Eggs Are A Problem (Again)? Something Is Fishy...

The NY Times provokes a mini reader revolt with their 'Everything Old Is New Again' report that eggs will give you heart disease:

Eggs, Too, May Provoke Bacteria to Raise Heart Risk

By GINA KOLATA

For the second time in a matter of weeks, a group of researchers reported a link between the food people eat and bacteria in the intestines that can increase the risk of heart attacks.

Two weeks ago, the investigators reported that carnitine, a compound found in red meat, can increase heart disease risk because of the actions of intestinal bacteria. This time they reported that the same thing happens with lecithin, which is abundant in egg yolks.

So now lecithin is a Bad Guy? Geez, these roster moves are tough to track, since lecithin has been widely touted for years as an important nutrient. From WebMD:

Lecithin is used for treating memory disorders such as dementia and Alzheimer’s disease. It is also used for treating gallbladder disease, liver disease, certain types of depression, high cholesterol, anxiety, and a skin disease called eczema.

Save my heart but lose my brain, liver and skin?  Hmm, we make these tough calls every day...

And did I say there was something fishy about this? Here is the mechanism the authors identify for the perils of eggs:

In the case of eggs, the chain of events starts when the body digests lecithin, breaking it into its constituent parts, including the chemical choline. Intestinal bacteria metabolize choline and release a substance that the liver converts to a chemical known as TMAO, for trimethylamine N-oxide. High levels of TMAO in the blood are linked to increased risk of heart attack and stroke.

So choline and TMAO are in play. We will come back to choline, but if TMAO is the culprit then the researchers should have tested fish, a famous source of the TMAO precursors - so famous, in fact, that researchers have pondered the "fish odor syndrome". Since you asked:

Trimethylaminuria is a disorder in which the volatile, fish-smelling compound, trimethylamine (TMA) accumulates and is excreted in the urine, but is also found in the sweat and breath of these patients. Because many patients have associated body odours or halitosis, trimethylaminuria sufferers can meet serious difficulties in a social context, leading to other problems such as isolation and depression. TMA is formed by bacteria in the mammalian gut from reduction of compounds such as trimethylamine-N-oxide (TMAO) and choline. Primary trimethylaminuria sufferers have an inherited enzyme deficiency where TMA is not efficiently converted to the non-odorous TMAO in the liver.

And how might one deal with this?

Intriguingly, many individuals have learned by trial and error how best to manage the disorder, including avoiding marine fish in their diet...

If you don't want to smell like fish, don't eat... eggs. We are so much smarter now.

An interesting clue as to where researchers might seek answers is tossed out here:

Given that even on the same dose of substrate precursor in loading tests there is a big variation in the amount of TMAO and TMA excretion, it is possible that the nature of the gut microflora may play a significant role in the generation of symptoms in some individuals.

So maybe the problem with eggs isn't the precursors (such as lecithin) but the way the gut flora process those precursors. So instead of telling people that eggs are the problem, maybe they we should be told that eggs will be a problem for people with an unhealthy mix of gut flora. One last aside as to why the smell of fish might bother us:

Marine fish contain large amounts of the N-oxide TMAO which plays a major role in osmoregulation, allowing marine fish to colonise a profoundly saline environment. Bacterial activity in rotting fish reduces the TMAO to TMA, imparting the characteristic odour, and the human ability to detect this odour so readily has led some to suppose that this may have a role in preventing humans from ingesting rotten fish.

I find that interesting. Of course, the rotten egg smell is also notable, but different.

But back to choline. The major building block of lecithin is choline, and the authors cited that as a problem. So where do we find choline in our diet?

The largest dietary source of choline is egg yolk. Choline can also be found in high amounts in liver, peanuts, fish, milk, brewer's yeast, wheat germ, soy beans, bottle gourd fruit, fenugreek leaves, shepherd's purse herb, Brazil nuts, dandelion flowers, poppy seeds, mung beans and other beans, and a variety of meats and vegetables, including cabbage and cauliflower.

