Why Are Eggs Linked to Cancer Progression?

Why Are Eggs Linked to Cancer Progression?

About two million men in the U.S. are living with prostate cancer, but that’s better than dying from prostate cancer. Catch it when it’s localized and our 5-year survival is practically guaranteed, but once it really starts spreading our chances drop to 1 in 3. So Harvard researchers took more than a thousand men with early stage prostate cancer and followed them for a couple years to see if there was anything in their diet associated with a resurgence of the cancer, such as spread to the bone.

Compared to men who hardly ate any eggs, men who ate even less than a single egg a day had a significant 2-fold increased risk of prostate cancer progression. The only thing worse was poultry (with skin) consumption, which showed up to 4 times the risk of progression among high-risk men. Researchers believe the higher risk might be caused by the cooked meat carcinogens (heterocyclic amines) that build up more in chicken and turkey muscle than in other meats.

But what about the eggs? Why would less than once a day egg consumption double the risk of cancer progression? The Harvard paper suggests that the choline in eggs may increase inflammation.

As I explained in my video Carnitine, Choline, Cancer and Cholesterol: The TMAO Connection, eggs are the most concentrated common source of choline in the American diet, which may increase the risk of cancer emergence, spread, and lethality. Another Harvard study, entitled Choline Intake and the Risk of Lethal Prostate Cancer, found that those with the highest choline intake had a 70% increased risk of fatal prostate cancer. Another recent study found that men who consumed 2 and a half or more eggs per week—that’s just like one egg every three days—had an 81% increased risk of lethal prostate cancer.

In the New England Journal of Medicine the same Cleveland Clinic research team that performed the famous study on carnitine (see my last post Avoid Carnitine and Lethicin Supplements), tried feeding people hard-boiled eggs instead of steak. As they suspected, the egg-eaters experienced a spike of the same TMAO compound associated with red meat consumption (and strokes, heart attack, and death).

It’s ironic that the choline content of eggs is something the egg industry actually boasts about. And they are aware of the cancer connection. Through the Freedom of Information Act I was able to get my hands on an email (displayed in my 9-min video Carnitine, Choline, Cancer and Cholesterol: The TMAO Connection) from the executive director of the industry’s Egg Nutrition Center to an American Egg Board executive talking about how choline may be a culprit in promoting cancer progression: “Certainly worth keeping in mind as we continue to promote choline as another good reason to consume eggs.”

For another behind-the-curtain peek at the egg industry, see Eggs vs. Cigarettes in Atherosclerosis and Egg Industry Blind Spot.

-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.

Image credit: Christopher Craig / Flickr

  • Jed L

    Are traditional corn chips unhealhty? You know, the fried yellow corn chips we use for dipping salsa and guacamole.
    Do small amounts of vegan fried foods have a place in a healthy vegan diet? Eating something that has been fried seems so bizarre, but who knows.

    • Dikaiosyne

      Cooking carbohydrates at a high temperature can produce acrylamides, which are associated with a greater cancer risk. See “Reduce cancer risk by limiting fried foods” at http://www.health24.com/Diet-and-nutrition/News/Reduce-cancer-risk-by-limiting-fried-foods-20131118

    • b00mer

      I avoid oil based on what I’ve read from Esselstyn, Novick, etc. If you haven’t read a lot on why some people choose to eat a specifically *low fat* plant based diet, those would be two good authorities to start with.

      But really what I wanted to share with you was my corn chip recipe: place corn tortillas on a pan in the oven at 375 F for about 12-15 minutes. I usually squeeze a lime wedge over them and spread out the juice with my fingers before putting in the oven. Once cooled they will be perfect and crispy. I throw them in the freezer to expedite the process :) Corn chips were maybe the only thing I “missed” when going no oil. I don’t eat them too often, but with some meals you just need that crunch factor.

      • Dikaiosyne

        You avoid oil??! All oil? I can undertand avoiding pro-inflammatory omega-6s and their ilk, but avoiding oil wholesale is not a good idea–imo… I mean what about the magnificent MCTs in coconut oil or the mouth-watering monounsaturated goodness of olive oil or the omnipresent omega-3s in hemp oil or. So it’s “No!” to nuts, too???! Have you gone avocados???! :)

        • Thea

          Dikaiosyne: With this statement: “So it’s “No!” to nuts, too???”, I think you are confusing the concepts of fat and oil. Oil is fat, but other foods like say nuts have fat in them. Nuts are not oil.

          As Toxins and Jeff Novick say, oil is the ultimate junk food, empty calories. To understand this statement, check out this great, short video (which talks specifically about olive oil):

          http://www.youtube.com/watch?v=lbALgjmZUek

          Hope that helps.

          • Dikaiosyne

            No, it doesn’t help–especially your statement, “Nuts are not oil.” Well, of course, they’re not oil–but they *contain* oil. Just google “nut fat” vs. “nut oil.” The latter wins (ah, blessed descriptive linguistics… :) An operational difference between fats and oils is that an oil is liquid “at room temperature.” If a person’s body was room temperature, that person would be dead. And coconut ‘oil’ is typically solid at room temperature and is very healthy.

            Olive oil in the Mediterranean diet–empirically one of the healthiest (e.g., see “Mediterranean diet linked to longer lifespan and better health” at http://www.medicalnewstoday.com/articles/268294.php )–can contribute as much as 50% of the daily calories. Yeah, olive is certainly a bad one. Just think how long people would live if they followed the Mediterranean diet w/o olive oil… ;) There’s just way too much empirical evidence that supports the health benefits of olive oil. For example, “Molecular mechanisms of inflammation. Anti-inflammatory benefits of virgin olive oil and the phenolic compound oleocanthal.” at http://www.ncbi.nlm.nih.gov/pubmed/21443487

            Also, it seems Mr. Jeff eschews consuming saturated fat. Why? Hasn’t he read “Saturated fats not linked to heart disease: Meta-analysis” at http://www.foodnavigator.com/Science-Nutrition/Saturated-fats-not-linked-to-heart-disease-Meta-analysis ?

