Doctor's Note

For more context, check out my associated blog posts:  Stool Size and Breast Cancer Risk and Bad Egg

  • Leomar

    The study also explicitely states that “…we demonstrated that infrequent egg consumption up to 6 eggs per week was not associated with MI, stroke, or total mortality in healthy US male physicians.”
    So if you skip it just once a week you should be fine.. if you’re a physician.

    • Michael Greger M.D.

      Sorry it took me so long to get back to you Leomar. Please see my blog post Bad Egg to put this older study in context as well as the most recent review on the subject posted in two parts here and here, concluding that no one (who isn’t dying from a terminal illness or something) should be regularly eating eggs. It’s true the Physicians’ Health Study did not have the statistical power to pick up a significant elevation in risk for eating less than one egg a day, but from what we know about the effects of dietary cholesterol, the ideal upper daily limit of intake is zero (same with trans fats).

      • lukeap

        Dr. Greger,

        I’ve watched the videos about egg cholesterol being bad. Is there any researching dealing with only eating the egg whites of eggs? Is this harmful, given the cholesterol is taken out of the equation. I often eat 4-5 egg whites for breakfast.

        Thanks for your help and website.

  • DrDons

    My question is why would you want to eat egg whites? I would guess that you believe it is good for getting the protein you need and a source of “quality” protein or essential amino acids. I recommend that you read two articles by Dr. John McDougall. They are in his monthly newsletters…”A Brief History of Protein”(December 2003) and “Where Do I Get My Protein”(April 2007. The take home message… no way you can not get the essential amino acids you need if you consume adequate calories on whole food plant based diet. Also the essential amino acid profile is virtually the same for eggs, broccoli and asparagus. Since we don’t store protein we must metabolize it. There is good data to show that consuming animal protein is bad for our kidneys based on the Harvard Nurses Study. It appears that plant proteins which have less sulfur based amino acids are preferable for a host of other reasons see(http://nutritionfacts.org/videos/plant-protein-preferable/). Before continuing to eat egg whites you should also review Dr. Greger’s video on the difficulties in preventing salmonella with egg preparation. (http://nutritionfacts.org/videos/total-recall/). I would recommend not using egg whites with the added benefit that you won’t have to waste or figure out what to do with the egg yolks.

    • Coacervate

      I think its ok to eat cooked egg whites.  Just don’t overdo the protein load.  I think even Dr Greger’s site says that it is not the protein source, rather the other baddies that come aloong with fish/meat/dairy that are bad. 

      I am suspicious of the Esselstyn/Cambell et al camp because they seem to have an animal welfare agenda too. 

      They don’t want you eating egg whites because it means you have to raise chickens to get them and the really don’t want anyone raising chickens or any of their other pals with faces and mommies and daddios.  Good for them but bad for science.

      • Lew Payne

        Another novel concept is that of avoiding bad things altogether, rather than trying to eat a specific section of them (e.g., egg whites in lieu of eggs). To me, it seems more economically feasible to discard an unhealthy food altogether, as opposed to paying for the entire food (e.g., egg) and discarding a portion of it (e.g., yolk).

      • Toxins

        The protein source is indeed an issue as seen with increased IGF-1 levels

  • Michael Greger M.D.

    Also be sure to check out my associated blog post Bad Egg!

  • Spike

    Hmm, seems at odds with many other studies: who do you believe?

    • Toxins

       This is simply a statistic that represents one egg every single day. What other studies do you have that actually show health benefits attributed with eggs despite the major harms?

      • Notspikemilligan

         The point isn’t about me “singing the praises” of eggs – merely taking issue with the seemingly biased article slating them. I’m 61, and as a child – and up to now – followed the “Go to work on an egg” maxim stated by our health service. I appear not to be suffering from the woes indicated in the article, so again I say “Who do you believe” – ie do you take this article as the gospel truth: I don’t.

        • Toxins

          No one food at one point in time can cause degenerative disease but consuming one food all the time as part of ones diet can. There is more then one study that goes against eggs. Here is the evidence against eggs.

