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Eggs, Cigarettes, and Atherosclerosis

study in the journal Atherosclerosis found that eating just 3 eggs or more a week was associated with a significant increase in artery-clogging plaque buildup in people’s carotid arteries going to their brain, a strong predictor of stroke, heart attack, and death.  If you check out my 3-min video Eggs vs. Cigarettes in Atherosclerosis you’ll see they found an exponential increase in arterial plaque buildup for smokers and egg-eaters. Those that ate the most eggs had as much as two-thirds the risk of those that smoked the most, the equivalent of a pack-a-day habit for 40 years or more.

This did not go over easy with the egg industry.

As revealed in a series of internal memos about this group of researchers retrieved through the Freedom of Information Act, the American Egg Board discussed the “wisdom of making industry responses when the public knows there is a vested interest…” So the Executive Director of the Egg Board’s “Egg Nutrition Center” proposed they contact “some of our ‘friends’ in the science community” to have an “objective, external source author the response.”

“If you do so,” the Egg Board wrote to one of their “friends” at Yale, “we’ll certainly compensate you…” But the prominent Yale physician refused to “participate in an overtly antagonistic letter” given his friendship with one of the co-authors of the eggs and atherosclerosis review.

If you can’t find someone with credentials to counter the science, why not just make one up? Check out Eggs vs. Cigarettes in Atherosclerosis to see this story’s bizarre twist involving an attempt to discredit the egg & smoking study with a hacked email account.

This is the same prestigious research team that wrote the landmark review upon which I based my videos Egg Cholesterol in the Diet and Avoiding Cholesterol Is a No Brainer.

More on eggs in:

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my videos for free by clicking here and watch my full 2012 – 2015 presentations Uprooting the Leading Causes of Death, More than an Apple a Day, From Table to Able, and Food as Medicine.


Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.

31 responses to “Eggs, Cigarettes, and Atherosclerosis

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  1. I’d really appreciate your thoughts on why the ancestral health/paleo crowd is so in love with eggs. The conflicting opinions in this are so absolutely polarized that we lowly lay-people are having a hard time finding something to hang out hats on. And as you know the argument there is that heart disease is first and foremost a disease of inflammation. Thanks! Really appreciate your work!

    1. The study mentioned above is not very reliable since it was based on questionnaires.

      If a study isn’t randomized, double blind, or placebo-controlled, its results might not be as dependable. In observational studies such as this one, it’s vital to ensure that different variables are controlled for.

      I wish respectable doctors such as Dr. Greger wouldn’t mislead people by referring to such poorly conducted studies.

  2. Not sure if I can agree totally with this study but I guess it all depends on a person’s gentic profile.
    I am in my mid 60’s and consumed for most all my life 1 or 2 eggs (for breakfast (non meat/fish eater), I choose organic for the love of animals. My blood pressure is generally around 110/70. In spite of a few minor pains, I am in great shape, walk (never had a car) but do not excercise specifically; sleep like a baby, never had hot flashes, never took hormones of any kind, never took supplements. My question is: with low blood pressure can one still have clogged arteries?
    Thank you.

    1. Liz,
      Sounds like you are in great health. Eggs are just a significant risk factor for cardiovascular disease, but that doesnt mean that you will become sick, if you eat them, but only that you have a higher risk – like eating meat, dairy, fish and processed oils, there are no guarantee that you will die early from stroke, heart attack or cancer, only that you have a significantly higher risk. You can eat a WFPB diet and still die young, but your risk is much lower. Then there are a lot of other factors wich also play a role, stress, genetics, environment etc. Back to your question – you can have massive clogged arteries with a normal or low blood pressure, but your risk is lower, but not zero. Dont think at it as a water hose – it is more complicated than that. Eggs contributes to inflammation in the body, not only to high cholesterol and plaque build up. Inflammation is also a risk factor for CVD.

    2. Until I fractured my spine from osteoporosis, and began eating only foods that fight pain and inflammation, my blood pressure was totally in the normal range, yet my blood cholesterol was extremely high. And while I ate organic poultry and wild salmon fish, I rarely ate eggs.