            And what in the world is “…oil is the ultimate junk food, empty calories…” suppose to mean? Our body needs oils/fats. Actually, the claim is the ultimate junk science. Don’t lump all oils together.

          • Toxins

            “Contrary to part of our hypothesis, our study found that omega-9 (oleic acid)-rich olive oil impairs endothelieum function postprandially.” They also make note that “In terms of their postprandial effect on endothelieum function, the beneficial components of the Mediterranean and Lyon Diet Heart Study diets appear to be antioxidant-rich foods, including vegetables [and] fruits”

            So basically, fruits and vegetables are really makes our arteries healthy, not oil. The fact that olive oil caused arterial impairment speaks volumes. The benifits seen with olive oil are with people who already consume an extremely unhealthy diet. Someone consuming a low fat, whole foods plant based diet would not benifit.

            http://content.onlinejacc.org/cgi/content/full/36/5/1455

            In regards to the saturated fat study, Jeff Novick has acknowledged this.

            One major problem with this study is they did not look at any studies where the saturated fat intake was less than 7%, which is the level recommended by the American Heart Association. Most of the diets had saturated fat intakes in the range of 10-15% (or more).

            So, just like the studies that criticize “low fat” diets, but never analyze any diet that is truly low fat and based on the principles of low fat, high fiber, whole plant foods, this study criticizes the impact of lowering saturated fat, but never looked at any diet that truly lowered saturated fat to the level recommended.

            Another problem with the study is what the subjects replaced the saturated fat with when comparing the 2. For many, if not most, it was with either (or products containing) hydrogenated/trans fat, white flour, white sugar and/or mono fats.

            Saturated fat is not negligible.

            “Saturated fatty acids are synthesized by the body to provide an adequate level needed for their physiological and structural functions; they have no known role in preventing chronic diseases. Therefore, neither an AI nor RDA is set for saturated fatty acids. There is a positive linear trend between total saturated fatty acid intake and total and low density lipoprotein (LDL) cholesterol concentration and increased risk of coronary heart disease (CHD). A UL is not set for saturated fatty acids because any incremental increase in saturated
            fatty acid intake increases CHD risk”

            http://www.nap.edu/openbook.php?record_id=10490&page=422

            “The saturated fatty acids, in contrast to cis mono or polyunsaturated fatty acids, have a unique property in that they suppress the expression of LDL receptors (Spady et al., 1993). Through this action, dietary saturated fatty acids raise serum LDL cholesterol concentrations (Mustad et al., 1997).”

            http://www.nap.edu/openbook.php?record_id=10490&page=432

          • Dikaiosyne

            “The fact that olive oil caused arterial impairment speaks volumes.”

            It certainly does speak volumes, especially in light of the recent research on its benefits on endothelial function:

            “The addition of a small amount of olive oil to the diet appears
            to improve endothelial function according to a new study by U.S. and Italian researchers.”

            Source: “Adding just two tablespoons of olive oil each day can improve blood vessel function.” at http://www.eyeonspain.com/blogs/ianandspain/11726/Adding-just-two-tablespoons-of-olive-oil-each-day-can-improve-blood-vessel-function.aspx

            Or how about this one: ”

            Adding this Oil to Your Diet Could Reduce Blood Pressure” at http://www.doctorshealthpress.com/food-and-nutrition-articles/adding-this-oil-to-your-diet-could-reduce-blood-pressure

            From the article:

            “The researchers concluded that the consumption of a diet containing polyphenol-rich olive oil can decrease blood pressure and improve endothelial function in people with hypertension.”

            Sorry, no olive oil induced endothelieum function impairment here…

          • Dan

            If I may butt in. Ornish and Esselstyn have actually published wonderful results in patients on very low fat diets – Ornish as a randomized trial with HARD endpoints (2.5 times fewer events in the experimental group) and Esselstyn as a longitudinal cohort study from his center (Cleveland). The diets typically restrict nuts and strongly advocate zero oil be added. Calorically, oil is a concern because it occupies very little space in the stomach (so minimal gastric distention, if any) and yet is so rich in calories for its volume, that our gastric calorie receptors have a very difficult time estimating its caloric burden. A wonderful experiment done in Pittsburgh comparing women instructed to eat the exact same dish – pasta and vegetables – but one group also had 3 tbsp. of olive oil on top found that the olive oil group, predictably, ate more calories when instructed to eat to satiety. Thus those women could not properly estimate the additional caloric burden of the olive oil.

            The saturated fat meta-analysis by Siri-Tarino had multiple issues – see the follow-up letter by cardiologist Jeremiah Stamler, which was persuasive:

            http://www.ncbi.nlm.nih.gov/pubmed/20130097

            I find people just want to justify their dietary habits by citing evidence that supports their way of eating, but often ignore contradictory our countervailing evidence which would support a healthier pattern of eating. I do this myself, I cherry-pick. But I am honest about it. I realize olive oil is a slippery slope towards calorie overnutrition and a worsening omega-6:omega-3 ratio (if that is relevant). I am better off without any processed food that our ancestors wouldn’t have ready access to – including industrially pressed olive oil – which our calorie receptor genes obviously are oblivious to in terms of sensing its caloric load.

          • I find many people, including doctors, like to justify their dietary patterns with misleading study titles and abstracts without even considering the data under the hood contradicts even the authors.

            The devil is in the details.

          • Toxins

            It is difficult to asses these 2 studies without the original article. Were there any confounding dietary factors, as seen with the Mediterranean diet studies? It is unclear based on the quick summaries. Please find the full study and share so that we may properly asses them. Limitations such as these
            “The olive oil may have interacted with other dietary components, participants’ dietary intake was self-reported, and the intervention periods were short.” are common.
            http://www.ncbi.nlm.nih.gov/pubmed/16954359

            Studies examining the effects of the brachial artery test are telling, as is the one I posted. Immediate arterial impairment after ingesting is important and cannot be simply ignored. It is noted that “In a clinical study, olive oil was shown to activate coagulation factor VII to the same extent as does butter. Thus, olive oil does not have a clearly beneficial effect on vascular function.”
            http://www.ncbi.nlm.nih.gov/pubmed/9409274

            3 tablespoons of olive, soybean and palm oil do not appear protective “All the vegetable oils, fresh and deep-fried, produced an increase in the triglyceride plasma levels in healthy subjects.”
            http://www.sciencedirect.com/science/article/pii/S0939475305002139

            I again ask, why insist on something that is empty calories when we can consume the whole food?