          Current levels of omega 3 in eggs are highly inadequate and one must
          consume around 30 eggs to reach an acceptable level of omega 3 for the
          day. A male needs around 1.6 grams of omega 3 per day, a female needs
          around 1.1 grams a day. Omega 3 processes to EPA which is also
          processed to DHA, which is highly anti inflammatory. Omega 6 processes
          down to arachadonic acid which is highly inflammatory. The fact that
          eggs are the top source of arachadonic acid nulls and voids benefits
          received from the omega 3 in the egg itself. High intake of arachadonic
          acid is linked to autoimmune diseases such as  rheumatoid arthritis,
          ulcerative colitis, as well as a clear link with  cancer development.http://www.ncbi.nlm.nih.gov/pubmed?term=20950616uid
          http://www.ncbi.nlm.nih.gov/pubmed/18774339
          http://www.ncbi.nlm.nih.gov/pubmed/21139128

          The
          Harvard physicians study followed 20,000 doctors for 20 years and
          those that ate just one egg a day had significant increase in all cause
          mortality.
          http://www.ncbi.nlm.nih.gov/pubmed/18400720

          In
          fact, David Spence, director of stroke prevention/atherosclerosis
          research center and one of the worlds leading stroke experts, said that
          based on the latest research, you can eat all the eggs you want IF your
          dying of a terminal illness. Eggs are not considered health promoting
          nutritionally speaking.
          http://www.ncbi.nlm.nih.gov/pubmed/18400699

          Eggs have been linked with heart failure
          http://www.ncbi.nlm.nih.gov/pubmed/18954578

          As well as type 2 diabetes.
          http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2628696/?tool=pubmed

          Furthermore,
          in the Canadian Journal of Cardiology, David Spence, David Jenkins
          (the inventor of the glycemic index) and Jean Davignon (director of
          atherosclerosis research group) posted a review on eggs claiming that
          the egg industry has been downplaying the health risks of eggs through
          misleading advertisements. As soon as you eat one egg, you expose
          your body to several hours worth of oxidative stress, inflammation of
          ones arteries, endothelieum impairment (what keeps you blood running
          smoothly) and increases the susceptibility of LDL cholesterol to
          oxidize (beginning stages of heart disease).
          http://www.ncbi.nlm.nih.gov/pubmed/21076725
          http://www.ncbi.nlm.nih.gov/pubmed/9001684

          The
          egg industry has claimed that cholesterol from eggs is not important
          and does not raise cholesterol levels. The fundamental flaw in the study
          the egg industry has used to make this claim is that they measured
          FASTING lipid levels at night and not levels through out the day after
          egg consumption. “Diet is not all about fasting lipids; it is mainly
          about the three-quarters of the day that we are in the nonfasting state.
          Fasting lipids can be thought of as a baseline; they show what the
          endothelium was exposed to for the last few hours of the night.”
          http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2989358/?tool=pubmed

          A
          single egg yolk contains approximately 215 to 275 mg of cholesterol. A
          safe upper limit can be capped at 200 mg if one is looking to prevent
          heart disease. One egg far exceeds this daily upper limit.

          In
          regards to egg whites, although true they are a good source of protein,
          this is possibly the only positive statement that can be made of it.
          Here is some evidence of a major component of egg whites, Methionine,
          possibly causing human harm.

          1. Egg whites are high in
          the amino Acid Methionine. Rice has 14 times less of this amino acid and
          beans 7 time less. When one consumes Methionine in a large quantity
          (like that found in egg whites), it is broken down into sulfuric
          compounds. these sulfuric compounds are buffered by the calcium of the
          bones. the result, over time, is osteoporosis and kidney stones.
          http://www.vivalis.si/literatura/6a00.pdf  

           2.
          Cancer cell metabolism is dependent upon methionine being present in
          the diet; whereas normal cells can grow on a methionine-free
          diet feeding off other sulfur-containing amino acids.
          http://www.ncbi.nlm.nih.gov/pubmed/14585259
          http://www.ncbi.nlm.nih.gov/pubmed/12416254

