Are Eggs a Health Food?

No, eggs should be limited to just an occasional food.

A friend recently e-mailed an MSN on-line “health & fitness” article highlighting their 25 Ridiculously Healthy Foods. Number one on MSN’s healthy list was eggs. In general, eggs have had a bit of resurgence in the popular press as a healthy food after many years of concern about their high level of cholesterol. Unfortunately this is a grave misconception; eggs are not a health food and just one or more eggs a day is correlated with the development of diabetes, congestive heart disease, and a statistical increase in the death rate.

Today’s blog confronts two of the issues causing confusion about nutrition in general and then addresses some concerns specifically about eggs.

#1. “Big Tobacco Tactics” – The business of generating confusion

 The painting, Skull with a Burning Cigarette, is Van Gogh’s 1886 rendition of the prevailing thoughts on smoking over a century ago – “it ruins your lungs and then it kills you”. Some forty years later Van Gogh’s prescience was confirmed when articles began appearing in the medical literature correlating smoking with lung cancer and early death. In 1964, almost eighty years after Van Gogh painted his smoking skeleton, the U. S. Surgeon General concluded that smoking was harmful.

In his book, Doubt Is Their Product: How Industry’s Assault on Science Threatens Your Health, David Michaels exposes how the tobacco industry created paralyzing doubt despite scientific certainty. By combating legitimate science with “industry experts”, Big Tobacco not only stalled regulations for decades, but also reassured smokers that the risk to their health was not that great. Dr. Michaels then goes on to detail how the tactics used by the tobacco industry were adapted by other industries (asbestos, coal, chrome, arsenic, mercury, beryllium, and others) to question legitimate scientific findings with what was essentially industry-sponsored propaganda.

I believe that “buyer beware” is the correct bias whenever assessing an industry’s defense of the safety of its product.

#2. Culture and nutrition at loggerheads – The myth about protein

In The China Study, perhaps the most important book ever written on nutrition, Dr. Colin Campbell outlines the discoveries of his highly respected scientific career, focusing on the findings from the most extensive epidemiological study ever done. The conclusions were as startling as they were statistically unequivocal. Numerous supporting studies have since confirmed one of the key findings: the high level of protein in our diet is not healthy.

Despite the cultural drumbeat that we need lots of protein, the truth is that we don’t. Heart disease, cancer, strokes, and diabetes are all diseases that are related to the excess animal protein in our diet.

As Galileo learned when publicizing his findings that the earth goes around the sun and not vice versa as had been believed, a scientific finding that does not conform to cultural norms is often not well received. Although the data on protein seems irrefutable, it is not popular, and so the myth about needing high levels of protein continues.

#3 Health issues and eggs –

A widely cited 1999 article in the Journal of the American Medical Association found no significant differences in coronary heart disease and stroke in those eating an increased number of eggs. This would be reassuring except for three more recent articles with the following highly statistically significant findings:

Ø  Higher rates of death with higher egg consumption (1)

Ø  Increased risk of heart failure with increased egg consumption (2)

Ø  Increased risk of type 2 diabetes with increased egg consumption (3)

Both the 1999 article and the three articles published since 2008 were large and well respected studies.

The later studies also did not show an increase in coronary artery disease with increased egg consumption. On the other hand, heart failure, type 2 diabetes and overall death rate were significantly increased with eating 7 eggs or more per week compared to one or less eggs per week.

Particularly concerning was the doubling of the death rate in people with diabetes who ate an average of one or more eggs per day.

So, since this data seems clear, where does the controversy come from? How can eggs appear on a most healthy foods list? Here one needs to remember the tactics of Big Tobacco.

One would assume that a 23% increase in mortality, a 64% increase in congestive heart disease, and a 58% increased risk in developing diabetes would be headline news. After all, we eat over 200 million eggs a day. But consumers have not decreased their egg intakes after these studies were published. Why not?

Ø  Most have never heard about the studies in the first place.

Ø  If one did hear a report about those studies, nutrition information is so confusing because of conflicting data that one isn’t sure what to do.