          • Dan
          • Toxins

            Thanks for the additional comments

          • Richard Breault

            You are very stubborn so have it your way, drink all the oil you want but it still is not the same as consuming a fruit or plant that has oil in it. In refining oil it is taken away from the natural whole plant-based concept….the fiber and other goodies that were in the whole package are now only 100% fat oil. If you can not understand the difference do what you want…

          • Interesting discussion that ensues. I would like to add a point about a problem with isolated nutrients, in fact, most processed foods, including isolated fats: They are more easily adulterated or contaminated. What you see is not always what you get.

            Losing ‘Virginity’: Olive Oil’s ‘Scandalous’ Fraud

            http://www.npr.org/2011/12/12/143154180/losing-virginity-olive-oils-scandalous-industry

            This is much more difficult, if not impossible, with whole, fat-containing plant foods. Intact fats are healthier fats.

          • Dikaiosyne

            No it doesn’t. Nuts contain oil, since, by definition, an oil is liquid at room temperature. Google “nut fat” vs. “nut oil” and the latter wins (ah, blessed descriptive linguistics… :)

            Olive oil is remarkable good for a person. Not only does it contain a powerful anti-inflammatory (“Molecular mechanisms of inflammation. Anti-inflammatory benefits of virgin olive oil and the phenolic compound oleocanthal.” at http://www.ncbi.nlm.nih.gov/pubmed/21443487 ), it can comprise up to 50% of the daily calories in the Mediterranean diet–empirically, one of the healthiest diets (“Mediterranean diet linked to longer lifespan and better health” at http://www.medicalnewstoday.com/articles/268294.php )

            And while Mr. Jeff evidently eschews consuming saturated fats, he should read “Saturated Fat Is Not Associated With Cardiovascular Disease” at http://anthonycolpo.com/saturated-fat-is-not-associated-with-cardiovascular-disease/ and “Low saturated fat intake associated with higher stroke mortality” at http://www.foodnavigator.com/Science-Nutrition/Low-saturated-fat-intake-associated-with-higher-stroke-mortality

            No, neither your statements nor the video are at all helpful.

        • Toxins

          Oil and nuts are completely different substances. Lets examine walnut oil and walnuts, gram for gram.

          I am not recommending that anyone eat this many walnuts in one day, but just for the sake of demonstration. Lets look at a 100 gram sample.

          100 grams of walnuts contain:
          654 calories
          7 grams of fiber
          15 grams of protein
          Plenty of minerals
          Plenty of vitamins
          Plenty of antioxidants.

          100 grams of walnut oil has:
          884 calories
          0 grams of fiber
          0 grams of protein
          0 minerals
          A tiny amount of vitamin k and barely any vitamin e, so essentially no significant vitamins.
          Barren of antioxidants

          Do you see the issue? One is far more calorie dense, not nearly as satiating, and provides extremely little nutrition. A food that is extremely high in calories, fat, sugar or salt and has very little nutritive value at all is considered a junk food. Whats stopping you from consuming the whole food? Also, coconut medium saturated chain fatty acids are nothing magical.
          http://nutritiondata.self.com/facts/fats-and-oils/589/2
          http://nutritiondata.self.com/facts/nut-and-seed-products/3138/2

          • Dikaiosyne

            “Oil and nuts are completely different substances.”

            I certainly hope you’re not serious with this Straw Man claim. Who in the world argues they’re the same? Nuts contain oil. The nut oil, in itself, in beneficial. For example, it’s nut oil that contains gamma tocopherol–another powerful anti-inflammatory and a wonderful vitamin E fraction (see http://nutritiondata.self.com/foods-012106000000000000000-w.html?maxCount=25 ).

            You’re also forgetting that many individuals are allergic to nut proteins, so extracting the oil for consumption–sans the offending protein–is beneficial for this population.

          • Toxins

            As I have shared, it is completely ridiculous to argue that nuts as a whole are not as beneficial as an extract of their fat. Isolating components of foods has never proved to be healthful. It is not something to be ignored that oil is pure fat, lacks fiber, vitamins, minerals, is not satiating and can easily lead to weight gain. Lets be fair in our comparison between oils and nuts and not exaggerate.

            In regards to your link, all of the top sources of gamma tocopherol were whole nuts. I am confused how this supports your position.

            You will notice that the antioxidant quality of olives compared with olive oil is quite dramatic.
            http://ndb.nal.usda.gov/ndb/foods/show/2356?fg=&man=&lfacet=&format=Full&count=&max=25&offset=&sort=&qlookup=olive
            http://ndb.nal.usda.gov/ndb/foods/show/631?fg=&man=&lfacet=&count=&max=&sort=&qlookup=&offset=&format=Full&new=&measureby=

            Please let us not pretend that the oil of an olive is a health food. I find it to be a poor excuse to continue eating an unhealthy food.

        • b00mer

          Hi Dikaiosyne,

          First it seems you are interpreting me “avoiding oils” as avoiding oils within whole foods, so let me clarify: I do not eat processed, isolated oils (or refined sugar or protein powders). I prefer to eat the whole food. Oatmeal and romaine lettuce are both around 15% fat, so obviously a whole-foods *oil-free* diet is not necessarily fat free.

          Rest assured, my intake of omega-3’s is through the roof on a daily basis – from whole foods. And from those whole foods I gain thousands upon thousands of other phytonutrients as well. Were I to consume isolated oils instead of their whole food versions, the overall nutrient density of my diet would decrease significantly.

