Love eggs? Maybe you should consider this

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In summary, even though eggs are a good source of cholesterol, recent studies have shown that they are not really the main player in CV risk.
  • #1
Wrichik Basu
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The main problem has been (and will be) cholesterol. Previously, the standards said that some amount of dietary cholesterol was good for the heart. But a recent study tells a different story.
The article said:
The evidence for eggs has been mixed. Previous studies found eating eggs did not raise the risk of cardiovascular disease. But those studies generally had a less diverse sample, shorter follow-up time and limited ability to adjust for other parts of the diet, Allen said.

"Our study showed if two people had exact same diet and the only difference in diet was eggs, then you could directly measure the effect of the egg consumption on heart disease," Allen said. "We found cholesterol, regardless of the source, was associated with an increased risk of heart disease."
The worse fact is:
Exercise, overall diet quality and the amount and type of fat in the diet didn't change the association between the dietary cholesterol and cardiovascular disease and death risk.
But don't banish eggs completely. Eat, but lower the quantity.

Article: JAMA (2019). http://dx.doi.org/10.1001/jama.2019.1572
 
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  • #3
256bits said:
Interesting,

On the same page is listed two studies from 2016, Feb and 2018, May stating that eggs do not link with risk.
https://medicalxpress.com/news/2016-02-high-cholesterol-diet-eggs-heart-persons.html
https://medicalxpress.com/news/2018-05-eggs-linked-cardiovascular-conflicting-advice.html

What is one to follow with the conflicting advice...
True, the advice is conflicting. Maybe the middle path is better: having occasionally is good, but having everyday isn't.
 
  • #4
As I'm used to say (IRL), you can be sure that there is a half-dead dose for everything. Including, for example: bean soup.
Yet, it would be quite weird to call it poisonous and the reason that we eat moderately of it is still something else...
 
  • #5
Wrichik Basu said:
The main problem has been (and will be) cholesterol. Previously, the standards said that some amount of dietary cholesterol was good for the heart. But a recent study tells a different story.

The worse fact is:
But don't banish eggs completely. Eat, but lower the quantity.

Article: JAMA (2019). http://dx.doi.org/10.1001/jama.2019.1572
Probably best stick to mainly whites with the occasional yolk thrown in for scrambled or poachedI love eggs, a full English is one of my guilty pleasures
 
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  • #6
This has been around the block a few times and they discovered some time ago that cholesterol in eggs is really dependent on what the hens were fed on. There has since been several landfills worth of research with the latest suggesting that cholesterol, if it has a role, isn't really the main player in cardio vascular risk.
The first problem is in the weak association between what is eaten and the blood levels of cholesterol, its a necessary fat and if your body decides you don't have enough, your liver produces more.
Statins do appear to reduce risk, mostly for people who already have established CV disease but there are several other drugs that reduce blood fats that don't appear to effect future risk.
Arterial disease is not a simple static process, its an active and often changing process that involves inflammatory immune processes, in the Vietnam war, post mortem examination of 19 year olds often found arterial plaques. We may be looking at a normal response to injury to the arterial wall, with clot formation which is then removed and remodelled by our white cells, unfortunately these clots often incorporate fats which are difficult for our white cells to remove, if they can't manage they tend to contain the area within a capsule, a plaque. The biggest cause of injury is the wear and tear of constant flexing and blood pressure, which increases with age. The surface of plaques are more likely to crack or become rough, a new clot forms and the process repeats so the plaque can grow, this can gradually reduce the blood supply to areas of the body. A plaque can rupture spilling its more liquid contents into the vessel which causes large clots to form suddenly blocking an artery
Arterial disease becomes more common as we age because our immune system becomes less efficient, chronic inflammatory conditions are clearly associated with increased risk of arterial disease, these can range from serious autoimmune diseases to chronic periodontal disease. A high dietary intake of simple sugars and the high blood levels of sugar seen in diabetes seem to effect this process and reduce immune competence these are significant risk factors for cardiovascular problems. Many of these also have a genetic component. Interestingly a secondary effect of statins is anti-inflammatory.
So its now increasingly thought that simple sugar intake might be more important than fats in the diet, statins can still help, a good diet and maintaining a healthy weight is still a good idea, it helps maintain the immune system and control blood pressure. Oh, and look after your teeth.
Unfortunately this may all change next month a lot of the evidence is based on epidemiology using very poor quality data, there are also a large number of vested interests involved and social value judgements, which brings me back to the issue of landfill. :)
 
