Apples, Oranges, and Eggs

Apples, Oranges, and Eggs

David Katz 07/06/2018 2

A just-published study in Heart is spawning headlines about the benefits of daily egg consumption. A health benefit from egg ingestion is possible, and this is a matter I've pondered before, and investigated directly. But I advise against taking such headlines too literally, as they turn over easily, and crack under very slight pressure.

Look no further than Table 1 of the actual article. Those eating the FEWEST eggs had the lowest education level; the highest rate of hypertension; the most smoking; the lowest average household income; and the least access to a "modern" diet. Was their health truly compromised for want of eggs- or for all the more fundamental wants of socioeconomic disadvantage?

The converse, of course, applies as well. Those with routine egg intake could, conceivably, have benefited directly from the eggs. But then again, maybe it was their higher education, greater wealth, and want of want- their nest egg, if you will, rather than eggs for breakfast.

Although there is, inevitably, a great deal of detail in the full research paper, there is arguably just one other, high-level issue bedeviling those provocative headlines, and scrambling the take-away message, namely: instead of what? This is where the apples and oranges- those classic illustrators of strained comparison- come in.

Whether or not eggs are "good" for you is almost certainly, nearly entirely dependent on that most-routinely-neglected, essential consideration of nutritional epidemiology. Why is "instead of what?" so routinely neglected? No doubt because it calls for nuance a world of click-bait provocation can't handle, and subtleties of consideration at odds with our predilections for scapegoats and silver bullets. But let's be clear, we pay a very high price to service our preference for simple-minded, stripped-down, hyped-up nutrition news. Any hope for actual understanding tends to get fried, and our gullibility is poached by the many industries profiting from perpetual pseudo-confusion.

Are eggs good for you? If in America, and replacing donuts- they might well be. If in China, and replacing even more white rice in a diet of mostly that- perhaps then, too. But if displacing, say, whole grain oats from your breakfast, or beans from your lunch- almost assuredly not.

You always get your nutrition headlines the way we like them- sunny side up. Check the fine print- or at least Table 1- for the devilry concealed there. Before reaching conclusions, determine if apples are being compared to apples, or oranges.

Or just eat both. We know for sure they are good for you.

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  • Finn Johnson

    Very well explained thanks a lot!

  • Jeff Baker

    Excellent content as usual

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David Katz

Healthcare Expert

David L. Katz, MD, MPH, FACPM, FACP, FACLM, is the Founding Director (1998) of Yale University’s Yale-Griffin Prevention Research Center, and former President of the American College of Lifestyle Medicine. He has published roughly 200 scientific articles and textbook chapters, and 15 books to date, including multiple editions of leading textbooks in both preventive medicine, and nutrition. He has made important contributions in the areas of lifestyle interventions for health promotion; nutrient profiling; behavior modification; holistic care; and evidence-based medicine. David earned his BA degree from Dartmouth College (1984); his MD from the Albert Einstein College of Medicine (1988); and his MPH from the Yale University School of Public Health (1993). He completed sequential residency training in Internal Medicine, and Preventive Medicine/Public Health. He is a two-time diplomate of the American Board of Internal Medicine, and a board-certified specialist in Preventive Medicine/Public Health. He has received two Honorary Doctorates.

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