Egg-ceptionally Bad

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A few days ago, while cruising my Facebook feed, I came across link that stopped me cold. The headline was “Study: Eggs Are Nearly as Bad for Your Arteries as Cigarettes.”

Bullshit, I thought. There’s no way that can be true. So I clicked on it, and ended up on the Atlantic’s Web site. But what was I reading? A blog? A news article that had come from the magazine? It wasn’t really clear. I recognized the genre immediately, however. I’m not sure it has a name. It’s not quite churnalism, because the author clearly read the paper and reported things not found in the press release. But the effect is similar: Read something, regurgitate it in your own words, don’t question the findings.

The Atlantic post simply describes the journal article: Here’s what they did, here’s what they found, here’s why you shouldn’t eat eggs very often. The author offers no assessment of the study’s credibility and does not solicit the opinions of outside experts.

Fair enough. There’s nothing wrong with taking a study at face value. Especially when the study says something like meadowlarks tend to prefer meadows with orchids over meadows with bluegrass (I made this example up). But when you’re a major news outlet and the study is concluding that eggs, a staple food, are nearly as bad for you as cigarettes, I’d like to see you do some reporting.

The Atlantic offered a description of the study with headings such as ‘problem,’ ‘methodology’, ‘results’.

The Washington Post’s The Checkup didn’t call anyone, but they gave us a hint that the study might be controversial: “The role of dietary fat and cholesterol in cardiovascular health has been under investigation in recent years. It was once believed that eating cholesterol-rich foods led to high levels of cholesterol in the bloodstream, but that assumption’s been questioned recently.”

The LA Times Booster Shots Blog didn’t call anyone either. The reporter did give us this paragraph, however.

In recent years, nutritionists have begun to agree with egg purveyors that chicken eggs — cheap and packed with protein — have gotten a bad rap as a dangerous source of cholesterol. Some studies have suggested that eggs may increase HDL, or ‘good cholesterol’ that protects against heart disease, even as it contributes to the artery-clogging LDL cholesterol, making egg consumption something of a wash. And regular egg-eaters may form larger lipoprotein particles that help clear the blood of fat particles and are not as likely to settle in artery walls.

Thank you Time for giving us an “in-depth” report on the subject. Unfortunately, the only outside expert Time quoted was ABC News. The reporter couldn’t even find time to talk to the study’s author.

Jezebel, admittedly not a major news source, called the story “Your Breakfast is Trying to Murder You” and quoted the Atlantic reporter.

Sydney Lupkin of ABC News, however, did a bang up job. God bless you, lady! (Google suggests you are a young lady and a recent grad of Boston University’s journalism program. True?). Lupkin quoted three (count them!) cardiologists who were not involved in the study, including Steven Nissen, who called it “very poor quality research.” And then she called a journalism professor and spent a paragraph talking about the coverage the study was getting.

Still, the good headline potential was too tempting for several media outlets to ignore and the story ran widely, and in some cases without any comment from outside experts

Dr. Tom Linden, a medical journalism professor at the University of North Carolina,said journalists should exercise caution when writing about studies like this. He said they should put the studies into context by explaining the caveats and consulting experts.

“The danger here is headline writers who aren’t necessarily science writers may go way overboard in headlining the story,” Linden said.

But let’s actually examine the study. Lead author J. David Spence and his colleagues wanted to determine whether eating egg yolks is linked to the buildup of fatty plaque in the carotid arteries, the two major arteries that carry blood to the brain. To do this, they examined medical records from 1231 men and women who had attended vascular prevention clinics at University Hospital in London. The records contained basic information such as age and gender as well as ultrasound results showing the amount of plaque in the patients’ carotid arteries and answers to a lifestyle questionnaire that contained questions like how often do you smoke and how often do you eat eggs. The researchers used those questionnaire answers to quantify the patients’ egg consumption in “egg-yolk years” (the number of egg yolks eaten per week X number of years the patient consumed eggs).

The researchers found that people who consumed two or fewer eggs per week had less carotid plaque than people who ate three or more eggs per week. The researchers also looked at the relationship between smoking and plaque buildup in order “to provide perspective on the magnitude of the effect.” They found that those who consumed the most eggs, a mean of roughly 4.5 per week, had about two-thirds as much plaque as the heaviest smokers. And now you understand why the press release was titled: “Egg yolk consumption almost as bad as smoking when it comes to atherosclerosis.” Change that to “Egg Yolks Almost as Unhealthy as Smoking” and, voila!, you’ve got instant click bait.

