The Eggsoneration Continues: Why Does Anyone Eat Egg Whites?

The skeptical cardiologist pointed out in 2013 that there was no good evidence supporting limiting dietary cholesterol to 300 mg per day.  I exulted, therefore, in 2016 , when this long-standing dietary recommendation came out of the US dietary guidelines.

Recognizing that dietary cholesterol doesn’t need to be limited means that eggs and egg yolks are fine.

Egg Whites: A Product of Nutritional Misinformation?

Why, then do egg whites continue to be created and consumed?

On a regular basis, patients tell me that they are eating egg white omelettes because they believe egg yolks are not heart healthy.

Old bad nutritional dogma takes a long time to reverse apparently. To this day, for example, the National Lipid Association still recommends limiting daily cholesterol consumption to <200 mg/ day

Therefore I find it necessary to highlight additional new studies that further eggsonerate eggs.

To wit, I shall briefly discuss two articles that were published earlier this month and brought to my attention by friends and readers who are aware of my rabid support for the egg.

Article One: The Wonderfully Acronymed DIABEGG Study

Entitled  “Effect of a high-egg diet on cardiometabolic risk factors in people with type 2 diabetes: the Diabetes and Egg (DIABEGG) Study—randomized weight-loss and follow-up phase” our fist study was performed in Australia at the Sydney Medical School,

Investigators randomized 128 patients with prediabetes or type 2 diabetes (T2D) to a high egg or a low egg diet.

Throughout all study phases, including the 3-mo weight-loss phase, participants consuming the high-egg diet were instructed to eat 2 eggs/d at breakfast for 6 d/wk (12 eggs/wk). Those in the low-egg group were directed to consume <2 eggs/wk, and to match the protein intake that the high-egg group had consumed at breakfast with 10 g lean animal protein (meat, chicken, or sh) or other protein-rich alternatives, such as legumes and reduced-fat dairy products (also consumed at breakfast). Recommended egg-cooking methods were boiled or poached, but they could also be fried if a polyunsaturated cooking oil, such as olive oil, was used. The prescribed diets were energy and macronutrient matched, as reported previously

At the end of 12 months both groups had lost about 3 kg in weight.
The investigators measured everything they could to look at diabetic and cardiometabolic biomarkers which might suggest adverse effects of egg eating on the cardiovascular system but they could find no difference between the egg eaters and the non egg eaters.
High egg consumption had no adverse effects on the following factors that are felt to be important in the development of atherosclerosis:

-measures of systemic and vascular inflammation [high sensitivity C-reactive protein (hs-CRP), IL-6, soluble E-selectin (sE-selectin)],

-oxidative stress (F2-isoprostanes), the adipokine adiponectin (which also modulates insulin resistance), and

-glycemia [fasting plasma glucose, glycated hemoglobin (HbA1c), and a medium-term measure of glycemia, 1,5-anhydroglucitol (1,5AG)].

The authors suggested that nutritional guidelines stop worrying about limiting eggs.

Article Two: Half A Million Chinese Can’t Be Wrong

This observational study published in Heart found that egg consumption in a huge Chinese population was associated with less stroke, and major cardiac events (MCE):

Compared with non-consumers, daily egg consumption was associated with lower risk of CVD (HR 0.89, 95% CI 0.87 to 0.92). Corresponding multivariate-adjusted HRs (95% CI) for IHD, MCE, haemorrhagic stroke and ischaemic stroke were 0.88 (0.84 to 0.93), 0.86 (0.76 to 0.97), 0.74 (0.67 to 0.82) and 0.90 (0.85 to 0.95), respectively. There were significant dose-response relationships of egg consumption with morbidity of all CVD endpoints (P for linear trend <0.05). Daily consumers also had an 18% lower risk of CVD death and a 28% lower risk of haemorrhagic stroke death compared to non-consumers.

The lower risk for stroke and cardiovascular death in egg eaters persisted after accounting for known CVD risk factors.

(And yes, I agree this is an observational study which we should take with huge grains of salt and pepper).

Are EGG Whites The Skim Milk Scam of The Egg Industry?

I’ve written about the scam that is skim milk but it occurs to me that egg white consumption is equally nonsensical.