      When my spine fractured, I found that even eating a small portion of wild salmon hurt my body. Whether it was my arteries or my blood vessels I know not, my body simply screamed with pain.

      I’ve since learned that ALL animal protein increases blood cholesterol.

      Unlike you, I swam 1.5 miles a day, walked 3 miles with my dog prior to her death, but did not do other weight bearing exercises until 2006 as part of rehab.

      My body, not my genes, told me to avoid eggs, and other animal proteins. I knew the diet my mother pushed on her family when we were small, and I knew of the heart disease my father had because of his lifestyle. All lifestyles were bad during the 1960’s in my world.

      Eating vegan and not eating any animal protein makes my body thank me because I feel better.

      BTW, when I was 60, I had high cholesterol but had not had a heart attack. I think my spinal fracture was a wake up call that helped me to take immediate action to eat healthier. Again, it was not a genetic decision, I was simply listening to my body.

  3. Sorry, one very questionable study versus a meta-analysis, gotta go where the meta-analysis:

    This study you cited was seriously flawed to begin with. Correlation most certainly doesn’t equal causation, but especially when you can’t even control very well other mitigating factors:

    Lastly, the authors of the Atherosclerosis study you cited have a major conflict of interest themselves: ” Dr Spence and Dr Davignon have received honoraria and speaker’s fees from several pharmaceutical companies manufacturing lipid-lowering drugs, and Dr Davignon has received support from Pfizer Canada for an annual atherosclerosis symposium; his research has been funded in part by Pfizer Canada, AstraZeneca Canada Inc and Merck Frosst Canada Ltd.”

    Gosh, that wouldn’t influence THEIR conclusions on things any, would it?

    1. The meta analysis you mention does not find an association with ‘higher’ egg consumption with CHD/stroke – unless you are a diabetic, perhaps… And ‘higher’ consumption is up to one egg a day.
      Hmmm. That begs the question – What about more than one egg a day? Do they give reasons for not asking that obvious question?

      And if those mitigating factors are potentially so bad: it’s either them or them and the eggs… better not to eat them at the very least. Why risk any of them? Didn’t vegan Seventh Day Adventists (typically health conscious, non-smoking, teetotal & caffeine free) have the lowest rate of CHD?

      1. ” That begs the question – What about more than one egg a day? Do they give reasons for not asking that obvious question?”

        A reasonable question, and the answer is likely seen in the study selection and exclusion criteria in their methodology. Are you aware of any other well-controlled, prospective studies to which consumption was > 1 egg/day where investigators “reported relative risks with 95% confidence intervals for at least three quantitative categories of egg intake,” and those studies were not reviews, editorials, non-human studies, and letters without sufficient
        data, and additionally did not examine exposures and other diseases except for CAD and stroke, to which the authors seemingly overlooked? Otherwise, I think their methodology involving their exclusion criteria is reasonable and sound.

        1. SOME of them are vegan/plant-based. Some eat meat (they have the same basic freedoms like everyone else). They’re quite a mix, 7th dayers – that’s why they are studied. Their lifestyle generally excludes many confounders but there is a range of diets followed (meat-eaters had the highest rate of CHD, if memory serves). BTW, I’m not even vegan, either (no vegan bias here). Although I could consider myself a ‘Catholic Vegan’ – I follow the teaching but lapse and sin regularly – sometimes daily – and definitely on my birthday – but I’m still of the ‘faith’.

          1. OK, eivann, fair enough. Any population could contain people who are also vegan. Would you mind sharing your source for the data on vegan Seventh Day Adventists? I’ve never seen any that separated out the vegan segment from the vegetarians, but would be interested to see how the two compare side by side. Generally, the data on SDAs is considered pretty soft as the pressure from the community to abstain from drugs, alcohol, smoking and extra-marital sex is pretty intense in the community. The confounders are so great that it’s impossible to draw many conclusions- but the exception to that would be if people in BOTH diet groups were SDAs.

  4. Was it a blessing that I fractured my spine, and then went looking for a diet to reduce pain and inflammation and found Neal Barnard, M.D.?

    Now I’ve found that if I have any animal protein, my body screams with pain. Perhaps, my change in diet will reduce my chances of high cholesterol causing plaque to build up in my arteries, which my father had and my brother now has.

