much more attention to philosophies of health that humanity has tested over decades and centuries: ayurveda, TCM, and osteopathy.