          3. Insulin like growth factor is raised significantly by Methionine. raised levels of IGF-1 = accelerated aging/tumor promotion.
          http://www.ncbi.nlm.nih.gov/pubmed/12176673
          http://jnci.oxfordjournals.org/content/92/18/1472.abstract

          4.
          Sulfur from Methionine is known to be toxic to the tissues of the
          intestine, and to have harmful effects on the human colon, even at low
          levels, possibly causing ulcerative colitis.
          http://www.ncbi.nlm.nih.gov/pubmed/9448181
          http://jnci.oxfordjournals.org/content/82/11/950.abstract

  • http://www.philippeorlando.com Philippe Orlando

    So, what’s the latest on egg whites? I exercise a lot, run, lift weights, and egg whites are the only animal products I eat. I don’t eat any dairy, fish or meat. Can somebody point me in the direction of good science saying that I should drop egg whites too? I will, but I do want to see the evidence. Thank you all. Philippe

  • Red Baron

    Don’t you think you should differentiate eggs? Factory farmed eggs and pastured eggs are COMPLETELY different. Didn’t the Harvard study use CAFO eggs?

    According to a study in Mother earth news, on average eggs from hens raised on pasture contain:

    • 1/3 less cholesterol

    • 1/4 less saturated fat

    • 2/3 more vitamin A

    • 2 times more omega-3 fatty acids

    • 3 times more vitamin E

    • 7 times more beta carotene

    They also have more B-12 and other vitamins and don’t have the same dangers from disease that CAFO eggs have. Huge difference. I personally wouldn’t recommend eating any of those nasty CAFO eggs, but the Harvard study also seems to say even the grossly inferior CAFO egg still isn’t harmful unless you eat too many.

    So my question is: Knowing the huge difference in eggs depending on how hens are raised, has there been a follow-up to the Harvard study using pastured instead of those nasty CAFO eggs?

    Thanks,
    Scott

    • Toxins

      Regardless of the differences, they are still essentially the same product. The only significant difference is with the cholesterol although it is still quite a large amount. Every other factor you mentioned is too small to make a difference on the big picture. Going from 5% of vitamin e to 12% does not make this food more healthy. We still have the issue of arachidonic acid, cholesterol and saturated fat and not to mention the IGF-1 raising effects of this food.

      http://nutritiondata.self.com/facts-C00001-01c200_S0000o180j05012G18000000060800030500040600020E0004060B07020A020403010NPastureqqdRaisedqq0Eggsqq0qq81qq0largeqq0qqjqq050gqq9.html

      http://nutritiondata.self.com/facts/dairy-and-egg-products/111/2

      • http://www.DonForresterMD.com/ Don Forrester MD

        Nice post. Couldn’t agree more.

      • Red Baron

        I honestly don’t understand. You sent two links, one to pastured eggs and one to standard (presumably CAFO) eggs. The links confirm a huge difference. For example:

        1g saturated fat Pastured

        2g saturated fat CAFO

        140mg cholesterol pastured

        211mg cholesterol CAFO

        Meanwhile the total fat is about the same…which means of course that the good fats like omega 3s, and unsaturated are in a high proportion.

        Then I go to the vitamins and get more confirmation there too.

        Then of course I consider the bacteria and pathogens found in nasty CAFO eggs not found in pastured eggs that wasn’t even mentioned in your links.

        And yet with all that you still claim “Regardless of the differences, they are still essentially the same product.” ?????

        So what’s up with proving there is a significant difference but not showing the same or similar Harvard study seeing if that difference has a different effect on human health?

        For years now CAFOs and industrial factory meat & dairy industry have been claiming there is no difference at all. Now we see they were lies and you just proved it. The Harvard study proves they are not as healthy too. Another Big Ag lie proven. Why is it a stretch to think those two things are related?