          I will eat nuts, avocados, coconuts, or any other plant food. But why would I eat one isolated macronutrient and throw the rest of the food away? Though I do use these particular foods sparingly in the diet due to their relatively high fat content; if you would like to understand why, I would recommend that you investigate what Novick, Esselstyn, and other experts in the field have to say. There is much more information that you will obtain in a comments thread. We have already seen that omega-3s are a non-issue; you will see the other topics you bring up addressed in detail: MCTs, MUFAs, etc. If you would like specific links let me know, I can try to find some good ones to start with if you would like.

          • Dikaiosyne

            Your clarification helps. I think it’s folly, however, to deprecate oil consumption, wholesale. I eat raw nuts galore–especially cashews–but also consume olive oil. I note that Novick speaks against olive oil, but the empirical evidence overwhelmingly supports its benefits. Olive oil improves endothelial function (Source: http://www.doctorshealthpress.com/food-and-nutrition-articles/adding-this-oil-to-your-diet-could-reduce-blood-pressure ) and is a powerful anti-inflammatory (Source: http://www.ncbi.nlm.nih.gov/pubmed/21443487 ). Additionally, olive oil in the Mediterranean diet–one of the healthiest (Source: http://www.medicalnewstoday.com/articles/268294.php )–can contribute as much as 50% of the daily caloric intake.

          • b00mer

            Hi Dikaiosyne,

            Again, you can find very detailed rebuttals to the concept of olive oil as “anti-inflammatory” and the “healthfulness” of the Medi diet. More detailed than I could give you here, but just trust me that there are very strong rebuttals to these concepts, mainly in terms of context or poor study design.

            I have not seen any responses to what you have posted in terms of improving endothelial function, but if you find the actual study (not a lay article) and post it to the McDougall forums I would bet Novick would respond. Every study I have seen him respond to he basically tears to shreds. Give it a try! In fact you might want to search first to make sure he hasn’t already addressed it. You can view the forums with no membership.

            From a simpler perspective, again, nothing you could say about the fats/oils *within* a food would make me want to process that food to extract the oils and throw the rest away. I would still just eat the whole food. :)

          • Richard Breault

            First of all there is no such thing as a Mediterranean diet and if you go to Greece today you will learn how unhealthy they are…getting fat too. The original concept of the diet came about in the 1950s and focused on the diet in Crete. The whole area was in economical trouble and the diet included very little fish and even less meat. The diet was healthy because of the large amount of fruits and vegetables despite the olive oil, not because of the olive oil!

        • Darryl

          MCTs are probably harmless (other than being empty calories). Unfortunately coconut oil is 15% MCTs (8% caprylic, 7% capric), and 73% C12-16 SFAs that increase LDL (48% lauric, 16% myristic, 9% palmitic), of which myristic has the strongest effect on hepatic LDL receptors. It seems recent interest has turned from the lipid hypothesis towards the systemic inflammation hypothesis, and there, too there are concerns with coconut oil fatty acids. The myristic acid and 2% stearic acid result in inflammatory ceramides, while its unclear which among the SFAs in coconut oil is most responsible for increased endotoxin import. There’s a reason 9-20% coconut oil diets, sometimes with 0.1-0.5% cholesterol, are commonly used to induce atherosclerosis in animal models. But then, monounsaturated fatty acids may not be much better.

          There seems to be a scientific consensus on a harm ranking for fatty acids: EPA,DHA < n-3 PUFA < n-6 PUFA < MUFA < SFA < trans (for CVD) and EPA/DHA < n-3 PUFA < MUFA,trans < n-6 PUFA < SFA (for inflammation/cancer). An unresolved question is whether n-6 PUFA or MUFA fall on the slightly positive or slightly negative side for overall health, when compared to proteins and complex carbs (both seem are better than sugars). There are rather few mostly n-3 oils (flax, walnuts, cold water fish), and perhaps all other oils are suspect. Nuts vary widely between high n-3 walnuts to high SFA macadamias and a past NutritionFacts video shares the hypothesis that its their magnesium content, rather than fat content per se, that accounts for their well established cardiac health benefits.

          • Toxins

            Thank you Darryl for the concise response

        • Richard Breault

          Get with it man, avoiding oil means refined oils whether coconut, olive or any other kind. If you think you are not getting enough fat from whole plants, which in reality you are, try eating olives, nuts, seeds and avocados…

      • b00mer

        TO EVERYONE: My apologies, I really have opened up a can of worms/bottle of oil here! I merely wanted to share an idea for tasty corn chips! :D

        Please let’s not forget the real message of this thread: that corn chips baked in the oven with lime juice are extremely delicious!

        • Toxins

          I rather enjoy these discussions ;)

  • And what about the studies on eggs and ovarian cancer? MIght the problem be the fats in the yolks or the concentration of pesticides in eggs?

    http://eatandbeatcancer.wordpress.com/2012/07/27/anti-cancer-recipes-can-eggs-cause-ovarian-cancer/

  • Dan

    Does this also hold true for the Egg-Beater type of egg substitution, which supposedly eliminates the yolk?

    • Darryl

      The choline is associated with with the yolk, but egg whites have the highest methionine content of any food, per calorie. And while there’s no strong association of TMAO from choline metabolism with cancer progression (yet), methionine has attracted considerable interest as a limiting nutrient for cancers and inducer of excess IGF-I growth signalling.

      • Dikaiosyne

        Interestingly, though, the 2012 article ”

        Dietary intake of B vitamins and methionine and prostate cancer incidence and mortality.” concludes that they, “…found little evidence of association between dietary intakes of B vitamins or methionine and prostate cancer risk.” Source: http://www.ncbi.nlm.nih.gov/pubmed/22527163

        In fact, “Serum levels of vitamin B6 and methionine were inversely associated with risk for lung cancer…” Source: http://www.medscape.com/viewarticle/724698

        This suggests a selective methionine-dependence with some cancer cell lines.

