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Why the Egg-Cancer Link?

August 21, 2014 by Michael Greger M.D. in News with 0 Comments

Why the Egg Cancer-link?

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 the five-year survival is practically guaranteed, but once it really starts spreading, chances drop to one in three. “Thus, identification of modifiable factors that affect the progression of prostate cancer is something that deserves study,” noted Dr. Erin Richard and colleagues at Harvard. So, they 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 spreading 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 consumption, with up to four times the risk of progression among high-risk men. They think it might be the cooked meat carcinogens that for some reason build up more in chicken and turkey muscle than in other meats. For more on these so-called heterocyclic amines, see my videos: Heterocyclic Amines in Eggs, Cheese, and Creatine?, Estrogenic Cooked Meat Carcinogens, and PhIP: The Three Strikes Breast Carcinogen.

But what about the eggs? Why would less than once-a-day egg consumption double the risk of cancer progression? “A plausible mechanism that may explain the association between eggs and prostate cancer progression is high dietary choline,” the researchers suggested.  Egg consumption is a determinant of how much choline you have in your blood, and higher blood choline has been associated with a greater risk of getting prostate cancer in the first place. So the choline in eggs may both increase one’s risk of getting it and having it spread.

Studies have associated choline consumption not just with getting cancer and spreading cancer, but also with significantly increased risk of dying from it. Those who ate the most had a 70% increased risk of lethal prostate cancer. Another recent study found that men who consumed two and a half or more eggs per week — that’s just like one egg every three days — had an 81 percent increased risk of lethal prostate cancer.

Maybe that’s why meat, milk, and eggs have all been associated with advanced prostate cancer—because of the choline. Choline is so concentrated in cancer cells that doctors can follow choline uptake to track the spread of cancer throughout the body. But why may dietary choline increase the risk of lethal prostate cancer? Dietary choline is converted in the gut to trimethylamine (see my video Carnitine, Choline, Cancer and Cholesterol: The TMAO Connection), so the Harvard researchers speculated that the TMAO from the high dietary choline intake may increase inflammation, which may promote progression of prostate cancer to a lethal disease.

In one of my videos, Eggs and Choline: Something Fishy, I talked about what trimethylamine might do to one’s body odor.

In the New England Journal of Medicine, the same Cleveland Clinic research team that did the famous study on carnitine repeated the study, but instead of feeding people a steak, they fed people some hard-boiled eggs. Just as they suspected, a similar spike in that toxic TMAO. So it’s not just red meat. And the link between TMAO levels in the blood and strokes, heart attacks, and death was seen even in low-risk groups like those with low-risk cholesterol levels. Thus, because of the choline, eating eggs may increase our risk regardless of what our cholesterol is.

It’s ironic that the choline content of eggs is something the egg industry actually boasts about. And the industry is aware of the cancer data. Through the Freedom of Information Act, I was able to get my hands on an email (which you can view in my video, Eggs, Choline, and Cancer) 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,” he said, “as we continue to promote choline as another good reason to consume eggs.”

 

With regard to the prevention of prostate cancer progression, chicken and eggs may be the worst foods to eat, but what might be the best? See my video Prostate Cancer Survival: The A/V Ratio.

To prevent prostate cancer in the first place, see videos such as:

What about reversing cancer progression? See Dr. Ornish’s work Cancer Reversal Through Diet?, followed up by the Pritikin Foundation: Ex Vivo Cancer Proliferation Bioassay. Flax may help as well (Flaxseed vs. Prostate Cancer).

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, and From Table to Able.

Image Credit: Christopher Craig / Flickr

How Eggs Can Impact Body Odor

August 19, 2014 by Michael Greger M.D. in News with 8 Comments

How Eggs Can Impact Body Odor

I previously lampooned the egg industry PR campaign that tried to promote eggs as a source of eyesight-saving nutrients such as lutein, by noting that a single spoonful of spinach had as much as nine eggs (see Egg Industry Blind Spot). The reason we’ll only hear that egg industry claim on websites and TV shows, and never in an ad or on an egg carton, is because there are laws against false and misleading advertising that don’t allow the industry to say eggs contain lutein because there’s such an insignificant amount.