        Isn’t it at least PLAUSIBLE to consider that if the nutrition content of CAFO eggs is proven different in exactly the things we now find are harmful, like saturated fats, cholesterol, and lacking in good fats like Omega 3s, and other nutrients like beta carotene, then the reason eggs are so bad for you is in fact the current CAFO conventional model?

        • Thea

          Red Baron: I don’t think you are understanding Toxin’s point.

          I don’t know if this will help or not, but let’s take one example metric: cholesterol. Let’s say it is fact that your pastured egg has 1/3 less cholesterol than a standard egg. A third less sure does sound significant, but it’s not so impressive when you look at the big picture. The big picture is that even *half* a standard egg has more cholesterol in it than the federal government considers OK for “low cholesterol”. In other words, your 1/3 less is still WAY to high. It’s not impressive at all and there is no reason to believe that this difference would lead to health improvements when we know what that cholesterol that *is* in your pasture egg does to the human body.

          Take Toxin’s example of Vitamin E. If you put it your way, “3 times more” sounds so impressive. Until you realize that the standard egg had only 5% to begin with and your pasture egg has only 12%. 12% is not significant. Yes, it’s more than 5. But so what? It’s my understanding that to classify as a “good source” of a vitamin, a food has to have 25% of your daily need. 12% is less than half of that–so low. On the other hand, according one site I visited, a serving of mustard greens has 75% of the daily vitamin E – an “excellent” rating. Or put another way: three times almost zero is still almost zero. (Yes, 5 is more than zero, but hopefully you get the point.)

          Here is another way to understand it: As Toxins said, having 12% of a vitamin in a food does not make that food healthy. You have to take the whole food into account. Dr. Greger’s fun example is Coke. Just because Coke is made up mostly of water and just because water is good for you, does *not* mean that Coke is good for you. All the bad things in Coke way outweigh whatever good you might get from the water. In the example of your eggs, this means: containing a little bit of Vitamin E or whatever else you want to look at does not make the egg healthy when there is still so very much about the rest of the egg that is unhealthy.

          Put another way: your reasons for calling the pasture eggs good sources of nutrients don’t add up. And then as Toxin’s points out, there are still all sorts of bad things about eggs that apply to all eggs – regardless of where they come from (ie, your pasture eggs too). Toxins may not have provided the links, but you can look up say arachidonic acid and IGF-1 on this site and learn how bad they are and how these problems are relevant to all eggs.

          Bottom line: There are some differences between pasture eggs and standard eggs. But those differences are not significant in terms of health when you understand what the numbers really mean.

          Hope that helps.

          • Scott

            So is there a study similar to the Harvard study, but on pastured eggs, that proves what you guys are saying? Or are you guys extrapolating?

            The question is: Has anyone actually tested the hypothesis? Because until actually proven there is no effect on human health, CAFOs are a potential confounding factor in studies like the Harvard study. At least in my mind it is more plausible than thinking animal products always were bad for you, even after it was a staple for millions of years or more?

          • Thea

            Scott: I don’t know the answer to your first question, but I believe that my answer above explains why I would consider your question to be irrelevant.

            Your second question, though, is interesting and one that I respect based on your understanding of history. re: “At least in my mind it is more plausible than thinking animal products always were bad for you, even after it was a staple for millions of years or more?” The problem is that I think your assumptions about history are incorrect. I’m not sure what you consider to be a staple, but everything I know about history suggests that the earliest humans probably ate animals the same way chimps do today – meaning probably 2-3 percent of our diet was on average from animal sources – and most of that was insects. I don’t consider that to be a staple. And at such a low percentage, the health impacts would have been negligible – especially compared to the need to get enough calories for an active lifestyle.

            You also might want to ask yourself where, prior to becoming farmers and giving up the nomadic life, we would have had a steady source of eggs in our diet? In other words, I highly question your assumption that eggs in particular was a “staple” in early homo sapiens’ history (which, FYI: goes only back about 200,000 years. If you want to talk millions of years, then you are looking at primates in general, which according to Wikipedia go back 65 million years. But then you are talking more like the chimp diet again – or maybe take a look at gorillas.)

