Avoiding Cholesterol Is a No Brainer

Eggs and brains are the two most concentrated sources of cholesterol in the diet.

September 1, 2011 | 

Egg Industry Caught Making False Claims

March 6, 2014 by Michael Greger M.D. in News with 4 Comments

Egg Industry Caught Making False Claims

On the basis of concerns from the American Heart Association and consumer groups, the Federal Trade Commission carried out successful legal action—upheld by the Supreme Court—to compel the egg industry to cease and desist from false and misleading advertising that eggs had no harmful effects on health.

Over the years, cholesterol concerns resulted in severe economic loss through a reduction in egg consumption, so the egg industry created a “National Commission on Egg Nutrition” to combat the public health warnings with ads that said things like “There is no scientific evidence whatsoever that eating eggs in any way increases the risk of heart attack.” The U.S. Court of Appeals found such outright deception patently false and misleading.

Even the tobacco industry wasn’t that brazen, trying only to introduce the element of doubt, arguing that the relationship between smoking and health remains an open question. In contrast, the egg ads made seven claims, each of which was determined by the courts to be blatantly false. The Court determined the egg industry ads were “false, misleading, and deceptive.” Legal scholars note that, like Big Tobacco, the egg industry did more than just espouse one side of a genuine controversy, but flatly denied the existence of scientific evidence.

Over the last 36 years, the American Egg Board has spent hundreds of millions of dollars to convince people eggs are not going to kill them—and it’s working. From one of their internal strategy documents that I was able to get a hold of: “In combination with aggressive nutrition science and public relations efforts, research shows that the advertising has been effective in decreasing consumers concerns over eggs and cholesterol/heart health.”

Currently, they’re targeting moms. Their approach is to “surround moms wherever they are.” They pay integration fees for egg product placement in TV shows. To integrate eggs into The Biggest Loser, for example, could be a million dollars, according to their internal documents. Getting some kids storytime reading program to integrate eggs may only take half a million, though. The American Egg Board keeps track of who is, and is not, a “friend-of-eggs.” They even pay scientists $1500 to sit and answer questions like, “What studies can help disassociate eggs from cardiovascular disease?”

From the beginning, their arch nemesis was the American Heart Association, with whom they fought a major battle over cholesterol. In documents retrieved through the Freedom of Information Act featured in my 6-min video Eggs and Cholesterol: Patently False and Misleading Claims, you can see even the USDA repeatedly chastises the egg industry for misrepresenting the American Heart Association position. In a draft letter to magazine editors, the egg industry tried to say that the “American Heart Association changed its recommendations to approve an egg a day in 2000 and eventually eliminated its number restrictions on eggs in 2002,” to which the head of USDA’s poultry research and promotion programs had to explain that the “change” in 2000 wasn’t a change at all. Nothing in the guidelines or recommendations was changed. What happened was that in response to a question posed by someone planted in the audience, Heart Association reps acknowledged that even though eggs are among the most concentrated source of cholesterol in the diet, an individual egg has under 300mg of cholesterol and could technically fit under the 300 mg daily limit. In 2002, they eliminated the specific mention of eggs for consistency sake, but the American Heart Association insists that they haven’t changed their position and continue to warn consumers about eggs.

The guidelines on the AHA website at the time explained that since one egg has 213 and the limit for people with normal cholesterol is 300 you could fit an egg in if you cut down on all other animal products. If you have an egg for breakfast, for example, and some coffee, some skinless turkey breast for lunch, etc., you could end up at over 500 by the end of the day, nearly twice the recommended limit. So if you are going to eat an egg, the Heart Association instructed, we would need to “substitute vegetables for some of the meat, drink our coffee black, and watch for hidden eggs in baked goods.” Furthermore, the limit for folks with high cholesterol is 200mg a day, which may not even allow a single egg a day.

This is how the senior director of nutrition education at the American Egg Board’s Egg Nutrition Center characterized the American Heart Association guidelines: “Maybe I’m being overly sensitive, but this reads like: ‘If you insist on having those deadly high cholesterol eggs your penalty will be to eat vegetables and you can’t even have the yummy steak and creamy coffee you love. Really it’s not worth eating eggs. Oh, and if you think you’ll be able to enjoy some delicious baked goods, forget it, the deadly eggs are there too!’”

How Toxic is Sugar

How 'toxic' is sugar?

Emerging research suggests that sugar may be linked to deadly diseases, but Health Canada’s current food labelling regulations make it tough for Canadians to get an easy picture of how much of the sweet substance they are consuming — and it doesn’t look like that’s going to change any time soon.

The groundbreaking and controversial research explored by the CBC’sthe fifth estate in its season premiere tonight links sugar to diseases ranging from diabetes to cancer and Alzheimer’s.

“Sugar is toxic beyond its calories,” Dr. Robert Lustig, an expert on childhood obesity at the University of California, San Francisco, told the fifth estate’s Gillian Findlay.