        • Darryl

          You’re correct, most studies show no significant association between methionine intake and cancer risk. Whether that’s because there is no association, a non-linear association that appears inside one of the quantiles (eg, in the U.S., >99% achieve the EAR for Met+Cys for a 70kg adult, 90% exceed it by 55%, on average they exceed it by 164%; see 1 2 3), a U-shaped association (seems likely to me from animal studies), or complex interactions with genotypes or other nutrients (also seems likely), I can’t say.

          My interest largely stems from a number of animal studies demonstrating methionine restriction is responsible for about half of the lifespan & healthspan increases from caloric restriction (a review). Whether we will see much fruit from ongoing studies integrating methionine restriction into cancer treatment (another review) will be rather interesting.

          I did find a few studies (we can all cherry pick) that suggest interesting avenues: This rather large prospective cohort study found lowest colorectal risk in those with low methionine and high folate consumption. Meanwhile this study found much higher prostate cancer risk (OR = 6.7) with high methionine consumption, but only in carriers of the common MTHFR A1298C allele. Its possible that dietary methionine is not the place to look, as bioavailable methionine, 5-MTHF levels, or regulation of folate between homocysteine methylation and DNA/RNA synthesis pathways has a much stronger role. There’s a lot of interest in MTHFR polymorphisms and cancer, this survey demonstrates just how many studies have found diametrically opposite significant conclusions.

      • Plants for better health

        Darryl, is the methionine in egg whites a problem for vegans who do not consume the huge methionine burden of omnivores in all other animal products?

        • Darryl

          I don’t know. I consider my diet a n=1 experiment to achieve some of the benefits of calorie restriction life-extension protocols, and perhaps retard growth of any microscopic cancers I might harbor, without eye-clawing hunger.

          I aim for the estimated average requirement (15 mg Met+Cys / kg / day), which in the context of Western diets, is a low methionine intake. Its easy to achieve in vegan diets if the major dietary protein is from legumes, especially lentils & peas. The amino acid requirement of most concern to vegans is lysine, so I looked at the lysine/methionine ratio, and legumes have a considerably higher ratio (avg 4.3) than grains (avg 1.5).

          In comparison, whole eggs have a lysine/methionine ratio of 2.4, and egg whites 2.0. Ie legumes are better for achieving adequate lysine (and hence protein) without excess methionine than eggs are. As I’m sure you’re aware, the commercial egg industry is probably the cruelest animal product industry.

          • Plants for better health

            that’s fascinating and again I learn from you. The NAC is interesting too. I avoid supplements but at least for NAC, one trial in dialysis patients by Tepel et al showed marked cardiovascular benefits (published in Circulation about a decade ago). I don’t know if it’s ever been replicated. Certainly we give NAC to tylenol overdose patients to regenerate hepatic glutathione stores, so given that fact and the NAC trial by Tepel et al, it should be safe to consume.

  • Dikaiosyne

    The conclusion of this 2010 single-study, “Intakes of meat, fish, poultry, and eggs and risk of prostate cancer progression.” cited in this article states that the “consumption of eggs and poultry with skin may increase the risk [of prostate cancer recurrence or progression]”. Source: http://www.ncbi.nlm.nih.gov/pubmed/20042525

    However, a 2012 meta-analysis titled, “No association between egg intake and prostate cancer risk: a meta-analysis.” indicates that their “analyses provided no evidence of a significant influence of egg consumption on prostate cancer incidence and mortality.” Source: http://www.ncbi.nlm.nih.gov/pubmed/23167401

    A meta-analysis is a more reliable methodology for evidencing a ‘trend’ association between egg consumption and prostate cancer risk. Thus, I think it’s prudent to be careful with the results of the single study cited in this article–especially when suggesting any prescriptive value to it.

  • Ron

    Michael i’m a follower and a fan of yours. your dedication and agenda are things i much relate to.
    it does strike me that in your posts (as far as i can tell) numbers are usually relative and not as much absolute. surely it would be just as useful to know for example whether “50% more chance to XYZ” refers to 3 vs 2 in a 100 subjects’ test or 3 vs 2 in a 10000 subjects’ test. knowing the risk and not just the relative (change in) risk is something your readers might wish to know as well and sure fill find useful.
    Keep on the good work :)
    Ron

    • Lagaya

      Ron- If you click on the highlighted area when studies are mentioned, or on the video when it is mentioned, you can see the actual study which will tell how many actual participants and the results. You’re right, though, the real numbers are much more meaningful.

  • aviweiss

    I’ve asked this before on prior NF egg/choline posts but haven’t seen your answer. There are numerous vegetable sources of choline as well, so it animal-based choline that is at issue, choline itself, or the dosing?

    Other trusted health-info sources proffer studies that seem to indicate choline to be helpful and necessary for a healthy diet: http://www.whfoods.com/genpage.php?tname=nutrient&dbid=50 and http://www.veganhealth.org/articles/choline. Any further thoughts as to how this seemingly conflict of info can be resolved greatly appreciated.

    Thanks

    -Avi

    • Dan

      choline in moderation is fine. Too little choline (50 mg/d) is not good and leads to fatty liver disease. Too much choline appears to stimulate prostate cancer and turns on TMAO synthesis. I think the perfect place to be is around 200-300 mg/d, which is where most vegans naturally seem to ‘sit’. This is from my reading of the choline studies that have been performed. I certainly wouldn’t supplement with choline, given the TMAO issue.

      • aviweiss

        Dan,

        Thanks for the reply. I’d be curious to get Dr Gregers thoughts, as he clearly implies, and even states, that Choline itself is an issue. He didn’t specifically talk to safe amounts in the video, but rather that the element itself appears problematic.

        • Plants for better health

          Heh Avi, sure let’s see what the good doctor says. I should also point out that choline is found in low but moderate amounts in plant foods, and it is probably the excessive amount in yolks, meat and pills that is the problem (those are the three that have been tested in terms of TMAO risk and their prediction of coronary events). From estimates I have seen, the average vegan will take in between 80 and 300 mg per day. The RDA for choline was set on the basis of a single 23-year-old study comparing 50 mg with 550 mg, with no intermediate threshold. The endpoint was not the vasculature but liver enzymes indicative of fatty liver disease.
          I just don’t believe that the relatively modest amounts of choline in plant foods, which are well below the RDA for this nutrient, would actually cause vascular problems (versus the huge amounts in eggs, meat and pills).

