I had a massive face palm moment a couple of weeks ago. I’m talking one of those moments where I wished I could stand on a towering platform to be seen and heard by the entire world, and bellow out in an impassioned, commanding voice:
“My fellow humans…
…what the #@$% is wrong with you?!?”
What exactly bought on such a misanthropic moment, you ask?
It was the sad realization that humans are the only species on this planet dumb enough to have bred what are known as nutritional epidemiologists. These are the ‘researchers’ who shun clinical trial research and instead dredge up data from population-based studies. Data of highly questionable accuracy and notoriously prone to a multitude of confounding factors.
They then publish this slop in prestigious medical journals, send press releases to major media outlets, and sit back with glee as their findings make headlines around the world. They smile and fill with self-importance as their highly-educated but poorly-informed colleagues soak up their alleged findings as if they were viewing data from tightly controlled double-blind clinical trials.
Nutritional epidemiologists, my fellow Earthlings, are a major reason why the modern dietary advice arena is such a complete and utter joke.
Guilt by Association
The primary task of an epidemiologist is to find statistical associations. This in itself is not always a worthless endeavour. Epidemiology is actually quite useful outside of the nutritional field; the realization that cigarettes were so harmful and the subsequent successful anti-smoking campaign owed a great deal to epidemiology.
But cigarette smoking is one of those activities that was so patently dangerous, it returned risk ratios so powerful researchers knew it was highly unlikely the findings were due to chance or confounding from other potentially carcinogenic factors. Not to mention that this powerful risk relationship was backed by a totally non-brainer hypothesis: People who fill their lungs with toxic gases for years on end will be more likely to get sick. Duh.
Unfortunately, the success of the anti-smoking campaign caused an explosion in the number of nutritional epidemiologists. Seriously, the little reality-hating bastards are everywhere. And I mean everywhere. Last night I heard a noise in my kitchen, went to investigate, and found two tiny Ancel Keys look-a-likes frolicking around in my rice puffs. I grabbed them, dangled them precariously for a few moments in front of my salivating American Staffy, then threw their annoying little butts out the door.
Bloody pests.
They waste valuable journal space by publishing papers on the association with CHD of obscure lipoprotein sub-fractions like Milano-Apo-A1-beta-lipase-acetylase-transferase-cholesterase-we-must-be-off-our-face that contribute absolutely nothing of any tangible benefit to cardiovascular disease prevention.
They publish papers reporting utterly inconsequential risk factors like 1.15 for red meat consumption and cancer incidence, then send out press releases making your steak sandwich sound like a bloody bowl of plutonium. Never mind that if you bother to read the actual study paper for yourself instead of accepting firsthand the Herald Sun version, you quickly see that the red meat eaters also had a greater incidence of harmful health traits that have absolutely nothing to do with red meat, such as smoking and physical inactivity.
They publish papers claiming that whole grain cereal consumption lowers your risk of CHD, cancer and diabetes, despite the fact that randomized controlled clinical trials (RCTs) examining these very endpoints found the only advantage of whole grain consumption is a newfound ability to rapidly clear entire department stores with a bolus of invisible but highly noxious gas. This, I’m told, works wonders for grabbing the best bargains at the half-yearly Myer sales.
Nutritional epidemiologists, my friends, are an absolute scourge.
From One Anthony to Another
Anyway, getting back to my face palm moment. It happened during a conversation with a buddy from New York, Anthony. In addition to having an awesome first name, Anthony shares with yours truly a keen interest in matters pertaining to diet and strength training. On this particular day, Anthony had taken time out from cavorting with crazy New York sheilas and beating the living snot out of 240-pound apprentice mobsters to chat with me on Gmail. A true gentleman.
I think it was at the point where we were comparing notes on some of our more memorable conquests, when he suddenly interrupted with a link to a news article about eggs.
Talk about a change of subject.
Folks, when two blokes of Italian descent suddenly switch their conversation from female-related matters to something else, you can be rest assured that something else is pretty damn important.
And it was. The almighty egg, that delicious little storehouse of high quality protein, vitamins, minerals, and essential fatty acids, is under attack again. From epidemiologists.