First, every scientist will tell you that correlation does not equal causation. This study doesn’t prove that eating egg yolks caused the fatty deposits, it simply shows that people who said they ate more eggs had more fatty deposits than people who said they ate fewer eggs.

Second, this study doesn’t account for other foods that might cause artery-hardening plaque. Think of the typical egg breakfast. Maybe it includes sausage, bacon, cheese, hash browns, biscuits . . . maybe even gravy? Isn’t it possible that the people who ate the most eggs in this study had really shitty diets? Maybe people who ate more eggs also ate more bacon and eating bacon causes the fatty deposits. It’s possible, right? Cardiologist David Frid echoed this sentiment in the ABC News article, “It may be that people who consume a lot of eggs also consume a lot of other fatty foods,” he said.

Third, do you remember how many eggs you ate or how many cigarettes you smoked 10 years ago? These are rough estimates based on people’s imperfect memory.

In other words, this is not a strong study. So why did so many news outlets take it at face value?

Maybe we, as journalists, can’t say whether eggs are good or bad, but we can make a couple of phone calls to people who can provide some context and insight. In fact, it’s our job. Is it a bad study? Is it a good study? How strong is the evidence? Is this a controversial issue? What other studies have been done? The general public shouldn’t be expected to sort all this out for themselves.

Conflict-of-interest disclosure: Cassandra Willyard enjoys eating eggs very much. She estimates her consumption to be 75 egg-yolk years.

Image credits:

Heart-shaped egg courtesy of Julian Burgess on Flickr

Lots of eggs courtesy of Pietro Izzo on Flickr

Delicious ham omelet photographed (and eaten) by Cassandra Willyard

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Categorized in: Cassandra, Food/Drink, Health/Medicine

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24 thoughts on “Egg-ceptionally Bad

  1. The problem is that if you’re a person employed by one of these outlets, you generally are paid by a quota of stories.

    You’re actually discouraged from doing too much actual reporting because 1. it slows you down and 2. there’s no real profit motivation for this.

    Because: people will still click on it and read the article regardless of “real” reporting. And sensationalist headlines get more page-hits than something much milder.

    I think many journalists would like to be doing more actual reporting but within the time constraints and how they currently get paid, it’s becoming very difficult – and there’s little motivation for the structure to change on the part of editors.

    Basically, it’s a huge structural problem, and the only way I can see that it will change is if the public begins to demand more in-depth reporting – it’s all based on the market.

  2. First: Before writing this blog post, did you speak to any of the researchers to allow them to respond to your concerns? Did you talk to multiple independent sources to see whether they agreed with your critique? Seems a little harsh to criticise others for just reading the paper if that’s all you did (but maybe I’m missing something).

    Now more broadly, I had exactly the problem you’ve discussed on a story I wrote recently. Part of the issue (in my view at least) is that we’re dependant on the scientific community. Our job, really, is to be reporters, not peer-review referees. If these papers get through peer-review and get published without caveats, then you’ve got to be realistic about what you can expect from the hacks. That’s doubly true if the university press office hypes it up.

  3. Geoff, I didn’t call anyone, so maybe I am being too harsh. But I’m not covering the study, I’m covering the coverage. And I would argue that LWON is a VERY different outlet from blogs that belong to the LA Times or The Washington Post.

    As far as giving the researchers a chance to respond to the criticisms, they acknowledge many of these deficiencies in the discussion section of their paper. And my point wasn’t that the paper shouldn’t have been published. I just wanted more skepticism from the journalists writing about it.

    And I don’t really blame the reporters — tight deadlines, low pay, etc. But there is huge danger in simply reporting the basic facts of a study like this without discussing the study’s credibility or giving context. Reporting like this harms the credibility of both journalists and scientists.

    “you’ve got to be realistic about what you can expect from the hacks. That’s doubly true if the university press office hypes it up.” Really? Can’t news outlets and journalists strive to do better?