          • aviweiss

            Yes, that was my original question: plants had choline as well, so there must be some aspect of either animal-derived choline, or the amount/concentration of choline that would be the additional risk factor.

            Either way, I would like to get more precision on the information rather than simply throw the baby out with bath water.

          • Plants for better health

            In my discussions with experts in this area, it appears to be the dose and concentration that makes the poison. For example, 500 mg of choline bitartrate in a pill-based supplement, or eating a couple egg yolks, is enough to severely elevate TMAO levels, and those levels directly predict CV risk.
            Conversely, on a plant-based diet, only ‘bits and pieces’ of choline throughout the day are scattered in low doses in plant foods (e.g. the 25 mg found in a tablespoon of wheat germ – and that’s considered a pretty rich source, yet it’s going to be 1/20th of the dose mentioned above).
            I learned this when I counted up my own choline intake, which at the time was around 200 mg per day. I was concerned, and considering a supplement, until I delved into the literature, read the studies and talked with several experts. The RDA is likely far too high, based on what we now know about TMAO.

            PS, in the Physicians Health Study, choline independent of egg intake predicted aggressive prostate cancer, but only at high levels, which is what one would expect to consume on an omnivore diet. So we are partially protected by eating a plant-based diet in that our habitual choline intake tends to be a lot less (for some, as low as 80 mg/day, but probably for most in the 200-300 mg/d range, from what I have seen).

          • Plants for better health

            PS, in the Physicians Health Study, choline independent of egg intake predicted aggressive prostate cancer, but only at high levels, which is what one would expect to consume on an omnivore diet. So we are partially protected by eating a plant-based diet in that our habitual choline intake tends to be a lot less (for some, as low as 80 mg/day, but probably for most in the 200-300 mg/d range, from what I have seen).

  • Brian

    Someone already alluded to this but what about differentiating between those who eat the egg yolk vs. only those who eat the egg whites?

  • Phil Cole

    I just listened to the Ben Greenfield podcast with guest Durianrider. Ben has some wacky notions about fat & animal consumption and seems to be preaching their benefits. Scary stuff.

  • nzreva

    If I don’t eat lecithin I have alot of pain in my right side

  • mary

    What about women? Any studies done?

    • There have been studies on eggs and ovarian cancer in women–and results are mixed. http://eatandbeatcancer.wordpress.com/2012/07/27/anti-cancer-recipes-can-eggs-cause-ovarian-cancer/

      • Darryl

        There were non-linear trends between egg consumption and breast cancer in the huge 2009 EPIC study. Here are the median egg intakes and breast cancer hazard ratios of the 5 quintiles (7 g/d = 1 egg/week):

        g/d hazard ratio & 95% confidence interval
        3.3 1
        8.5 1.09 (1.00, 1.18)
        14.4 1.07 (0.98, 1.16)
        21.6 1.08 (1.00, 1.17)
        36.7 1.07 (0.98, 1.16)

        The increased hazard was significant in the 2nd and 4th quintiles, and it appears that combining the 2-5th quintiles there would also be a significant result that eating one or more eggs per week increases breast cancer risk by about 8%, with no greater risk for higher intakes.

  • William Dwyer

    The Life Extension Foundation has published a rebuttal to the Nature Medicine study implicating carnitine in cardiovascular disease. The rebuttal can be found here: http://www.lef.org/magazine/mag2013/aug2013_Rebuttal-to-Attack-Against-Carnitine_01.htm

    The rebuttal, which is worth reading, cites a meta-analysis by the Mayo Clinic that looked at 3,600 patients and found huge cardiac benefits in those who supplemented with L-carnitine. This meta-analysis represents the largest, most powerful scientific review of carnitine’s cardiovascular benefits to date. By contrast, the study blaming TMAO included only 10 people and ignored contrary evidence which would have cast doubt on its findings. Yet the media publicized the Nature Medicine study while ignoring the Mayo Clinic’s far more reliable meta-analysis.

    If eggs are a risk factor for cancer, it is not the choline, which is an important and beneficial nutrient, but something else that’s responsible for it. Correlation is not causation.

    • Darryl

      In 4007 patients followed for 3 years, the quartile with highest fasting plasma TMAO had 2 ½ times the CVD events as the lowest TMAO quartile.

      Tang, WH Wilson, et al. “Intestinal microbial metabolism of phosphatidylcholine and cardiovascular risk.” New England Journal of Medicine 368.17 (2013): 1575-1584.

      I have issues with the idea that carnitiine/TMAO is the primary inflammatory compound in meat, but in the context of Western diets, it does seem like a useful marker for exposure to the full range meat compounds and metabolites implicated in CVD (C12-18 saturated fats, ceramides, endotoxins, AGEs, Neu5gc, and yes, free choline and carnitine).

      • DH

        Please elaborate on the statement “C12-18 saturated fats, ceramides, endotoxins, AGEs, Neu5gc, cholesterol, and yes, free choline and carnitine.”

        AGEs = advanced glycosylation endproducts — which is the sine qua non of diabetic microvascular disease — are these present in meat cooked at high temperatures?

        What are ceramides? Do you meant substances like acrylamide?

        What is Neu5gc?

        And finally, what about trans fatty acids found in animal products?

        Thanks very much.

        • Darryl

          C12-18 saturated fats:
          lauric acid 12:0, myristic acid 14:0, palmitic acid 16:0, stearic acid 18:0 All (esp myristic acid) increase plaque building LDL cholesterol through downregulating hepatic LDL-R expression. All directly activate Toll-like receptor 4 (TLR4) and TLR2 proinflammatory signalling. Palmitic and stearic acids are metabolized to proinflammatory ceramides. Saturated fat rafts increase import of endotoxins (gram negative bacterial cell walls) from the intestine. All this inflammatory signalling is suspected in the endothelial dysfunction and insulin resistance following high saturated fat meals.