I don't think vegetarians will be running from wheat germ, soy products, beans, cabbage or cauliflower. Yet somehow choline from eggs is dangerous, because it leads to TMAO. Of course, eating fish leads to TMAO and no one claims fish to be heart-unhealthy; quite the contrary. Which means we have a study with a lot more questions than answers.

The absolute collapse of critical thinking at the Times on certain health-related topics is both alarming and comical.  I can think of several of their columnists who would happily cite any study denouncing red meat, even if the causal mechanism invoked extra-terrestials angered by the slaughter of their brethren. And eggs manage to linger in that "Flyover Country Only, Not Fit For The Upper West Side" niche, although the Times busts the mold ocassionally. Here is Mark Bittman trying to keep a foot in each camp:

Let’s cut to the chase: The diet that seems so valuable is our old friend the “Mediterranean” diet (not that many Mediterraneans actually eat this way). It’s as straightforward as it is un-American: low in red meat, low in sugar and hyperprocessed carbs, low in junk. High in just about everything else — healthful fat (especially olive oil), vegetables, fruits, legumes and what the people who designed the diet determined to be beneficial, or at least less-harmful, animal products; in this case fish, eggs and low-fat dairy.

Let me press on a bit more. Science jockeys will want to peruse "Does Dietary Choline Contribute to Heart Disease?" by Chris Masterjohn. He pounds the table for fish and adds this:

There’s just one major problem with this [TMAO] hypothesis.  Studies in humans have shown that neither phosphatidylcholine nor choline-rich foods produce detectable increases in trimethylamine.

...

In fact, these authors even fed 46 different foods to humans and looked at the subsequent excretion of trimethylamine and TMAO.  Choline-rich foods like liver and eggs did not produce any increase in urinary trimethylamine or TMAO over control levels.  In fact, even carnitine-rich meats failed to increase excretion of these compounds.  The only foods that increased excretion of TMAO were seafoods, which naturally contain some trimethylamine, giving them their “fishy” smell.

In normal, healthy people our liver and kidneys deal with this stuff. However...

Blood levels of choline are currently considered an emerging marker for destabilization of coronary plaques or ischemia in acute coronary syndrome, as reviewed here.  During the process of blood clotting, inflammatory enzymes release choline from membrane phospholipids in order to also generate phosphatidic acid, which is used as an important signaling molecule.  Elevated blood levels of choline, then, and perhaps its metabolite betaine, could simply reflect an inflammatory or pro-clotting environment.

So elevated choline may be a symptom rather than a cause of heart disease.

Comments

[Ignatz]

Breaking;
We're all gonna die.

[GUS]

The NEW ICE AGE is coming!!!!!!

[Rob Crawford]

Sounds once more that the goal isn't to find out what's actually healthy, but what they can use to push a peculiar (vegan) diet.

[Rick Ballard]

The important question is whether Big Fish or Big Egg will put up sufficient dough to fund the denialist counter models necessary to discredit the scientistic efforts of the fear mongers.

I'll think about that one after I make the critical decision tomorrow morning regarding ham, steak or sausage with my eggs.

[sbwaters]

Just for the fun of it, and because my daughter's health calls for it, I decided to take probiotics (25 billion teensy colonies) to see if I detected a change in how my gut responded. After all, I'd rather have good colonies than bad colonies doing their work down there.

We'll see what happens.

[Janet]

I'm starting to think that these "researchers" don't know what the hell they're talking about.

[Rick Ballard]

"I'm starting to think that these "researchers" don't know what the hell they're talking about."

Janet,

Come now, the point of the exercise is funding for further research.

Scientismists always know what they're talking about.

[NK]

Is TomM having some kind of midlife crisis?-- enough with the nutrition stuff already. What's next for TomM? leg warmers and Zumba classes at the Y?

[GUS]

NK is TOM wearing those YOGA pants that show of his package/crackage?
Rick, why do you hate SCIENCE?

[Frau Spiegelei]

Certainly not Kinder eggs!