What happens to the wonderfully nutritious yolk of the egg when it is brutally separated from its white? It is put in a container and sold as  liquid egg yolk. Makers of mayonnaise are big consumers of liquid egg yolk.

Thus, like dairy farmers who double their sales by selling skim milk and its dairy fat separately, egg producers are probably delighted that Americans are consuming egg whites , allowing them to get two products from a single egg.

As I wrote previously: not everyone is an egg lover and I’m fine with that. There is no evidence that you have to eat them. You could feel towards them as did Alfred Hitchcock :

“I’m frightened of eggs, worse than frightened, they revolt me. That white round thing without any holes … have you ever seen anything more revolting than an egg yolk breaking and spilling its yellow liquid? Blood is jolly, red. But egg yolk is yellow, revolting. I’ve never tasted it.”

For those that don’t find yellow revolting, however, avoiding egg yolk makes no nutritional sense.

Eggsplicatively Yours,

-ACP

8 thoughts on “The Eggsoneration Continues: Why Does Anyone Eat Egg Whites?”

  1. Why do they continue to produce egg whites and why do people eat them? Because they’re a great source of protein without the fat. If you’re working out and also decreasing fat in your diet and you can have a nice protein-filled omelette without all the fat – what eggs-actly is wrong with that??

    1. Although Greger’s NutritionFacts.org comes across as objective the agenda is clearly to promote a vegan diet.

      His information on eggs which vegans cannot eat predictably focuses on the “dangers”. He starts off talking about salmonella which clearly one can get from undercooked eggs. Then he launches into an attempt to link eggs to prostate cancer and cardiovascular disease which relies on citing very weak observational studies and focuses on the potential role of choline and TMAO.

      Here is a good summary of the current science on TMAO and human disease Trimethylamine N-Oxide: The Good, the Bad and the Unknown https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5127123/). Bottom Line-the importantce of TMAO in humans at this point is mostly unknown.
      Here’s a quote from that review

      Emerging evidence indicates that consumption of diet high in carnitine or rich in choline could potentially lead to increased cardiovascular disease through generation of TMAO [3]. The Atherosclerosis Risk in Communities study [48] and the European Prospective Investigation into Cancer and Nutrition study [49] did not report increased cardiovascular risk with increasing dietary intake of choline. In addition, fish, which is an important source of trimethylamine in the diet [50], is not associated with risk of cardiovascular disease in the Physicians’ Health Study [51]. On the contrary, a meta-analysis concluded that fish consumption is inversely associated with fatal coronary heart disease [52].

      And Harriet Hall has an excellent summary at Science-Based Medicine (https://sciencebasedmedicine.org/death-as-a-foodborne-illness-curable-by-veganism/)of the limitations of the information that comes from Greger’s videos.

      Although they seem really science-based they suffer from confirmation bias (Greger onlly wants to discuss evidence that supports his vegan diet) and cherry-picking.
      I do not recommend Greger’s website for any nutritional information/advice.

      1. One other thing. Greger’s book “How Not to Die” seemingly promises immortality.
        Here’s a paragraph from his website promoting the book

        History of prostate cancer in your family? Put down that glass of milk and add flaxseed to your diet. Have high blood pressure? Hibiscus tea can work better than a leading hypertensive drug—and without the side effects. What about liver disease? Drinking coffee can reduce liver inflammation. Battling breast cancer? Consuming soy is associated with prolonged survival. Worried about heart disease (our #1 killer)? Switch to a whole-food, plant-based diet, which has been repeatedly shown not just to help prevent the disease, but arrest and even reverse it.

        Do you see a common theme here?

        Also, I find this advice to be potentially dangerous. It encourages patients to give up their proven effective hypertension or CAD medications or treatment for cancer with the false hope that certain plants will fix them.

  2. I own 7 chickens and have 1 to 2 eggs everyday! From my observations it only very slightly affects my cholesterol levels. However, diabetes runs in my family and I feel healthy.

    So, Happy Memorial Day and thanks for writing Doc!

    I have one future blog post recommendation if you will indulge me. Could you please write about lipoprotein little a or lp(a)?

    Thanks!

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