          AGEs are present in any food with both protein and sugar exposed to high temperatures. Grilled meat, but also bread crusts. These activate a receptor for AGE, which induces all sorts of inflammatory and prooxidative activity (NADPH oxidase activity etc). It seems well-cooked protein looks like aged protein (we also produce endogenous AGEs) which our immune system would houseclean. Exogenous AGEs put staff on overtime,

          Neu5gc is a cell-surface molecule found in beef, pork and veal, which is taken up and presented on our own cell surfaces, and causes autoimmune activation.

          In populations that eat few animal products or refined fats (eg, the Tarahumara, ~11% fat, ~3% saturated fat) cardiovascular disease is rare. Within typical American ranges (interdecile range is 26-40% fat, 7-18% saturated fat), dietary interventions have limited impact: perhaps 26% fat, 7% saturated is sufficient for the inflammatory cascades.

      • DH

        This is fascinating. Thank you for all that!

        By eliminating animal products, it almost seems to me that a vegan diet could be a panacea by definition for many different diseases.

        I was wondering if you take aspirin as there is also a tremendous amount of evidence supporting daily aspirin use for preventing a wide variety of malignancies, particularly (but not at all exclusively) colorectal adenocarcinoma – also, lymphoma, prostate cancer, brain cancer and others. Rothwell et al x repeated posts in The Lancet.

        I plan to start taking low dose aspirin soon, perhaps by my 45th birthday, which is when authorities begin to recommend it. One needs at least 5 years of therapy to begin to see an effect, which then persists up to 20 years. But I would like to continue it long-term. Of course it also prevents myocardial infarction but increases the risk of GI and CNS bleeding.

        • Darryl

          I’ve started taking low dose aspirin at age 38. Turns out that while aspirin is merely okay at reducing vascular events (it reduces non-fatal MI, but has little effect on fatal MI or strokes), its terrific for cancer prevention, reducing cancer mortality with long-term use by about a third.

          Much of that benefit is from aspirin’s well understood non-specific COX inhibition, but it was other mechanisms like AMPK activation as well as autophagy induction that caught my eye. Autophagy is cellular housecleaning, induction of which may has preventative/therapeutic potential in protein aggregation diseases like Alzheimer’s and Huntington’s. To date, all dietary and pharmaceutical and interventions that increase mice lifespan also increase autophagy, leading some to speculate that increased autophagy is necessary for mammalian longevity. Aspirin is one of very few compounds found to extend mice lifespan.

          • DH

            Another possible mechanism is the fact that aspirin very commonly causes subclinical heme iron depletion from the GI tract. A trial that randomized peripheral arterial disease patients to phlebotomy (bloodletting) versus control showed a 50% reduction in incident cancer.

            I was also wondering if you steam your cruciferae and whether you were concerned about goitrogens in raw cruciferous vegetables (brassicaceae), which ones have the most goitrogenic compounds, and how long you steam them for (assuming you do).

          • Darryl

            Mostly raw broccoli, baby kale and red cabbage in gargantuan salads. I was unaware of the goitrogen concern, but to date my thyroid doesn’t feel enlarged. I might start adding iodine to the supplement routine, as I’ve cut down on salt considerably.

          • DH

            Endocrinologists love guesstimating the size of their patients’ thyroids on physical examination to within 5 grams and I am sure some study somewhere has shown how realistic (unrealistic) this is, versus doing ultrasound imaging. Of course the most sensitive earliest marker of hypothyroidism is a rising TSH level (4th-generation assay). I only ask about cruciferae because I have started consuming them with every meal, mostly raw, and Dr Greger has a video on the risk of goitre with excessive amounts of bok choy (case report in N. Engl. J. Med.). Steaming them apparently inactivates myrosinase(?) which hydrolyzes the goitrogenic glucosinolates — hence far fewer goitrogenic compounds are present for uptake in steamed brassicaceae. I don’t know how much of a big deal this if but if a raw foods vegan finds themselves slowing down over time, getting colder, duller, more constipated, rougher skin, hair falling out, depressed, slower heart rate, slower overall metabolically, they need to pay attention to this issue.

            I don’t know what steaming does to the anti-cancer properties of these vegetables however.

          • Darryl

            The ancient generic rheumatic arthritis drug salsalate likely offers the anti-cancer benefits of aspirin (as an NF-kB inhibitor and AMPK inducer) without the gastric injury or clotting inhibition. The same mechanisms are believed responsible for salsalate’s recently discovered benefits in glycemic control and insulin sensitivity in diabetics and pre-diabetics.

            The major downside would appear to be the requirement for a prescription and the much higher cost due to industry consolidation / limited competition (the chemical itself is no more expensive to produce than aspirin). Should the epidemic of metabolic syndrome be added to salsalate’s indications, then I’d expect costs will plummet as more manufacturers enter the field.

          • VegAtHeart

            Given how well-researched you are, you have probably read the 2007 U.S. Preventive Services Task Force recommendation against low dose aspirin for prevention of colorectal cancer:

            http://annals.org/article.aspx?articleid=658984

            Side effects seem to be part of their argument. What do you think of this?

            Also, some studies have suggested that the observed benefits of aspirin are mostly associated with a genetic subset of the population that have the PIK3 mutation:

            http://www.nejm.org/doi/full/10.1056/NEJMoa1207756

            http://www.nature.com/onc/journal/vaop/ncurrent/abs/onc2013244a.html

            What do you think?

          • Darryl

            The more recent 2011 Rothwell pooled analysis found significant reductions for other cancers, a 12% reduction in non-vascular deaths, and that the known increased risk of major bleeding (ulcers, etc) with aspirin only occurred in during the first 3 years of followup (or so this editorial notes). Combined, these results change the risk/benefit balance, though benefits don’t clearly win out until 3 to 5 years on aspirin.

            A study last year found a 55% increased risk of major bleeding with aspirin. Some advocate adding Pepcid to prevent ulcers, but intracranial bleeding is another matter. Clearly those with other risk factors like hypertension, alcoholism or a family history of hemmorrhagic strokes will have a very different risk/benefit from aspirin than someone like me (40s, bp 110/70, no family history).

