
Associations of egg consumption with cardiovascular disease - manidoraisamy
http://heart.bmj.com/content/early/2018/04/17/heartjnl-2017-312651
======
brolover
This might suffer from the same issue the alcohol consumption study lacked.

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.

~~~
nabla9
> dietary cholesterol does not increase serum cholesterol

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.

~~~
brianbreslin
Do you have any additional links on this? I'm curious to read more.

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Jedd
> From this prospective cohort study, we found more frequent egg consumption
> was associated with CVD, IHD, MCE, haemorrhagic stroke and ischaemic stroke,
> independent of potential confounders. Notably, daily consumers (up to <1
> egg/day) were associated with a 26% lower in risk of haemorrhagic stroke.

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.

~~~
Empact
There's more research linked here, with mostly good news for you:
[https://examine.com/nutrition/are-eggs-
healthy/](https://examine.com/nutrition/are-eggs-healthy/)

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."

~~~
brolover
[https://sydney.edu.au/news-opinion/news/2018/05/07/-eggs-
not...](https://sydney.edu.au/news-opinion/news/2018/05/07/-eggs-not-linked-
to-cardiovascular-risk--despite-conflicting-adv.html)

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.

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assblaster
The body regulates cholesterol balance via the liver, and this is most
influenced by genetics. Dietary cholesterol simply is inconsequential, and the
old warning against too much dietary cholesterol was just bad medical advice
based on incomplete knowledge of cholesterol metabolism.

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.

~~~
JohnJamesRambo
What are your cholesterol levels eating 4-6 eggs a day?

~~~
microcolonel
Most of my calories come from meat, cheese, and organs, and my blood work
looks just fine. I honestly just don't pay any attention to the ping-ponging
research findings these days unless something is directly toxic.

~~~
b3b0p
I'm the same way. Follow a similar sounding diet. My total cholesterol is
high, but the ratios are considered very healthy and my trigs are extremely
low. From my research cholesterol is still an unknown and everyone has an
opinion. It's hard to believe too much of the foods that we are supposed to
eat (natural, meat, eggs, veggies, ...) can harm us to such an extent to
actually become worried and obsessive about it.

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your-nanny
What is typically eaten alongside eggs in China?

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.

------
fencepost
Take from this what you can take from many studies of this sort: Eggs have a
fair amount of nutrition, and there's no sign of significant downsides or vast
advantages to eating them in moderation.

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.

------
Faaak
As a non-native English speaker, I find the conclusion sentence very
confusing: "Among Chinese adults, a moderate level of egg consumption (up to
<1 egg/day) was significantly associated with lower risk of CVD, largely
independent of other risk factors."

Don that mean that it's best to eat a lot or less eggs ?

~~~
mistersquid
One paraphrase of the quote you provide is "Among Chinese adults, consuming
less than 1 egg per day is associated with lower risk of CVD".

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"

~~~
tgb
No that's exactly wrong. Consumption of eggs was positively correlated with
better CVD outcomes but they only had data to conclude that this holds up to
an amount less than 1 egg per day. People with .76 fared better than those
with .29 per day.

~~~
mistersquid
Thank you for clarifying. Even this native English speaker was confused.

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

------
emtel
I'm pretty sure there is no such thing as "an egg", and I'm skeptical that the
health effects of consuming eggs can be generalized over all eggs.

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.

------
aviv
It's amazing to me that these studies (and the people who look at them and
comment) rarely ever consider the difference between eggs from sick factory
farmed chickens on a nasty grain diet, vs. pasture raised chickens fed on
grass and forage.

People are just that clueless.

~~~
emmanuel_1234
Do we have indications that it actually makes a significant difference,
nutrition-wise?

~~~
aviv
This is one of those things you need to use common sense to realize these
diseased animals are not going to have a positive effect on your body. This
knee jerk reaction to ask for a full blown research paper on HN is getting out
of control.

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gadders
For anyone who has the space (and they don't need a lot of space), I recommend
getting your own hens.

Great fun, and about as hard to look after as a rabbit. Plus the best eggs you
will have ever tasted.

~~~
udp
Totally agree, they're great fun. :-)

It's also why I don't agree with the moral argument for veganism - happy hens
lay eggs too and eggs gotta be eaten!

~~~
Vinnl
...but what happens to the roosters when everyone gets hens? :)

~~~
gadders
That is the saddest thing. You only really need one rooster per flock. If
anyone invents a machine to sex hens whilst still in the egg they will have a
lot of grateful chicken owners.

~~~
udp
You need exactly zero roosters per flock if you're only after eggs.

~~~
gadders
That is true. Having a rooster makes it easier to introduce new hens into a
flock though and raising your own hens from eggs is fun.

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crb002
How much is egg, and how much is having carbs alongside that egg early in the
morning? There are some health benefits to intermittent fasting by not eating
in the morning.

------
onion2k
Does it count if it's in a cake?

~~~
bshimmin
To the same extent that the grapes in wine count as part of your five a day, I
think.

~~~
KozmoNau7
So that's a yes, absolutely?

Great news!

------
ssijak
Pointing fingers at just one food item is really dumb. Especially when you
point that finger at the most nutrient dense and rich food on the planet. It
is already shown that eating cholesterol will lower the cholesterol production
so you end up with the same amount.

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.

------
EGreg
Can someone summarize these findings? So is eating one egg a day “better” than
not eating them at all?

~~~
zaroth
The answer, as always it seems, is that no one really has a clue — probably
because nutrition can’t be reduced to these cute little nuggets of wisdom.

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!”

------
ianai
(Opinion zone) Eggs cannot be healthy for you. They’re mostly cholesterol and
saturated fat. The B vitamins in them come from supplementing their mothers
with synthetics.

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.

~~~
Jedd
> (Opinion zone) Eggs cannot be healthy for you. They’re mostly cholesterol
> and saturated fat.

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.

~~~
amrx101
> 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.