Watch The Secrets of Sugar on the fifth estate on CBC-TV tonight at 9 p.m.

 

While Canadians have become used to warnings about the dangers of consuming too much fat or salt, nutrition labels on food have never included recommended daily limits specifically for sugar.

Health Canada does not have a recommended limit for how much sugar Canadians should consume in a day.

A representative of Food and Consumer Products of Canada, an industry organization that represents the largest food companies in the country, says it sees “no need” for a recommended daily limit on sugar intake.

Health Canada declined numerous requests by the fifth estate for an interview, but former Health Canada employees did speak off the record, and said the department does not think that sugar should be singled out as a major culprit behind chronic diseases.

Stirring up debate

According to Statistics Canada, the average Canadian consumes 26 teaspoons of sugar per day. That works out to 40 kilograms per year —– or 20 bags.

While neither the Canadian nor U.S. governments has a recommended daily limit for sugar consumption, one major U.S. medical group is recommending people cut back on the sweet substance.

The American Heart Association is suggesting men consume no more than nine teaspoons a day. For women, the recommendation is a maximum of six teaspoons.

Dr. Robert LustigDr. Robert Lustig, as expert on childhood obesity at the University of California, San Francisco, says ‘sugar is toxic beyond its calories.’ (CBC)

That recommendation comes as research from a small but influential group of medical researchers is stirring up debate on the impact sugar has on health.

One of the most vocal of those researchers is Lustig, an author who has become a YouTube sensation for a 90-minute lecture in which he calls sugar a toxic poison.

“I use those words and I mean them. This is not hyperbole. This is the real deal,” he told Findlay.

“Everyone thinks that the bad effects of sugar are because sugar has empty calories. What I’m saying is no, there are a lot of things that do have empty calories that are not necessarily poisonous.”

Breaking down the sugar

Lustig says that sugar, which is made up of glucose and fructose molecules, is a poison because of the way our bodies break it down.

“When you metabolize fructose in excess, your liver has no choice but to turn that energy into liver fat and that liver fat causes all of the downstream metabolic diseases.”

But not everyone agrees with Lustig’s theory, including other doctors and food industry representatives.

Dr. John Sievenpiper, a researcher at St. Michael’s Hospital in Toronto, questions Lustig’s methodology and his view that “sugar and only sugar” is the prime factor in the international food supply that “predicts [the] diabetes rate worldwide.”

Sievenpiper notes that during the same time period when Lustig points to increasing sugar consumption and rising rates of obesity —– something that has been linked to diabetes — there was also increasing consumption of bottled water.

‘We have to be careful in putting too much of the biological plausibility in wanting to believe patterns that we see.’– Dr. John Sievenpiper

“But there’s no real biological plausibility in the link between bottled water and [being] overweight and obesity. We have to be careful in putting too much of the biological plausibility in wanting to believe patterns that we see.”

Sievenpiper isn’t recommending people eat a lot of sugar, but he does suggest we should be careful about saying fructose is largely responsible for various health problems.

“As long as you match for calories, fructose does not behave differently than does any other form of carbohydrate, namely starches or fine starches and glucose. And that’s not to say that they’re benign, because I don’t think we should be having a lot of refined starch or glucose. But it’s not behaving any differently.”

Industry skepticism

A representative of Canada’s largest food industry association is also skeptical of Lustig’s research.

Phyllis Tanaka, vice-president of scientific and regulatory affairs for Food and Consumer Products of Canada, isn’t worried about Lustig’s claims about one of her industry’s key ingredients and doesn’t think consumers should be either.

Phyllis TanakaPhyllis Tanaka, vice-president of scientific and regulatory affairs for Food and Consumer Products of Canada, says her group has worked with Health Canada over the last few years on how to help consumers make ‘informed choices.’ (CBC)

“I think it’s important that we step back and look for ways to educate and help consumers fit sugar into a healthy dietary pattern,” she said.

But current food labelling regulation can make it difficult for consumers who want to avoid sugar.

On Canadian nutrition labels, manufacturers are required to list ingredients in order from greatest to least volume. But many labels list multiple kinds of sweeteners with different names. For example, honey, barley malt syrup and evaporated cane juice could all be listed separately, even though the human body treats them all as sugar.

Also, sugar is measured in grams on labels, instead of more consumer-friendly teaspoons. For someone trying to keep track of intake, four grams of sugar equals one teaspoon.

In a can of Coke, for example, there are more than 10 teaspoons of sugar. The popular “Healthy Choice” microwave chicken dinner has 5½ teaspoons.

Tanaka says her group has worked with Health Canada over the last few years on how to help consumers make “informed choices,” and that for those who want to avoid sugar, all the information they need is already on the label.

“At this point in time, I’m comfortable in saying the science just isn’t there to support a role in chronic disease.”

