Too much choline, a compound concentrated in eggs and other animal products, can make bodily secretions smell like rotting fish and may increase the risk of heart disease due to conversion in the gut to trimethylamine.
Images thanks to MrX via Wikimedia Commons.
If you remember, I lampooned the egg industry PR campaign trying to promote eggs as a source of eyesight saving nutrients such as lutein by noting the amount found in a single spoonful of spinach had as much as nine eggs. The reason you'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. This is an email retrieved through the Freedom of Information Act from the head of the USDA's poultry research and promotion programs reminding the egg industry that they can't mention lutein in an egg ad. Can't say it helps people with macular degeneration. Can't even talk about how good lutein is for you 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 you can lie through your teeth, but there're laws covering truthfulness in ads.
Also can't say eggs are a source of omega 3s,or a source of iron or folate. Can't even honestly call eggs a rich source of protein. The USDA Agriculture Marketing Service suggested the egg industry instead boast about the choline content in eggs, one of the only two nutrients 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.’ Maybe they could partner with a physician's group and write an advertorial. They developed a number of "advertorials" 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.
Turns out most people get about twice what they need and, in fact, too much choline may be the real problem. For one thing, too much choline can give your breath, urine, sweat, saliva, and vaginal secretions an odor resembling rotten, dead 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).In fact, individuals oozing trimethylamine often become vegans, as reducing the ingestion of dietary animal products rich in lipids decreases TMA production and the associated noxious odor. The other 99% 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 OK for the 99%, but not anymore.
Researchers at the Cleveland Clinic found that dietary choline, found predominantly in eggs, milk, liver, red meat, poultry, and fish, (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 peoples’ arteries. This may set us up for heart disease, stroke, death, and cardiac surgery.
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.
Choline may be one of the reasons people following the Atkins diet are at increased risk of heart disease whereas a plant-based diet like Ornish’s can instead reverse our number one killer. 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.
To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Ariel Levitsky.
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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 juiciness in Eggs and Cholesterol: Patently False and Misleading Claims, Eggs vs. Cigarettes in Atherosclerosis, and my latest live presentation More Than an Apple a Day: Combating Common Diseases.
What else might make you smell fishy? See Bacterial Vaginosis and Diet.
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