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  • #7
Laroxe said:
... Statins do appear to reduce risk ...
According to https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096178/, "statins interefere with the production of mevalonic acid, which is a precursor in the synthesis of coenzyme Q10". Responsibly-conducted studies seem to be somewhat in conflict over whether statin-induced CoQ10 deficiency may or may not be adequately addressable with or without CoQ10 supplements. Some physicians prescribe CoQ10 supplements along with statins.
 
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  • #8
sysprog said:
According to https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096178/, "statins interefere with the production of mevalonic acid, which is a precursor in the synthesis of coenzyme Q10". Responsibly-conducted studies seem to be somewhat in conflict over whether statin-induced CoQ10 deficiency may or may not be adequately addressable with or without CoQ10 supplements. Some physicians prescribe CoQ10 supplements along with statins.
Its interesting, I haven't seen this and it try's to explain a side effect that stops many people from taking statins, Q10 is supposed to have a number of other useful effects in reducing cardiovascular risk so if it works to reduce side effects this could be very useful.
 
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  • #9
Laroxe said:
Its interesting, I haven't seen this and it try's to explain a side effect that stops many people from taking statins, Q10 is supposed to have a number of other useful effects in reducing cardiovascular risk so if it works to reduce side effects this could be very useful.
This article (abstract-only link): https://www.ncbi.nlm.nih.gov/pubmed/30302465 says ubiquinol is more effective than ubiquinone.

Brain 'likes' certain cholesterols, and if it's not getting enough of them by ingestion, it will trigger the hepatic system to produce more.

What first caught my eye in your post was your remark about the influence (on egg content) of what the hens eat .
 
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  • #10
An article questions the soundness of the conclusions of this study.

This latest study was a meta analysis.The data was based on recall of what people ate over a past interval of time. It apparently did not take into account other sources of cholesterol or other factors linked to early death as high BMI, fat consumption and smoking. The study merely showed a correlation between excess egg consumption and CV disease and early death. A single large egg has about 190 mg of cholesterol. The study concluded that 300 mg/day above the recommended level was correlated with negative health effects. That is about one dozen of eggs per week.

So is this just another poorly designed medical study relying on the "power" of statistics to "prove" a point.?
 
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  • #11
gleem said:
An article questions the soundness of the conclusions of this study.

This latest study was a meta analysis.The data was based on recall of what people ate over a past interval of time. It apparently did not take into account other sources of cholesterol or other factors linked to early death as high BMI, fat consumption and smoking. The study merely showed a correlation between excess egg consumption and CV disease and early death. A single large egg has about 190 mg of cholesterol. The study concluded that 300 mg/day above the recommended level was correlated with negative health effects. That is about one dozen of eggs per week.

So is this just another poorly designed medical study relying on the "power" of statistics to "prove" a point.?

Great, so I am back to two eggs full fat which suits me fine. Just need to look at studies for bacon, if you have a meta analysis demonstrating it's ok then that will be nice. I will settle for one pack per week fat removed where possible.
 
  • #12
pinball1970 said:
Great, so I am back to two eggs full fat which suits me fine. Just need to look at studies for bacon, if you have a meta analysis demonstrating it's ok then that will be nice. I will settle for one pack per week fat removed where possible.

Yeah, you got to have bacon with your eggs. Your British bacon Is what us Yanks call Canadian Bacon which has less fat than our "streaky" bacon although both are considered processed making them "unheathy" in a different way.
 