Here’s the link that Anthony sent me:
Study: Eating egg yolks almost as dangerous as smoking
Read it and weep, folks.
I quote: "Researchers found that eating egg yolks regularly increased plaque buildup [SIC] approximately two-thirds as much as smoking would."
The frightening thing is they’re being serious. Bless FOX News for blindly reprinting this rot, and bless every other media outlet in the world who entrusts public health to gullible journalists with absolutely no training whatsoever in the art of identifying pseudoscientific bullshit. Way to go!
Oh no, there I go again, being all 'nasty' and 'vitriolic'. But wait a minute – how do you think hard-working egg farmers feel when the highly nutritious source of their livelihood is unfairly labelled as deadly? Do you think they may be feeling just a little annoyed? Unlike nutritional epidemiologists, egg farmers actually get off their butts and make an important contribution to society by providing a healthy product with tangible benefits.
The reality is someone needs to put a leash on these dangerously clueless epidemiologists, who’ve utterly failed to reduce the incidence of heart disease, cancer and diabetes despite billions of wasted dollars and years of touting hare-brained statistical associations between this food and that disease.
The only thing these jokers have succeeded in doing over the last several decades is driving hordes of people away from perfectly healthy and highly nutritious foods like meat and eggs, and into the arms of anti-nutrient-laden whole grains and other assorted foodstuffs of highly dubious quality such as soy. And don’t get me started about the millions of people who were conned into embracing linoleic-rich vegetable oils and trans-fat-rich margarines as a result of the anti-fat/anti-cholesterol idiocy that kicked off in earnest with the cherry-picked epidemiology of the aforementioned Ancel Keys back in the 1950s. While health authorities later quietly backed away from trans fats, there are still a few diehard organizations like the Australian National Heart Foundation who persist in awarding ‘heart healthy’ ticks to linoleate-rich oils that have been strongly linked to cancer and CHD (Note to NHF: Don’t bother knocking on my door with your donation can…)
And while even epidemiologists now generally accept that trans fats should be avoided, the anti-cholesterol/anti-fat stupidity is still very much alive and well, doing a fantastic job of distracting researchers and public alike from the real causes of heart disease, thus ensuring CHD retains its position as the number one killer in most modernized countries.
No thanks to epidemiology, the medical field has dramatically improved emergency medical care of heart attack victims and has been able to greatly extend the lives of many CHD patients with anti-clotting agents. But when it comes to finding an actual cure for CHD, or at least instituting a highly effective preventive strategy that greatly reduces the actual incidence of heart disease, modern medicine has failed miserably. Yep, despite six decades of intense scrutiny and quite literally billions of dollars in research, heart disease is as prevalent as ever. And for that we can thank the dangerously distracting force of epidemiology, the original source from which the useless anti-fat/anti-cholesterol sham was derived.
Oh, and did I mention a little thing called The Obesity Epidemic? Thanks to the same anti-fat stupidity originally brought to you by a disgruntled Minnesota epidemiologist in the 1950s and subsequently peddled by just about every major health organization, Planet Earth may just have to change its name to Planet Girth.
Anyway, enough epidemiology-bashing...for now. Let’s take a closer look at the research (and I use the term loosely) that had major media outlets hysterically comparing nutrient-dense eggs to noxious cigarettes.
Humpty Dumpty Sat on a Wall, then Along Came a Friggin' Epidemiologist…
Let’s open up the study which has caused this latest bout of anti-egg hysteria, and see what exactly it purported to find. You can access the full text right here:
Egg yolk consumption and carotid plaque
The way the media outlets describe the results, you’d think the researchers fed a bunch of people eggs and then observed that they subsequently developed far more atherosclerosis than people who didn’t eat eggs.
But as you can see from the actual study paper, they did nothing of the sort.
Here’s what did happen: The researchers simply gathered data from questionnaires given to patients during their initial visits to Canadian CVD prevention clinics.