Ø  One loves eggs and/or hates statistics to the point where one just doesn’t bother with inconvenient findings.

These three points are key to remember if one wants to sell more eggs.

In general, industry studies are more widely publicized because favorable findings, no matter how biased, are sent as press releases to every media outlet. When there is damaging data, one can expect the study to be questioned on highly technical and methodological grounds. One can also expect massive diversionary marketing to occur whenever the media covers negative results.

In conclusion, you can be certain that most of what you read or hear about eggs is the industry’s attempts to “egg you on”.

An example of industry positioning would be a recent on-line article in “Risk Analysis”. This research, paid for by the egg industry’s Egg Nutrition Center, concluded:

 …”focusing on decreasing egg intake as an approach to modify coronary heart disease risk would be expected to yield minimal results relative to changing other behaviors such as smoking and other dietary habits.”

This conclusion is consistent with the data, but effectively diverts one’s attention from the more significant facts - congestive heart failure, diabetes, and death rates go up as people eat more eggs.

I would offer three conclusions:

#1. Be wary of industry generated media and industry sponsored research.

#2. Remember that “we need a lot of protein” may be a cultural mantra, but it is not true.

#3. Eggs should not be on your list of most healthy foods.

 

Expressly yours,

carl myers

Healthcare Reform

PART 2 – FOCUS ON PREVENTION

A few evenings ago I listened to a thoughtful National Public Radio guest who suggested “inappropriate healthcare” as a place to save dollars. I believe such efforts are worthy, certainly not new, and unlikely to significantly change healthcare cost trends.

Yet the words “inappropriate healthcare” struck me. Have I been part of the “inappropriate healthcare” that he referred to? Every day in my medical practice I would see at least one cancer patient whose disease had not been significantly helped by the chemotherapy drugs that I had prescribed. Every day I would also see at least one patient who had been cured by their chemotherapy. We often celebrated with patients who had been helped by chemotherapy despite poor odds.

Even in hindsight, I have difficulty defining when I rendered inappropriate care. A few times in my career a patient or their family sought a new physician because I had stressed (as compassionately as I could) that in my opinion chemotherapy treatment in their situation would likely cause more harm than good. What if this patient was one whose cancer would have responded against great odds? Did this make my advice inappropriate? What if the next physician decided to treat them and the patient was just made sicker by tens of thousands of dollars of drugs that did not work?

By addressing these complex aspects of care I do not mean to say that efforts to evaluate the appropriateness of care should not continue. However, I doubt that these are the most germane questions to ask.

The succinct adage - ‘garbage in, garbage out’ - quickly reminds one that a computer does not fix faulty data. Such a reminder helps focus efforts where they really count, since even the most elegant analysis of bogus data is a waste of time.

Our current medical model could use such a pithy slogan to focus our efforts more effectively.

‘Billions of dollars of junk food in, trillions of dollars of pills and surgery to chronically maintain the junk out’ is hardly pithy, but it accurately fits our healthcare reality. And like ‘garbage in, garbage out’, it should focus our efforts where they belong - avoiding the ‘garbage in’ in the first place.

Hypertension, heart disease, and diabetes are only a few of the ‘junk in, disease out’ illnesses that plague us. More studies won’t make it any more obvious that our high fat, high salt, high sugar, and non-nutritious diets make us obese and then kill us. Largely ignoring junk food in the healthcare equation has resulted in millions of Americans dying prematurely and trillions of wasted healthcare dollars.

I sometimes quiz audiences about this ‘junk in, illness out’ perspective. I’ll ask them to raise their hands if they think they eat more junk food than they should. Most people giggle a bit and then sheepishly raise their hands.  I then follow this question by asking them if they also put diesel fuel in the tank of their gasoline-powered car.

In an instant the audience gets a glimpse of the depth of the delusion supporting our junk food habit. It becomes clear, if we were as smart with our bodies as we are with our cars, we could be much healthier.

To paraphrase Clinton’s message on the economy - as far as spiraling healthcare costs are concerned, - ‘it’s the food, stupid’.