  5. I am not “pro-egg,” but I must point out that with all due respect, unless otherwise specified (and they would specify if they could), these studies are conducted with C-R-A-P eggs, raised by feeding hens GMO corn, too much wheat, and of course, drugs. Laying hens need to be free-range-fed (or at least grass-raised) or fed flaxseed and plant mixtures (all fairly cheap, just not government subsidized) in order to produce eggs that don’t contribute to chronic disease.

    1. Agreed. Not only that, but it’s another observational study that can’t conclude anything. What were the eggs eaten with? An Egg McMuffin? A bagel and processed American cheese? Pancakes or waffles? Sodaruit juice coctail? Margarine? Who knows.

      Wheat was four times better correlated with disease than animal food in Campbell’s 40+ years of research. It’s probably time to look at that.

      If this is the result of “scouring” the research, it’s not very impressive, Dr. Greger.

      1. Please share your source for the wheat correlation. I used to be a low-carb sucker, too. Please tell me it’s not DM or some ‘skeptic’ who has been sucked into the blogosphere (guess who they read?) Please – it’s respected peer reviewed journal, your source. Right?
        BTW, my layperson’s understanding is Campbell discovered nothing particularly new to science. The previous evidence was pointing that way. His advocating a plant-based diet – now that annoyed some people. And some people in the science community disagreed but they published in proper journals – not the blogosphere. And I don;t remember mentioning a correlation with wheat causing heart disease (although refined wheat is part of the SAD).
        How come eating wholegrain wheat was part of those diets used as part of REVERSING heart disease – y’know the studies have only been published in the Lancet and similar respected journals. Of course I’m sure there are studies of people eating eggs and grass-fed meat that reverse heart disease.

        1. This is the source. Diet, Lifestyle and Mortality in China

          The reason we see whole grain wheat in the so-called “healing diets” is because it’s better than processed wheat. But this doesn’t mean it’s better than no wheat. It’s the filtered/light cigarette thinking.

          I realize you’re not vegan, but consider this. Campbell looked at total wheat consumption and total animal food consumption among many other things. Considering we know that there is a significant difference between pastured beef and bologna, for example, we would expect a similar situation. So you hear the wf-omnis pointing out that the study included lots of processed meat… and so it did. And even so, the wheat was 4 times worse.

          It would be cool if we could break it down further by whole and processed foods. I’m sure that that is where the key lies and not in plant versus animal.

          1. The source I remember for the vegans having least Heart disease is not made itself apparent in my history/files altough I unearthed this (quoted from a secondary source but on 2nd looks, the page was not so great – could be post a reference thing – anyway, the abstract gives littleaway but a quick glance at a more recent study puts them behind vegetarians but whether that is B12 denial/ignorance, time will tell (meat eaters still came last). That’s enough trawling. There’s plenty on the SDA study site searching ‘vegan

            – and that study (thanks) – just correlation – not an intervention study is it? Like those … ‘So called “Healing diets”‘ – I am lost for words. But you are welcome to your interpretation. Bye and good luck – my input on this topic is over, as I have other things to do.

            1. Thank you for the link. For what it’s worth, I did write that wheat was “associated” and “correlated”, two phrases that specifically apply to observational data.

              The point was that if you’re going to depend on observational data for your meat-eating education, you can’t leave out the observational data on wheat. Either you think observational data is important to pay attention to or you don’t. Otherwise you’re just picking and choosing what suits your ideal at the moment.

              Campbell was also quoted saying this about his actual controlled studies looking at wheat– “Wheat protein, unlike casein for example, did not stimulate cancer development, but when its limiting amino acid, lysine, was restored, it acted just like casein. There have been literally thousands of studies going back many decades showing a similar effect on body growth and other events associated with body growth—all resulting from differences in amino acid composition of different proteins.” So unless you have a way to eat your wheat without any other foods that will fill in the missing aminos, it had the same properties as isolated casein. (which is not a whole animal food either.)

              Good luck to you as well.