Here’s some insight into the questionnaires from the researchers themselves:
"In earlier years, data on smoking and egg consumption were recorded by patients into a lifestyle questionnaire at the time of referral. Since 2000, when our referrals were scheduled on an urgent basis soon after transient ischeamic attacks or strokes, a more limited set of lifestyle questions were asked at the time the history was obtained."
In other words, despite the fact that epidemiological data is ridiculously prone to a multitude of confounders, the clinics saw fit to reduce the number of questions regarding the patient's lifestyle.
That makes sense. Not.
This data was then used to examine the link between smoking, egg consumption and carotid plaque volume.
The researchers explain:
“The responses for smoking and egg yolk consumption were used to compute pack-years of smoking (number of packs per day of cigarettes times the number of years of smoking) and egg-yolk years (number of egg yolks per week times number of years consumed).”
The researchers further explain:
"For example, a person who consumed 3 eggs per week for 50 years would have a score of 150 egg-yolk years."
Whoa, stop right there!
Did you all catch that? In a one-time questionnaire, patients were asked to provide information on their egg intake for up to fifty years previously! How many of you can accurately recall how many eggs you ate during the last fortnight, let alone five decades?
Yet this highly questionable information was used to determine the relationship of egg consumption with plaque volume, even though under- or overestimating weekly egg consumption by even a single egg could significantly sway the results.
And remember, this data was obtained from patients who had recently suffered a stroke, an event well documented to routinely impair subsequent cognitive and neurological function.
The absurdities don’t end there.
Initially, there was egg consumption data available for 2,831 patients. Of these, consent to use the data, and data on pack-years of smoking and carotid total plaque area were only available in 1,231 patients. The mean age of these patients was 62 years; 47% were women.
“The total plaque area among people who consumed 2 or fewer eggs per week (n = 388) was 125 mm2, whereas it was 132.26 mm2 in those consuming 3 or more eggs per week (n = 603).”
Note that while the researchers adjusted for age, for sex, serum total cholesterol, systolic blood pressure, diabetes, body mass index and pack-years of smoking from this small and select group of patients, they did not adjust for alcohol consumption or exercise. And, like most epidemiologists, they didn't even consider a plethora of other important factors such as bodily iron stores, n-3:n-6 ratios, antioxidant status, refined carbohydrate consumption, and psychosocial stress.
And here’s where it really gets ridiculous. According to the researchers, “egg-yolk years was more predictive than fasting cholesterol or BMI. Triglycerides, HDL cholesterol and LDL cholesterol were not significant predictors of baseline [total plaque area] in stepwise linear regression”.
Again, let’s stop and pause for a moment. The entire anti-egg thesis is predicated on the high cholesterol content of eggs, yet here we have the researchers claiming that egg consumption was allegedly more dangerous than total blood cholesterol itself (?!), and admitting that LDL cholesterol (the supposedly ‘bad’ cholesterol) had no association with plaque volume!
This study, folks, is a load of bollocks.
While they do throw the token line into their conclusion about further research being required to confirm their “eggs cause atherosclerosis” hypothesis, the researchers seem pretty damn sure they’ve found a causal link. They claim in the paper:
“Fig. 1B and C shows that compared to age, both tobacco smoking and egg yolk consumption accelerate atherosclerosis, in a similar fashion."
The UK’s Sun paper, which also swallowed the anti-egg findings whole, quotes head author of the paper, David Spence, as saying:
“The study shows that, with age, plaque builds up gradually in the arteries and egg yolks make it build up faster.”
Spence and his crew seem to have made up their mind, and they’re not mincing words. None of this “these results would suggest…” tentativeness for them. Nope. They’re stating categorically that egg consumption accelerates atherosclerosis. They are presenting the results, not as mere association, but as showing a causal effect for egg consumption on the progression of carotid atherosclerotic plaque. They do this from figures in an epidemiological paper that can at best only determine extremely shady statistical associations.
Lawdy, lawdy…when exactly did nutritional science sink to the same standard of proof as tarot card reading? And you sensitive types wonder why I hold epidemiologists in such poor regard?
What Does the Clinical Trial Evidence Show?