  4. You might want to do a little research of your own before jumping to your own flawed conclusions. Eating bacon, sausage, cheese and other “shitty” fatty foods has never been proven to cause heart disease either. Never, ever, ever been proven. The mainstream media also passed the Saturated Fat myth along to the american consumer thanks to Ancel Keys’s highly-flawed “Seven Countries Study” (which omitted data from every other country on the planet) and the deeply controversial “Consensus Conference” in which the flawed “consensus” report was written by the corporate sponsors before the conference even started. Sally Fallon’s excellent “The Oiling of America” lecture details the entire fraud.

    A new documentary, “$tatin Nation: The Great Cholesterol Cover Up” comes out in September to expose the cholesterol and saturated fat myth.

    Diets high in natural Saturated fats and cholesterol have sustained cultures for millennia with low incidence of heart disease. Heart disease exploded when sugar and modern vegetable oils were introduced into the food supply. Heart attacks exploded after 1920 — and were ver rare before 1910. Don’t expect to ever see a major study funded to prove this though.

    Keep in mind that more than half of published studies are erroneous and flawed. And these flawed studies are often cited — without question — in subsequent studies. Meaning that most “studies” are nothing more than junk science. The Atlantic had an excellent piece on this phenomenon…

    http://www.theatlantic.com/magazine/print/2010/11/lies-damned-lies-and-medical-science/8269/

    So, no… even eating “shitty” food like bacon, cheese, sausage, gravy and eggs have never been proven to cause heart disease. It’s all junk science funded by corporate interests who want people to shelve natural foods for synthetic replacements and pharmaceuticals. Do your own research and you shall see how little evidence there is to support the diet-heart hypothesis that everyone believes in.

  5. Bill, you have a point. I should have done more research before I made bacon into a scapegoat. I see people have been pointing a finger at refined carbs of late. But my main point still stands . . . other dietary factors could have been to blame (waffles? pancakes? french toast?). Or factors unrelated to diet, for that matter.

    I apologize for calling those foods “shitty.” I love them as much as the next American. Bacon and cheese, will you ever forgive me?

  6. You cover coverage for the first half of the post, but you critique the study in the second. Just seems a little funny to me to spend the first half criticizing others before doing exactly the same thing they do (except being critical instead of laudatory). It’s our job to talk to people, no? Your point about venue is taken, but I guess I think it’s a little 2000s. These days, if you write something it shouldn’t matter whether it’s a blog, a story, or whatever, you should do the same job (since, as you point out, readers frequently can’t tell the difference). But I accept that’s not the way the world works.

    And yes, the hacks should do better. I should do better.

  7. Bacon and cheese always forgives. That’s why we love them. Your main point is correct. Other dietary factors could certainly have been to blame.

    And I should have clarified.. Arteriosclerosis became much more widespread in observed pathology in the years leading up to 1900. And then it really took off after that. The sharp increase in observed arteriosclerosis corresponded to the rise in mass production of “refined” sugar. Sugar had been around for ages before the mid-1800s, but the mechanized production of table sugar (sucrose) provided increasing amounts of sugar to everyone.

    See: http://books.google.com/ngrams/graph?content=sucrose%2Carteriosclerosis&year_start=1800&year_end=2000&corpus=0&smoothing=3

    (Google normalizes its data so that the number of published books does not skew its data)

  8. We all should do better, Geoff, including me as you repeatedly point out.

    And I think it DOES matter whether it’s a blog or an article. A person can only do so much research if they’re getting paid $50 to write something (or in my case, nothing). I’m railing against the whole goddamned system, I guess.

    What really bothered me was that many news outlets simply took this study at face value without critiquing it. I’m certainly not doing that. (In fact, I pulled out my trusty Medicine in the Media binder to help assess the study’s strength.) I do concede, however, that it’s not very sporting of me to say that our job is to make phone calls and talk to outside experts and then talk to no one myself. Though I hardly need to call a scientist to get confirmation on the statement “correlation does not equal causation”.

  9. Yes, I realized how silly that blog comment was the minute I wrote it. I just meant that the “just a blog” mentality isn’t a healthy one. But we’ve all got it.

  10. If bad journalist keep crying ‘wolf!’ we’re all going to die when the “wolf” really shows up. Wait…what was that about global warming?