  • #13
gleem said:
Yeah, you got to have bacon with your eggs. Your British bacon Is what us Yanks call Canadian Bacon which has less fat than our "streaky" bacon although both are considered processed making them "unheathy" in a different way.

Pork is a fatty meat, even if you cut visible fat off. Still tastes great.

Our ancestors would have found a clutch of eggs and just eaten the lot there and then, white yolk, bits of shell and chalaza (horrible if you have ever tried to eat a raw egg) the yolk being a valuable source of fat/energy and fat soluble vitamins, not that they were aware of it. For bacon a pig or wild boar nothing would have been wasted, meat fat and offal. Hide for clothing, bones for arrow heads darning equipment and jewelry.
I don't think many of them lived long enough to develop cardiovascular disease and die from it.
 
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  • #14
I thought it was well understood that there’s no correlation between dietary cholesterol and blood cholesterol. Saturated and trans fats are the culprits and it’s coincidental that many foods high in bad fats are also high in cholesterol. I’m not a biologist but I come from a family with a predisposition to heart disease.
 
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  • #15
alan2 said:
I thought it was well understood that there’s no correlation between dietary cholesterol and blood cholesterol. Saturated and trans fats are the culprits and it’s coincidental that many foods high in bad fats are also high in cholesterol. I’m not a biologist but I come from a family with a predisposition to heart disease.

It's complex I would read the whole thread (jokey ones aside about bacon) if you haven't already.
If your folks died young you have to get checked often and take more care on your diet don't smoke watch your alcohol don't get fat or regularly stressed.
 
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  • #16
alan2 said:
I thought it was well understood that there’s no correlation between dietary cholesterol and blood cholesterol. Saturated and trans fats are the culprits and it’s coincidental that many foods high in bad fats are also high in cholesterol. I’m not a biologist but I come from a family with a predisposition to heart disease.
Maybe it would be more accurate to say that the impact of dietary cholesterol on serum cholesterol is much less than that of trans fats. On the whole, this Mayo Clinic expert's answer seems to be in accord with your comment.
pinball1970 said:
It's complex I would read the whole thread (jokey ones aside about bacon) if you haven't already.
If your folks died young you have to get checked often and take more care on your diet don't smoke watch your alcohol don't get fat or regularly stressed.
It is complex -- for example, this 2014 presentation says, among other things, that it's important to measure LDL-P, and not just look at LDL-C levels as determined by a standard lipid panel https://www.medscape.org/viewarticle/815311.
 
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  • #17
A long off-topic digression has been removed from this thread. It's about eggs in the human diet, not the care and feeding of chickens.
 
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  • #18
pinball1970 said:
It's complex I would read the whole thread (jokey ones aside about bacon) if you haven't already.
If your folks died young you have to get checked often and take more care on your diet don't smoke watch your alcohol don't get fat or regularly stressed.

Yes, I’m pescatarian, lots of fish and beans, no alcohol, plenty of exercise. I also average an egg per day and so far I’ve outlived every male ancestor and blood tests are great.
 
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  • #19
alan2 said:
Yes, I’m pescatarian, lots of fish and beans, no alcohol, plenty of exercise. I also average an egg per day and so far I’ve outlived every male ancestor and blood tests are great.

I had to look that up!

I thought the stem would have been pisc not pesc. Anyway have you read the studies? When I was at college it was a HDL LDL scenario (80s) things have changed since then.

It's still fat so probably best treat it as such, yolks that is.
 
  • #20
Before we start pronouncing on the fat content/type in foods, please do a quick check here: https://ndb.nal.usda.gov/ndb/ If you want types of fatty acids select the "Full Report (All Nutrients)"

FWIW - pork tenderloin is 2.45b/113g or 2.17% fat. Chicken light meat (skin removed) is 1.65% These are very comparable values. Chicken light meat is considered a low fat meat choice.
 