            PIK3CA refers to a common mutation in many cancers, not an inherited genetic predisposition. Unfortunately, by the time the cancer is diagnosed, biopsied and genotyped its a bit late to see if aspirin would slow its progression.

          • DH

            Do you think halving an enteric coated 81 mg ASA would work, while reducing the hemorrhage risk (“the dose makes the poison”)? I personally don’t think so. In my investigation of Dutch TIA, a trial that compared 30 mg with 283 mg of ASA, there was a statistically significant benefit on colorectal cancer death at the higher dose, and for all cancers, a strong non-significant trend (RR 0.71, p=0.14). Quoting these numbers from memory, so they may be off slightly. So I wouldn’t halve an ASA tablet.

            On the other hand, the >300 mg dose range seems to exert faster benefit including significant reduction in cancers well within the first three years of follow-up. What I worry about at this dose is GI bleeding risk. Yes it can be abolished by adding pepcid but then you are losing your gastric acid production which may have many unanticipated effects (calcium, magnesium, B12, iron malabsorption).

          • VegAtHeart

            Thanks for providing a detailed response to my question. The research that you cite on the benefits of low dose aspirin are very intriguing.

            As you may know, Dr. Greger previously presented a video suggesting that vegetarian diets inherently provide substantial quantities of aspirin. I don’t know if aspirin supplements would benefit people like you and I who already eat a pure whole foods plant-based diet and probably get have inherently high levels. I guess there aren’t studies focussing on our group specifically, are there?

          • Darryl

            From the paper Dr. Greger cited, serum salicylic acid in µmol/L: median min max
            omnivore 0.07 0.02 0.20
            vegetarian 0.11 0.04 2.47
            75mg ASA/d 10.03 0.23 25.40
            The median serum salicylate level for those taking low-dose aspirin was 90 times greater than in vegetarians. Even the vegetarian outlier with maximum salicylate only absorbed only 1/4th as much.

          • VegAtHeart

            True, regarding the large difference between the medians, though quoting this paper (pg.2, results para 1): “Eight of the 37 vegetarians had serum SA concentrations above the lowest serum SA concentration found in the aspirin group and six of the 14 patients in the aspirin group had serum SA concentrations below the highest vegetarian value.” So it looks like 43% of the aspirin users had blood levels of SA that were theoretically achievable on a vegetarian diet. What blood level of SA could a person following a whole foods plant based diet achieve?

          • Darryl

            I suspect the major part of variation among both groups was the timing of blood draws; from 3 to 20 hours after aspirin ingestion, and who knows how long after meals. There’s a lot of salicylate in curry powder, hot paprika, and thyme, and as with aspirin, those levels would decline with time.

          • VegAtHeart

            What you say seems like a logical explanation for the results of that paper. Interestingly, this editorial entertains the possibility that dietary salicylates may contribute to the beneficial effects of a vegetarian diet.

        • Thea

          DH: I think you will be interested in the following Nutrition Facts blog post:

          http://nutritionfacts.org/2011/10/04/inflammation-diet-and-vitamin-s/

          Including the following sentence and video:

          My video “Aspirin Levels in Plant Foods” suggests that the low levels of salicylic acid in fruits (particularly nectarines), vegetables (particularly asparagus), and herbs and spices (especially mint, cumin, thyme, and paprika) may provide the best of both worlds.

          • DH

            Thank you very much, Thea. I will check that blog post out.

  • Amanda

    What about egg whites (as opposed to the whole egg)?

  • Concerned, not quite a vegan
  • gobsmacked

    I am continually amazed that studies single out one item and write a theory about it rather than looking at the whole person, their environment, emotional pathology, health history, Every person comes with their own particular set of challenges. One minute salt is bad, then eggs, then the revelation that we were wrong. the truth is if your body systems aren’t working look at the whole body and then the environment don’t just stop eating eggs, it may help with inflamation to stop eating eggs but not if you are living in an unhealthy emotional world, or in a toxic environment, or you consume far too much sugar and your body is damp and yeasty.

  • Caroline

    I have only read that Choline is an anti-inflammatory. I am confused as to why this article says Choline increases inflammation.

  • Vinod

    Hi , what’s the limit of egg whites per day. I am doing workout in Gym.

  • danar dev

    apparently everything we eat, drink and breath cause cancer there is no way out eat and get cancer then die or stop eating and starve to die.

    • Thea

      danar dev: Welcome to the NutritionFacts.

      re: “apparently everything we eat..cause cancer”
      Happily, that’s not true. If you spend some more time on this site, you will see that there are a huge number of foods that not only do not cause or promote cancer, but help prevent and fight cancer! You can learn which foods help and which foods hurt.

      Let me know if you are seriously interested in learning more and I will give you some specific references to investigate.

  • Pet Rat

    Couldn´t methionine be the culprit just as well? And how should I get enough choline for a. acetylcholine production b. to keep the homeocysteine in check?

  • Mayank Gupta
  • inder

    My mother was diagonsed with Ca Rectum which she was followed surgery, radiation, chemo but the Stil the Dr say she is at IV stage. Day by day she is loosing her weight. Before chemo she was 51 and know she is only 41 kgs. Tell me what to do to gain her weight. Why after doing so treatment she reached to Stage IV is there is a better treatment where i can take her for the best treatment. In India Dr are waiting for a cancer paitents and as cancer paitents come there a lottery for them all the Dr have different views about the same systoms. I want my mother to save her life. Plz suggest me how to control her un bearable pain which we have followed with the pain killers and patches.

  • sssa
  • Livity

    Choline is also found in tofu, soymilk, quinoa, broccoli, spinach, beets, wheat, nuts, beans and peas so should cancer patients avoid these foods?

  • OzSydDr

    I remember viewing this article (the actual research article and study done), but what was the safe Choline choice to take. I believe I remember CDP Choline didn’t increase risk at all. Most do however.