Pure White and Deadly

Reducing sugar intake

The World Health Organization is again urging people to lower the amount of sugar they eat.

The Geneva-based global health agency says getting daily sugar intake to below five per cent of one’s daily caloric intake would be optimal but reiterated that restricting intake to no more than 10 per cent is also good.

“We should aim for five per cent if we can … but 10 per cent is more realistic,” said Dr. Francesco Branco, head of nutrition for health and development for WHO.

The draft recommendations, which will likely be contentious, will be open for public comment for the rest of the month until March 31. Then the agency and scientific advisers will finalize the guidance.

“Sugar might become the new tobacco in terms of risk,” said Branco at a news conference in Geneva on Wednesday morning.

The 5 per cent rule

  • Five per cent of sugar intake daily is about 25 grams of sugar/day for an adult.
  • That is about six to seven teaspoons.
  • A can of Coke has more than 10 teaspoons of sugar.

Branco warned about the “sugars that we don’t see.”

“It’s sometimes in condiments, sauce added to meats, a tablespoon of ketchup has up to seven grams of sugar [and] sweetened yogurt up to six grams.”

The WHO has long urged people to limit sugar calories to below 10 per cent of their daily calories, but the five per cent target is new.

To put it into context, five per cent would be about six teaspoons of sugar a day; a can of sugar-sweetened soda contains about 10 teaspoons of sugar.

Branco was particularly concerned about pop drinks and children.

“An average serving at a fast food place of sugar-sweetened soda … approaches 30 grams of sugar per serving,” noted Branco. “That already exceeds the recommended daily serving for a child.”

He emphasized that if parents can limit their child’s intake to the five per cent mark, the child will have almost no tooth decay in addition to being healthier and unlikely to become overweight and obese.

Free sugars

The recommendations relate to what are called free sugars — those added by manufacturers, cooks or consumers. And they abound in prepared foods.
They relate to all monosaccharides — things like glucose and fructose — and disaccharides such as sucrose or table sugar, as well as sugars in honey, syrups, fruit juices and fruit concentrates.

The recommendations do not relate to “intrinsic” sugars — those built into whole foods such as fruits or vegetables.

The recommendations look at limiting sugar intake in relation to lowering the risk of obesity and dental decay, two conditions scientific studies suggest are linked to excess sugar consumption.

The report, from the WHO Department of Nutrition for Health and Development, says consideration was given to also looking at the evidence related to sugar intake and two other conditions — heart disease and diabetes. But in the end the focus remained on obesity and tooth decay.

Nutritional experts have been expecting new recommendations from the WHO.

In 2004 when the WHO tried to include the 10 per cent sugar limit recommendation in its Global Strategy for Diet, Physical Activity and Health, the U.S. Congress — under pressure from the sugar industry lobby — threatened to withdraw U.S. funding for the agency. The direct reference to the 10 per cent figure was removed from the final report.

No recommendations in Canada

In Canada, the Heart and Stroke Foundation has begun a consultation process to determine if it should recommend that Canadians restrict the portion of their daily calories that come from sugar.

Health Canada does not have a recommended limit for how much sugar Canadians should consume in a day.

‘We are woefully inadequate in the evidence around sugar consumptions for Canadians. Also the role of added sugars throughout all the processed foods.’– Dr. Tom Warchawski, Childhood Obesity Foundation

According to Statistics Canada, in 2004, the average Canadian consumed 26 teaspoons of sugar per day. That works out to 40 kilograms per year —– or 20 bags. Experts say that amount should not exceed 13 teaspoons per day, if sticking to the 10 per cent benchmark.

“We are woefully inadequate in the evidence around sugar consumptions for Canadians. Also the role of added sugars throughout all the processed foods,” Dr. Tom Warshawski told CBC News. Warshawski, a pediatrician, is also chair of the Childhood Obesity Foundation in Canada.

“Health Canada could not, in all fairness, have come out with more rigid guidelines because the evidence wasn’t there. But the evidence is coming so now we have to grasp it, study it and come forward with meaningful recommendations for the public.”

Current food labelling regulations can make it difficult for consumers who want to avoid sugar.

On Canadian nutrition labels, manufacturers are required to list ingredients in order from greatest to least volume. But many labels list multiple kinds of sweeteners with different names. For example, honey, barley malt syrup and evaporated cane juice could all be listed separately, even though the human body treats them all as sugar.

Also, sugar is measured in grams on labels, instead of more consumer-friendly teaspoons. For someone trying to keep track of intake, four grams of sugar equals one teaspoon. In a can of Coke, for example, there are more than 10 teaspoons of sugar.

The WHO’s Branco suggests that final recommendations from his organization “will have to be taken up through policymakers” in governments around the world.

“[Our recommendations] can be used to develop policies to provide healthier food in public institutions or it can be used in the context of public information campaigns but much more has to be considered.”