  11. Again, the Atlantic article I posted above makes it pretty clear why most studies are junk science. It’s pretty clear, after reading that article, that many studies are often purposefully published with major flaws in order to bait the media into reporting sensationalist headlines. These headlines cause millions of people to choose certain medications, or to replace natural foods with cheap imitations. It’s how the industry works. And the media falls for it every time.

    The money to fund these studies often come from companies and organizations with deep pockets and specific agendas. It’s no wonder that much of it is junk science.

  12. Cassandra, You definitely deserve some positive feedback for this article. I see that your mission was to cover the coverage in this piece. I get that.

    So two things:

    (1) As a wannabe science writer (and why I subscribe to LWON), this is a great reminder for reporters (and bloggers) to be skeptical, especially with headlines like the one on which you are reporting. The science should be tested for soundness in terms of the current research, which can include the weaker observational studies with all of their uncontrolled, confounding variables (e.g., bacon and cheese … perhaps). Your article is just pointing out that this skepticism was sorely lacking, as evidenced by the lack of fact verification. I get it.

    (2) As it turns out, your headline, “Egg-ceptionally Bad”, and the heart-shaped egg in the greasy frying pan especially drew me into your article. And yes, it was because of the OTHER headlines, which I found very difficult to believe (okay …there’s the skepticism) that stopped me from hard-boiling any eggs this week (oh-oh … there is unfounded belief setting in). I jumped into your article immediately because of those OTHER headlines. I was hoping to find some ray of hope in there that eggs aren’t as bad as this new study suggests. Bad as cigarettes!!!? I’m not smoking them … Oh, it’s the coverage that is bad. Whew! :-)

    So, on these two accounts at least, I need to thank you for your piece and pointing me toward this ‘Medicine in the Media’ thing. I suppose they get into p-values, randomized control studies, and such. Good stuff :-)

    Also, thanks to you and Geoff for pointing me toward Geoff’s website and blog “Freak of Nature”. I am in the process of designing a science-oriented blog (oh-oh, not another blog) and Geoff’s looks like a good archetype in terms of design and content. My objective, like Geoff’s is to write about things scientific that I find interesting, but more along the lines of evolutionary biology, cosmology, and Earth Science … so Life, the Earth, and the Stars. :-)

    Thanks too to Bill T. for the links and the book recommendation. I want to follow up on the one about refined carbohydrates and heart attacks. I have been off such things for quite a while now, but a nutrition specialist recommended that I have bigger breakfasts (smaller dinners) and consume more eggs for the protein. I suppose that I would be somewhere around 100 eggs per year. Bacon wasn’t “off the table” though. Hmmmm … I will send her a copy of this article … :-)

  13. I have read that cholesterol levels are determined by individual body chemistry far more so than by cholesterol in the diet.

    Here is one paper by a department of social medicine that shows that eating one egg a day is beneficial to HDL levels whilst decreasing total cholesterol levels.

  14. I can’t help but feeling that the real culprit in all of this is the scientific method when it seeks to make sense of anything behavioral. Every study is hugely incomplete. Every study is hugely skewed by faulty memory or lack of correlation. 1 + 1 always equals “what are the P values” and “correlation doesn’t equal causation” and “however other studies have found”. And as a consequence journalists continually are counseled to – as in this blog – effectively un-publish a paper.
    What to do? You can give “how to read medical paper” courses to journalists over and over and over again. Or you can change the message before journalists weigh in with their faulty translation of what the data means.
    My feeling is that in an age of increasingly open access to all sorts of scientific results that papers should come bearing different meaning fonts. Amongst others there should be a “preliminary finding” font, and a “low p value” font and an “other studies have found differently” font and on a rare occasion a “this really matters and is quite definitive” font.

  15. Cassandra wrote: I do concede, however, that it’s not very sporting of me to say that our job is to make phone calls and talk to outside experts and then talk to no one myself.

    I don’t want to dig at this point: I myself have tried writing blog posts that cover the coverage of a thing and got in trouble for my coverage of the thing, so I realise it’s not easy. I just wanted to say that as a supposed expert who has, once or twice, been consulted by the media (heavens help them), it’s also possible that the journalist in this case called… and couldn’t get an answer before deadline time. It was only the second time someone tried me that I’d taken on board what kind of schedule journalists work on and that an answer in a week or two wouldn’t help them much.

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