  • #21
jim mcnamara said:
Before we start pronouncing on the fat content/type in foods, please do a quick check here: https://ndb.nal.usda.gov/ndb/ If you want types of fatty acids select the "Full Report (All Nutrients)"

FWIW - pork tenderloin is 2.45b/113g or 2.17% fat. Chicken light meat (skin removed) is 1.65% These are very comparable values. Chicken light meat is considered a low fat meat choice.
50% plus fat for the yolk? We were not talking tender loin pork we were talking bacon.
 
  • #22
I think generally, most dietary advice is based on very poor quality and often highly biased research which many people see as marginally less credible than astrology. This is at a time when many scientists talk about how people don't understand their work, I suspect they often understand it to well.
I think we have to remember that we are not designed to live forever and our metabolic processes are in themselves rich sources of damaging chemicals, any food we eat that we use to provide energy is slowly killing us, nothings safe. Luckily there are also lots of things that our body can use to offset some of the harm and while we are young these systems are surprisingly efficient. Most health and lifestyle advice is really operating on relatively low level risk factors, the most important, age, is very difficult to control, I've tried (cancelling birthdays doesn't work, in case anyone was considering it. :) ). However this also means that researchers are looking for evidence around risk in areas where the effects can be barely measurable and when we have a limited understanding of the physiology involved.
This gives a reasonable overview about fats and sugars and begins to explore some of the physiology involved, but it often surprises people that we still don't have a clear understanding about this.

https://www.ncbi.nlm.nih.gov/pubmed/26586275
I thought the second link was interesting in that it not only sings the praises of eggs as a food source, but implies that there may be other factors involved that are yet to be discovered.

https://www.ncbi.nlm.nih.gov/pubmed/30909449
Just to cheer people up, for some reason the rate of heart disease in the west has significantly fallen, and at a rate that is not explained by improvements in medical interventions or the predictions associated with obesity. We don't understand that either.
 
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  • #23
Laroxe said:
Just to cheer people up, for some reason the rate of heart disease in the west has significantly fallen, and at a rate that is not explained by improvements in medical interventions or the predictions associated with obesity. We don't understand that either.
Wouldn't this be attributable to a decrease in smoking as smoking is a risk factor for cardiovascular disease?
 
  • #24
Ygggdrasil said:
Wouldn't this be attributable to a decrease in smoking as smoking is a risk factor for cardiovascular disease?
Apparently not, while some of the changes can be easily attributed to some factors, not all of them can be, I don't know if I can find the source, but I'll try.
 
  • #25
Laroxe said:
Apparently not, while some of the changes can be easily attributed to some factors, not all of them can be, I don't know if I can find the source, but I'll try.
Reduction in smoking being viewed as a significant factor in reduction in heart disease seems reasonable to many, given the huge amount of high-quality study that's well established the associated physiological mechanisms. "Quitting smoking now greatly reduces serious risks to your health." That, and other tobacco product warnings, including the more severe Canadian ones, seem well justified to me and to many other reasoning persons.
 
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  • #26
Laroxe said:
Apparently not, while some of the changes can be easily attributed to some factors, not all of them can be, I don't know if I can find the source, but I'll try.

Here's an analysis from the NEJM:
From 1980 through 2000, the age-adjusted death rate for coronary heart disease fell from 542.9 to 266.8 deaths per 100,000 population among men and from 263.3 to 134.4 deaths per 100,000 population among women, resulting in 341,745 fewer deaths from coronary heart disease in 2000. Approximately 47% of this decrease was attributed to treatments, including secondary preventive therapies after myocardial infarction or revascularization (11%), initial treatments for acute myocardial infarction or unstable angina (10%), treatments for heart failure (9%), revascularization for chronic angina (5%), and other therapies (12%). Approximately 44% was attributed to changes in risk factors, including reductions in total cholesterol (24%), systolic blood pressure (20%), smoking prevalence (12%), and physical inactivity (5%), although these reductions were partially offset by increases in the body-mass index and the prevalence of diabetes, which accounted for an increased number of deaths (8% and 10%, respectively).
https://www.nejm.org/doi/full/10.1056/NEJMsa053935
 
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  • #27
Sysprog, I'm sorry if I implied that known risk factors are not important, they clearly are, and you identify one of the most significant. Worldwide smoking continues to be the lifestyle choice that presents the single greatest threat to peoples health and efforts to reduce smoking are hugely important.