            There is an interesting TED talk about the “paleo” diet. I don’t agree with her final conclusions, but her research and information seems pretty solid and might interest you. Here’s the sound bite for the talk:
            “In recent years, the “paleo diet,” a diet based on the perceived eating habits of prehistoric people has become wildly popular. But, says paleontologist Christina Warinner, this diet is based on an incorrect view of how early humans lived. Using modern day research, Warinner traces the roots of the human diet to discover what we can really learn from the food of our ancestors.”
            http://blog.tedx.com/post/45914179742/debunking-the-paleo-diet-christina-warinner

            Here’s the question I would throw back at you: Knowing that the health detriments of eggs and other animal products become apparent (kill you) only after *decades*, not days or months, why would you think that the health effects would have ever been noticed by any pre-modern times human? Doesn’t it make more sense that pre-scientific people would eat these things (especially to get through starvation time) despite unknowable health effects just because the food is there? And is addictive?

          • Red Baron

            Thea,
            Thanks for the long detailed reply. No I am not a “paleo”. Far from it. The paleo diet, whatever it was, is pretty much impossible in modern times anyway.

            I was trying to ask Dr. Gregor specifically about the Nutritional composition of eggs because I admire his research and honesty.

            I saw his hour long speech on Omega 3′s. He was investigating research as to why with all the benefits of vegan diets, there still were no benefits to longevity, dementia etc.. During the speech he hit on the n-6 to n-3 ratio as one of the primary causes, because of its effect on DHA and EPA. Another major factor was B-12. This issue is in people who eat no meat, milk or eggs at all. He was discussing it in the context of Dinshah’s death by heart attack. Meanwhile people with high fat and even high cholesterol eating a Mediterranean style diet were in many cases at the same or lower heart attack rates. You would have to see the whole speech for context, but I recommend it. Very interesting and enlightening and backed up by good reputable science.

            His conclusion was that vegetarian is not enough. Maintaining a n-6 to n-3 ratio at 4:1 or less is at least as important, B-12 too. He said there were other factors too, but relatively minor in comparison.

            That’s when I had an AHA moment. The n-6 to n-3 ratio is completely different in CAFO eggs compared to pastured eggs.

            If the n-6 to n-3 ratio is so important in vegetarian diets, might it be at least plausible that it is just as important or more in other diets as well? Has there been studies done? In my opinion, if true, it could be leveraged into a ban of ALL CAFO’s, because CAFOs cause the n-6 to n-3 ratio to climb to astronomical levels.

            Thanks,
            Scott

          • Thea

            Wow Red Baron. Awesome reply and great explanation. Thanks for explaining all that. I had not seen that talk you are talking about. I’m going to look for it!

          • Red Baron
          • Thea

            Cool! Thanks so much for taking the time to link to this video for me (and others I’m sure). I’ll take a look at it.

            I hope you get the answer you are looking for.

          • Thea

            Red Baron: I wanted to thank you again for pointing me to this video. It is excellent!

            I know that you are looking for a reply from Dr. Greger and I hope you get it. I just thought I would share my thoughts:

            1) This lecture is a decade old. It was fascinating to me how much is the same and which recommendations are different/have evolved since then.

            2) One of the things that is different since that time is studies showing that vegans/vegetarians do indeed live longer. At least in more recent studies with huge numbers of people. (see below for a quote) I wonder if Americans have improved our diets over the last decade based on Dr. Greger’s recommendations and that accounts for the differences in the studies???

            3) I finally understand why Dr. Greger recommends that we take DHA as a supplement. And I finally understand how all the different fats relate to each other. That’s huge. Thanks again!