In an email I retrieved through the Freedom of Information Act (you can see the email in my video Eggs and Choline: Something Fishy), the head of the USDA’s poultry research and promotion programs reminded the egg industry that they can’t mention lutein in an egg ad. They can’t say it helps people with macular degeneration, and can’t even talk about how good lutein is for us since “eggs have such a wee amount, and given eggs’ fat and cholesterol content this is a nonstarter for anything but PR.” So for public relations, companies can lie through your teeth, but there are laws covering truthfulness in ads.

The industry can’t say eggs are a source of omega 3s, iron, or folate either. They can’t even honestly call eggs a rich source of protein. The USDA Agriculture Marketing Service suggested that the egg industry instead boast about the choline content of eggs, one of only two nutrients that eggs are actually rich in, besides cholesterol.

So the egg industry switched gears. A priority objective of the American Egg Board became “to make choline out to be an urgent problem and eggs the solution.” They outlined how they could partner with a physician’s group and write an “advertorial.” They developed a number of them for nutrition journals. An advertorial is an advertisement parading as an objective editorial. They sent letters out to doctors arguing that “inadequate intake of choline has tremendous public health implications.” So forget about the cholesterol—the “elephant-in-the-room,” as the industry calls it—and focus on this conjured epidemic of choline deficiency.

People actually get about twice the choline they need and, in fact, too much choline can be the real problem. For one thing, too much choline can give breath, urine, sweat, saliva, and vaginal secretions an odor resembling rotten fish. Millions of Americans have a genetic defect that causes a fishy body odor and might benefit from a low-choline diet, since choline is converted in our gut into the fishy compound trimethylamine (TMA). Individuals oozing trimethylamine often become vegans because reducing the ingestion of dietary animal products rich in lipids decreases TMA production and the associated noxious odor. The other 99 percent of us, though, can turn the fishy choline compound into trimethylamine oxide, which is 100 times less stinky. We used to think extra choline was harmless for the 99 percent, but not anymore.

Researchers at the Cleveland Clinic found that dietary choline (after it is converted in our gut to trimethylamine and oxidized in our liver to form trimethylamine oxide) may contribute to plaque build-up in people’s arteries. This may set us up for heart disease, stroke, and death. Which foods is choline predominantly found in? Eggs, milk, liver, red meat, poultry and fish.

The good news is that this may mean a new approach to prevent or treat heart disease, the most obvious of which would be to limit dietary choline intake. But if that means decreasing egg, meat and dairy consumption, then the new approach sounds an awful lot like the old approach – adopting a plant-based diet.

Choline may be one of the reasons people following the Atkins diet are at increased risk of heart disease whereas a more plant-based diet like Ornish’s can instead reverse our number one killer (see Low Carb Diets and Coronary Blood Flow). This new research adds choline to the list of dietary culprits with the potential to increase the risk of heart disease, making eggs a double whammy—the most concentrated common source of both choline and cholesterol.

I previously did a more in depth dive into the choline issue in Carnitine, Choline, Cancer and Cholesterol: The TMAO Connection.

More on eggs and cholesterol in Egg Cholesterol in the Diet and Avoiding Cholesterol Is a No Brainer.

More Freedom of Information Act finds in Eggs and Cholesterol: Patently False and Misleading Claims, Eggs vs. Cigarettes in Atherosclerosis, and probably my favorite, Who Says Eggs Aren’t Healthy or Safe?

What else might make one smell fishy? See Bacterial Vaginosis and Diet.

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my 2012-2013 live year-in-review presentation Uprooting the Leading Causes of Death and 2013-2014 From Table to Able.

Image Credit: Shannara00 / Flickr

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