The decline in CV mortality was totally unexpected and had been going on for more than 10 years before the medical establishment took notice. In 1978 they establishes a panel of experts to investigate the decline and its causes, the Bethesda Conference and while they still didn't understand the scale of the reductions they were quickly claiming credit for them. The declining rates have continued, the age-adjusted annual heart disease mortality per 100,000 fell by 56% from 307.4 in 1950 to 134.6 in 1996.
Since then mortality rates have continued to decline falling by 22% from 376 to 274 per 100,000 from 1990 to 2013. Similar declines have been observed in nearly all regions of the world, especially in high-income North America, Western Europe, Japan, Australia, and New Zealand. These declines are phenomenal and unmatched in any other major area of medicine.
To be fair the early attempts to explain these findings were disappointing but this lead to the establishment of more detailed international data collection, which provided evidence of a strong and robust relationship between the changes in event rates and absolute changes in risk factors across populations.
I don't find the NEJM very convincing to be honest, the claim of the large effect of medical interventions simply doesn't seem credible. If you consider that approximately two thirds of 28-day CHD deaths in men and women occurred before reaching the hospital, opportunities for reducing CF through improved care in the acute event are limited. We might expect a greater effect from interventions for secondary prevention but in fact surgical interventions while they improve functioning have little effect on long term mortality.
Drugs that reduce risk certainly seem to work but most have been introduced after the decline started and perhaps more worrying is the American Heart Association finding using the cardiovascular risk index that cardiovascular health has been declining since 2003.

https://www.ncbi.nlm.nih.gov/pubmed/26396200/

So there is still a body of opinion that while control of risk factors and better interventions do explain a lot, they don't explain it all.
This provides an extensive review of the issues, but its a bit long and I suppose its worth asking does it matter, generally its still good news.

https://www.annualreviews.org/doi/full/10.1146/annurev-publhealth-031210-101234
 
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  • #28
I agree that such an important trend should be thoroughly investigated ...
 
  • #29
U.S. Department of Health & Human Services
https://www.nhlbi.nih.gov/

Egg consumption linked to higher risk of heart disease and death

March 18, 2019

An NHLBI-funded study found that the higher the consumption of dietary cholesterol or eggs, the higher the incidence of cardiovascular disease, which includes heart disease and stroke, and death from any cause among U.S. adults.
The findings are sobering news for Americans who have been freely eating eggs, the most cholesterol-rich food in a typical U.S. diet, since the 2015-2020 Dietary Guidelines dropped the limitations on cholesterol and egg consumption.
The study, published in the Journal of the American Medical Associationexternal link, reports that 300 mg of dietary cholesterol per day is linked to 17 percent higher risk of cardiovascular disease and 18 percent higher risk of death. An average adult typically eats about 300 milligrams per day of cholesterol and three or four
eggs per week.

https://www.nhlbi.nih.gov/news/2019/egg-consumption-linked-higher-risk-heart-disease-and-death
 
  • #30
Here we go again. A new study found that there was no significant association between eggs consumed and blood lipids, mortality or major CVD events based on < 1 egg per week vs >= 7 eggs per week for about 177,000 persons in 50 Countries.
 
  • #31
I think that eggs keep well for a long time in the refrigerator.
 
  • #32
gleem said:
Here we go again. A new study found that there was no significant association between eggs consumed and blood lipids, mortality or major CVD events based on < 1 egg per week vs >= 7 eggs per week for about 177,000 persons in 50 Countries.
These discussions on eggs no longer seem fruitful. If you find one study claiming that eggs are not related to cardiovascular diseases, it will be not too late before you find another saying the exact opposite thing. At the end, no proper conclusion can be reached.
 
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  • #33
I conclude by saying 'Thread is at an impasse', now closed.

gap.jpg
 
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