[narciso]

Eggs may kill you, eventually, but let's get some perspective about more dangerous things;

http://frontpagemag.com/2013/dgreenfield/boston-bomber-magistrates-middle-eastern-connections/

[lyle]

Wait a minute. Why are the solons at NYT worried about diet and health when most, if not all, of them yearn for the rest of us an early, lightly medically-intervened, death? Y'know, to "bend the cost curve" downward.

I'm too much of a rube, obviously.

[NK]

Lyle-- they want healthy people when they give us the needle, or untie the burning longboat, or wave goodbye to the ice flow. They find that more... poignant

[Captain Hate]

Hitler was a vegetarian

[Janet]

Who cares about this healthy eating crap. Smoke pot, get STDs & have a good time!

[jimmyk]

Hitler was a vegetarian

Godwin's law in a diet thread!

[GUS]

Narciso. This Admin. is so completely corrupt. Most of it is based on ideology or politics, but a lot of it is based on partnerships that keep the ball rolling left.
IF, there was a problem with not mirandizing the p.o.s., then why were they allowed to question him at all???? Obama and Holder are sick mutherfuxers.

[peter]

OMG, Gus, you are too funny. LUN

[maryrose]

No sequester cuts in the DOJ's office. Actually I think Americans would take a plane being on time over flunkies in the DOJ twiddling their thumbs and ignoring CIA warnings about radicalized aliens ,legal or illegal in our country.

[Marlene]

My Dad has congestive heart failure,lung cancer and last week was hospitalized with an intestinal infection.The hospital dietician sent him home with a recommended list of food.One of my siblings went grocery shopping and Dad grumbled,"don't get anything on that damned list,just get some eggs."

[Walter Sobchak]

I found a way to reduce my blood pressure and decrease my risk of a stroke.

I cancelled my subscription to the NYTimes, and stopped reading their website.

I feel much better now.

[Porchlight]

Godwin's law in a diet thread!

Godwin's law is actually in every thread, whether or not Hitler is ever mentioned. It's a law. :)

[Clarice]

Me, too, Walter. Right behind foolish nutrition articles I place stupid medical tests that tell you nothing useful.

[Hartley]

Gina Kolata? Does she have a sister named Pina?

[MarkO]

Hartley, you are under arrest.

[Gus]

I went to a NY TIMES article today. I think I followed an LUN on JOM. Anyway, reading the comment thread after any article is literally painful. The l-tards are so illogical and deluded, that it's hard to relate to what they are saying. Most of it starts with BUSH DID THIS...or BUSH JUST MADE STUFF UP....etc etc. I consider these leftists my enemy. I do. They use the very taxes that we provide to live nicely, yet they hate us.

[NK]

Another Instalanche

[peter]

Gina Kolata's sister is Chiquita Banana.

[Forbes]

So Bittman's Mediterranean diet is just a warmed over low fat/high carb diet the USDA started pushing decades ago--at the onset of the US obesity explosion--with a nice name, of course.

[Rex]

Actually, Bittman's Med Diet is a moderate fat, moderate carb (and avoiding starches and many sugars), moderate protein diet.

[Carol Herman]

Can't live forever. And, any health kick is fakery.

[Patriot4Freedom]

What's next for TomM? ...Zumba classes at the Y?
Posted by: NK | April 25, 2013 at 01:23 PM

NK - Was TomM sneaking off up to Maine for some "Zumba classes"?

That might explain his absence a few months back.
LUN

[Nate Whilk]

Knoll's Law of Media Accuracy: Everything you read in the newspapers is absolutely true—except for the rare story of which you happen to have firsthand knowledge. —Erwin Knoll, editor, "The Progressive"

Gell-Mann Amnesia Effect: "...You read with exasperation or amusement the multiple errors in a story, and then turn the page to national or international affairs, and read as if the rest of the newspaper was somehow more accurate about Palestine than the baloney you just read. You turn the page, and forget what you know." --Michael Crichton

"Nothing can now be believed which is seen in a newspaper. Truth itself becomes suspicious by being put into that polluted vehicle." —Thomas Jefferson, Letter to John Norvell (June 11, 1807)