Preventive Medicine:

Dr. David Katz

Are eggs good or bad for us now? Yes. A recent meta-analysis, widely covered by media ever hungry for just such dietary provocations, reported that the more eggs people ate over time, the more prone they were to heart disease. This, inevitably, has been juxtaposed with the advice in the 2015 Dietary Guidelines to abandon a specific focus on dietary cholesterol — and unleashed the predictable round of breathless expostulations about the deplorable state of nutritional science and understanding.

Actually, the deficiency is sense, not science. Absent sense, science doesn’t work.

Vexing though such nuance may be- defiant though it may be of our penchant for dualistic, Manichaeistic sound bites and simple-minded clickbait — the simple truth is that science is rarely a matter of absolutes. It’s the truth about almost everything in science, and it’s certainly the truth about food: actual understanding requires more than over-simplified, over-generalized summary judgment. It actually requires thinking, and interpretation, in context. It’s the truth our information-over-fed culture fails to chew, and refuses to swallow. And, yes, it’s the truth about eggs.

The 2015 Dietary Guidelines Advisory Committee, and the subsequent Dietary Guidelines, never said that eggs were entirely innocuous, and certainly never said they were “good” for us. They simply said, based on the weight of relevant evidence, that they were not a helpful focus for the current dietary guidelines. Guidelines are intended to help fix what’s broken, and as of 2015, most Americans were consuming dietary cholesterol below the recommended threshold.

Short-term intervention studies of egg ingestion — including several from my own lab (industry funded, by the way, for those who want that disclosed immediately) — have indeed suggested eggs to be relatively free of acute harms across a wide array of relevant measures. Large, observational studies over long periods of time have suggested much the same.

But- and here’s the nuance- the right, large observational studies also help us understand why this might be both true, and false. Consider, for instance, the prevailing, and utterly misguided, pop-culture notion that saturated fat has been redeemed and is good for us now. Actually, the two meta-analysis underlying this contention simply showed that across fairly narrow and fairly high ranges of saturated fat intake, rates of heart disease were high and rather constant.

A 2015 study by researchers at the Harvard School of Public Health explained why. When saturated fat in the diet is replaced with added sugar and refined carbohydrate, which is how most Americans have replaced it over recent years, it’s a lateral move. We have no evidence that saturated fat is good for us now; we just have evidence that there’s more than one way to eat badly, and Americans are committed to exploring them all.

Everything causing confusion about eggs is readily interpretable when some related sense is applied. Eggs and dietary cholesterol are not a major public health concern at present simply because we’ve got bigger problems: sugar, ultra-processed foods, saturated fat, and sodium to name a few.

Here’s my take on eggs, both before and after the new study: whatever harm they might do is often obscured by the bleak character of the typical American diet. To observe effects on, say, blood cholesterol, we must test eggs in the context of a high-quality, plant-predominant baseline diet. I think they are better for us than much of what passes for food in America these days (e.g., toaster pastries), but not nearly as good for us as whole grains, whole fruits, nuts and seeds, beans and lentils, or vegetables. And, yes, we should consider the treatment of hens, often subject to rather horrible abuse on large “factory” farms. If you do eat eggs, try to source them locally, from a farm you can visit, and where maybe they even name the chickens. Failing that, at least confirm that no hens were confined, and clipped, and abused in service to your breakfast. Cruelty should never be offered a place on our menus, or at our tables.

Studies will continue to show eggs are both good and bad for us because of the context sense readily appends to the science: eggs instead of what? What, instead of eggs? To unscramble egg studies, and nutrition overall, we must apply sense to science.

Connecticut Media Group