How about we leave the sloppy world of epidemiology behind and raise the standard of evidence up to a far more reputable level before we go damning the poor old egg as a hard-boiled heart attack?
To do this, we need data from RCTs.
And guess what?
Despite all the cocksure pronouncements that eating eggs will cause heart disease and stroke, there have been a grand total of zero clinical trials examining the effect of egg-free versus egg-containing diets on CVD incidence and mortality. That’s right, not one single trial.
So if there are no long-term intervention studies, what else are we left with? Well there’s a whole bunch of trials examining the effect of egg consumption on blood lipids, some finding no change and others finding increases. I won’t even begin to waste my time or yours discussing these findings, because blood cholesterol does not cause heart disease or stroke, something I explain extensively in The Great Cholesterol Con. Especially relevant here is the fact that autopsy and PET scan studies repeatedly show no relationship between serum cholesterol and cardiac and carotid atherosclerosis, and several decades’ worth of dietary cholesterol-lowering trials have failed dismally to reduce CHD mortality, despite successfully lowering blood cholesterol. In fact, the most successful dietary intervention study of all time (the Lyon Diet Heart Study) noted a whopping CHD reduction in the treatment group, despite the fact that cholesterol levels were virtually identical with the control group throughout the study. The other big winner in CHD intervention trials, fish oil, has reduced cardiac death despite raising simultaneously the so-called ‘bad’ LDL cholesterol.
Suffice to say that changes in blood cholesterol levels are a terribly poor indicator of CVD outcomes.
What I will quickly discuss instead are the trials that looked at changes in actual cardiovascular function, as opposed to mere biochemical markers obtained from serum samples. I searched and found only the following two (if anyone knows of any I missed, feel free to email the citations).
In the first study, Yale researchers took forty-nine healthy adults (mean age 56 years, 40% females) and assigned them to eat either two eggs or oats daily for 6 weeks in random crossover fashion with a 4-week washout (this means that all participants followed both diets for six weeks each, four weeks apart). Brachial artery function was tested prior to dietary assignment and at the end of each six-week diet phase.
The result?
The ability of the arteries to dilate in response to heightened blood flow after having a high pressure arm cuff deflated was stable in both egg and oat groups, and between-treatment differences were not significant (egg 0.96%, oatmeal 0.79%; p > 0.05). There were also no differences in BMI or systolic blood pressure levels after the egg and oat treatments.
In the second study, researchers here in sleepy old Adelaide assigned sixty-five diabetic folks to consume similar weight loss diets, the only difference being that participants in one group consumed two eggs per day, whereas the other group replaced the eggs with 100 grams of lean animal protein. After 12 weeks, there was no significant difference in weight loss, and all the subjects reduced systolic and diastolic blood pressure. Markers of glycemic control such as HbA1c and insulin also dropped in both groups, while plasma folate and lutein increased more on the egg diet. As the researchers noted:
"These results suggest that a high-protein energy-restricted diet high in cholesterol from eggs improved glycaemic and lipid profiles, blood pressure and apo-B in individuals with type 2 diabetes."
Note that in both of these studies the egg subjects were instructed to consume fourteen eggs per week, and suffered absolutely no adverse consequences. Yet Spence et al are claiming, in all earnestness, that a mere 3 eggs per week is going to clog your arteries with nearly the same efficiency as cigarette smoking.
Altogether now: Cup hands, shake head, and bury face into palms.
So there you have it folks. When we wash away all the murky epidemiological hogwash, we’re left with bugger all studies examining the effect of eggs on actual CVD outcomes, and two studies showing egg consumption produces no detrimental changes in arterial function, blood pressure or glycemic control.
Based on the currently available research, any researcher who tells you eggs cause heart disease or stroke and that eating eggs is almost as bad as smoking desperately needs to get a real job.
Note: The author has no relationship with the egg or poultry industry, financial or otherwise.
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Anthony Colpo is an independent researcher, physical conditioning specialist, and author of The Fat Loss Bible and The Great Cholesterol Con. For more information, visit TheFatLossBible.net or TheGreatCholesterolCon.com
Copyright © Anthony Colpo.
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