            4) I still didn’t see anything in the video that would say to me that pasture eggs are dramatically better than factory eggs. I say that because Dr. Greger addressed fish in the video. And despite whatever omega 3 are in the fish, Dr. Greger still didn’t recommend them because the omega 3s did not compensate for all the bad things in the fish. Based on what I understand about eggs (of any type), I would expect the same response. Please note that I suspect that I may not be understanding your question or point. I just wanted to state my take on it after having watched the video.

            —————————–

            FYI: Here’s a study of many more people (covering more time than the studies Dr. Greger quotes in the video?) that relates to longevity:

            from PCRM:

            Vegetarians Live Longer

            Vegetarian diets can extend life expectancy, according to early findings from the Adventist Health Study-2. Vegetarian men live to an average of 83.3 years, compared with nonvegetarian men who live to an average of 73.8 years. And vegetarian women live to an average of 85.7 years, which is 6.1 years longer than nonvegetarian women. This study is ongoing and includes more than 96,000 participants. The results further indicate vegan diets to be healthful and associated with a lower body weight (on average 30 lbs. lower than that of meat eaters), and lower risk of diabetes, compared with diets that include animal products.

            Fraser G, Haddad E. Hot Topic: Vegetarianism, Mortality and Metabolic Risk: The New Adventist Health Study. Report presented at: Academy of Nutrition and Dietetic (Food and Nutrition Conference) Annual Meeting; October 7, 2012: Philadelphia, PA.

  • Paolo Marco Perona Neyra

    hola doctor y solo las claras de huevo , tambien son perjudiciales ?

  • D Couch

    One of the problems with the Harvard Study is that it did not study what the doctors who ate just one egg per day ate in addition to eggs. Did they consume a good deal of sugar, bad fats, etc.

    The problem with such studies is that they draw conclusions on much too narrow parameters.

    Scientific literature such as that published in Current Opinion in Clinical Nutrition and Metabolic Care clearly indicates that egg consumption has no discernible impact on blood cholesterol levels in 70% ofthe population. In the other 30% of the population (termed hyperresponders”), eggs do increase both circulating LDL and HDL cholesterol.

    We have been conditioned to believe that anything that
    raises LDL cholesterol (so-called “bad” cholesterol) should be avoided like the plague. But recent research suggests that it’s not the amount of cholesterol in an LDL particle that drives heart disease risk, but instead the number of LDL particles in the bloodstream. Egg consumption is likely to protect against heart disease because it increases the proportion of large, buoyant LDL particles. Larger LDL particles can carry more cholesterol, which means fewer particles are needed overall. In other words, egg consumption may decrease LDL particle concentration, which is the most significant risk factor for heart disease.

    Dr. Steven Nissen, chair of the Department of Cardiovascular Medicine at the famed Cleveland Clinic Foundation, expressed misgivings about
    the “very poor quality” of the Canadian study that you mention and indicates the study “should not influence patients’ dietary choices.” According to Dr. Nissen, the research depended too heavily on participant’s self-reporting, which is notoriously unreliable, and other dietary and lifestyle factors were not or only insufficiently included.

    Similar concerns were raised by Dr. David Frid, a cardiologist at the Cleveland Clinic. He didn’t think egg consumption should be equated to smoking, even though both can contribute to ill heart health Smoking, he said in an interview with ABCNews.com, causes arteries to become inflamed, which can result in the build-up of plaque, however, in a different way than from cholesterol. Moreover, he said, people who like eggs, often have a preference for other fatty foods. That possibility must be taken into account as well, he added.

    The study published in the medical journal “Atherosclerosis” found that egg yolk consumption appears to damage and thicken the arteries, almost to the same degree as smoking.

    The study looked at egg yolk consumption in about 1,200 people with a history of transient ischemic attacks (small strokes where symptoms disappear). BUT here is the kicker — The found that those who ate three or more yolks a week had significant amounts of plaque build-up compared with those who ate two or fewer yolks a week. The study does not follow the other foods these folks ate and also seems to OK two or fewer egg yolks per week.

    Additionally heredity was not taken into account in the studies.

    Ultimately, until the experts come to a consensus and that will probably be never, using our best judgment is pretty much all we have.