Eggs Are Bad for You—Again

I was at dinner with friends one evening and used the phrase “the politics of science.” Another guest, trained as a physicist, didn’t know what I meant. He knew, of course, that science gets kicked around in the political process. But, in his view, the practice of science has nothing to do with politics—it’s just the facts and enlightened discourse.

The politics of health science show up in two places: in how health science reaches civilians such as you and me and in how the results of health science are produced and accepted as facts in the first place.

When I was young, eggs were recommended as a high quality food. As I grew older the cholesterol theory of heart disease took hold and as a consequence eggs were discouraged because they are high in cholesterol. Then later eggs were let off the hook when it was recognized that serum cholesterol (that is, cholesterol in the blood) is unrelated to dietary cholesterol from eggs.

The egg industry rejoiced.

Those who understood that the cholesterol theory of heart disease is nonsense ate eggs throughout. But for those who followed scientific thinking, eggs were in, then out, then in again.

Last week, the media reported Canadian researchers found that eating eggs is as dangerous as smoking. MSNBC, Fox News, and the Huffington Post among others dutifully reported the results with headlines such as “Egg Yolks As Dangerous As Smoking, Experts Say.”

So you might think this is a bit of alarmist hyperbole by the media. In fact, it’s part of the research design, a central feature that provides what the researchers call “perspective on the magnitude of the effect.”

So the journalists are innocent of misreporting the science, which is manipulative by design. However, they are guilty of failing to critically present the science in context. For example, they fail to mention the many factors left out of the analysis that might explain the greater effect of eggs on people. Nor is there a discussion of the age of the subjects for this study: all 61 and older. Nor of the study subject’s medical condition: already diagnosed as at risk of heart disease. Nor of the well-known fact that high cholesterol in the elderly reduces the risk of what’s politely referred to as “heart events.”

But even if that information was in the news reports, what most people are going to hear is that eggs are as bad as smoking and, if they’ve got any sense, they’ll stop eating eggs—which seems to be the intention of the researchers.

That’s politics: getting other people to do what you want—even if it’s not in their interest.

Yet another failure of the reporting is structural. It’s news. And, as you know, if it’s new it’s better. Yet actual science consists, not of snappy and eye-popping facts that capture our attention, but careful observation and corroboration. This was only one study. And yet everything about how this research is presented to you presses you to change what you eat.

John Ioannidis is a researcher who made fame with an article titled “Why Most Published Research Results Are False.” (Ioannidis, 2005) By implication, what journalists report about most research is equally false.

The same forces are also at work in the scientific community: the focus on the new and novel, the loyalty to institutionally sanctioned ideas, and the profound inability to critically evaluate actually existing evidence.

In an opinion piece to the New York Times, H. Gilbert Welch writes, “The truth is that for a large part of medical practice, we don’t know what works.” In answer to what needs to be done, he says, “Medical research is dominated by research on the new: new tests, new treatments, new disorders and new fads. But above all, it’s about new markets. We don’t need to find more things to spend money on; we need to figure out what’s being done now that is not working.”

As I’m sure you know, fascination with the new is not unique to health and medicine. Nor is the force of commerce, which fosters and exploits the fascination with the new, which caters to our monkey curiosity.

Welch’s recommendations include developing a healthy skepticism among physicians that would give them the skills and the courage to question the standard of care. He acknowledges that, currently, to do so is to commit “career suicide.”

If losing the fascination with the new and gaining a healthy skepticism and the courage to question the standard of care are good for medical science, shouldn’t it be good for us too? Unfortunately, because they don’t know what works, neither can we—which is far worse than career suicide since it leads to suicide by ignorance.

So tomorrow I’m having an omelette.