              1. Levels of IGF-1 in vegans is lower regardless of whether they mixed foods. The HIGH content of essential aminos in the diet is what determines the levels of this hormone, and not whether foods are combined to make a “complete” protein.
                ” IGF-I concentration is lower among women who adopt a vegan diet. In addition, IGFBP-1 and IGFBP-2 concentrations are substantially higher in vegan women compared with meat-eaters and vegetarians, suggesting that the amount of bioavailable IGF-I may be lower in vegan women. The nutritional characteristics of the vegan diet that account for these differences are not clear but may be related to vegans’ lower intake of protein high in essential amino acids.”

            1. See the comment you just replied to for the citation. It is a study spanning many years and conducted by a plant-based advocate. You can’t get any less biased than that.

              Cordain’s papers are published and peer-reviewed. You have claimed they are “ridiculous” several times but have failed to say how. The fact that you don’t like the conclusions doesn’t make something ridiculous. If you are going to convince anyone that that’s true, you’re going to have to do a little work, try a little investigating of your OWN, point out the specifics you take issue with and provide COUNTER evidence.

              A link to another Nutritionafacts blogpost isn’t going to cut it.

              1. I am sure you know this already but if you are linked to a video by someone you simply open the link and read the research that was conducted and Dr Greger referenced to make the video.

                You obviously do not have a family history of heart disease or you wouldn’t be so flippant with your health– willing to follow the latest fad of high fat and high animal protein.

                But I must admit, you have definitly bought into the theory.

                1. Obviously? Until 6 years ago when I went Paleo, I was diabetic and hypertensive with cholesterol over 300. My mother had 2 heart attacks and a quadruple bypass in her 40s and eventually died when her liver was destroyed by the fructose her endo told her was “perfectly safe” for diabetics. She was insulin dependent by then. My little sister recently died at 40 of a heart attack and my older brother had his first heart attack at 39. My remaining sister is obese and both diabetic and hypertensive and all of my maternal and paternal aunts and uncles are or were diabetic. (Though both of my grandmothers lived well into their 90s) My younger brother had elevated cholesterol and was gaining some weight and I convinced him to give this a shot and his cholesterol came back down and he dropped 20+ lbs.

                  There isn’t a flippant bone in my body where it comes to nutrition. I am educated by both the data and empiricism. My heart and arteries resemble those of a teenager whereas as a vegan that was definitely not the case- and my serum cholesterol is below 150 and I am no longer diabetic or hypertensive (like I was as a wf-vegan). My inflammation markers are so low that they don’t register on the blood work.

                  Regarding a link to a blog post- I’m pretty good at finding the data. My husband’s an educator and I have access to most of the medical journals online for free. The reason I insist that someone share the actual data is because this shows that THEY know what the data means. It’s easy to throw a blog-post at someone and pretend it’s an actual response. But that isn’t discussion-worthy, that’s you [not you specifically] being a repeater. If you can actually discuss the data fluidly, you probably have a working understanding and could be worth having a discussion with. If not, why would anyone take the time to argue with what amounts to a human search engine?

                  You are right about one thing, I bought into the theory.

                  Theory– “a well-substantiated explanation of some aspect of the natural world, based on knowledge that has been repeatedly confirmed through observation and experimentation. Scientists create scientific theories from hypotheses that have been corroborated through the scientific method, then gather evidence to test their accuracy.

                  1. Just curious–how do you know your heart and arteries resemble those of a teenager now and that they didn’t as a vegan?

                    It sounds as though you have a family history of obesity? That is definitely a risk factor.

                    My father and his brothers were ideal weight. But, as with many in their generation meat guys. And of course this was before the processed frankenfoods of today. So..I can only go with what I consider to be an accumulation of reliable research. The alternative is too risky.

  6. Hi, Lisel81. First of all, this article draws data from many different studies, some of which had flaws such as excluding diabetics. Type II diabetes is a risk factor for cardiovascular disease, and egg consumption is a risk factor for type II diabetes. Second, some of the studies included do not factor overall diet quality into their conclusions. People in China, for example, who eat more eggs may be vegetarian. Even though they are eating eggs, they may be eating more fruits and vegetables, and avoiding meat. It is well-documented that vegetarians have lower risk of cardiovascular disease than omnivores. I hope that helps!

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