Doctor's Note

If you’re a long-time follower and some of this sounds familiar, it’s because I had to fast-track some of this choline information to offer background for my Dr. Oz Show appearance. A longer video that covers this can be found in Carnitine, Choline, Cancer and Cholesterol: The TMAO Connection. In my last video, Eggs and Choline: Something Fishy, I talked about what trimethylamine might do to one’s body odor.

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 recent video Prostate Cancer Survival: The A/V Ratio.

More on the heterocyclic amines in chicken and eggs in:

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).

For more context, check out my associated blog post: Why the Egg-Cancer Link?

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  • Brian Humphrey

    Great job exampling (the graph really helped) how increase intake of Choline can lead to a spike in TMA levels in throughout the body! Also love the email at the end. Priceless!!
    Thanks again Dr. Greger!

  • Don P

    Is there Choline in egg whites? Does the consumption of egg whites promote the same results?

    • Roberta Peck

      See my comment above, the choline is primarily in the yolk.

    • http://www.eatandbeatcancer.com/ Harriet Sugar Miller

      Is it the methionine in egg whites that might be problematic?

  • SFR53inAZ

    Choline has been touted as good for your memory – and is only in the yolk?
    Is this true and what else can do the job of choline for your memory?
    Thanks

    • Roberta Peck

      There is choline in many plant based sources,only in much lower amounts.

    • Thea

      SFR53inAZ: I highly recommend the book, “Power Foods For the Brain” by Neal D. Barnard, MD. I think that book will answer your questions about the best way to protect your memory. Good luck.

  • Roberta Peck

    Dr.Barry Sears states that the only way to eat eggs is to throw the yolk away since it contains so much aracodonic acid. After I looked up the choline in whites vs yokes, I found that the choline is primarily found in the yolk.

    • Toxins

      Regardless of this fact, egg whites have the potential to raise IGF-1 and should be generally avoided.
      http://nutritionfacts.org/index.php?s=igf-1

    • blackbart

      A scientific advisory from the American Heart Association has favorably evaluated the health impact of dietary omega-6 fats, including arachidonic acid.[21] The group does not recommend limiting this essential fatty acid. In fact, the paper recommends individuals follow a diet that consists of at least 5–10% of calories coming from omega-6 fats, including arachidonic acid. Dietary ‘ARA is not a risk factor for heart disease, and may play a role in maintaining optimal metabolism and reduced heart disease risk. It is, therefore, recommended to maintain sufficient intake levels of both omega-3 and omega-6 essential fatty acids for optimal health.’

      http://en.wikipedia.org/wiki/Arachidonic_acid

  • HemoDynamic, M.D.

    LMAO about TMAO!
    Did you get a Whiff of that?
    (Gotta have some fun these days :)

  • Toxins

    Please view the last video for some reference. Choline is easily attained and most people get too much already.
    http://nutritionfacts.org/video/eggs-and-choline-something-fishy/

  • eva101

    what about choline from soybeans. how much is harmful?

  • otto9n9otto

    Should we also shun radishes (which help prevent prostate cancer) and peas due to the choline content?

    http://nutritiondata.self.com/foods-000144000000000000000-18.html

  • Melissa

    I have a similar question: do high choline plant foods contribute a problem here?

  • Tara D

    Dr Gregor- is it still safe to continue taking my plant derived choline supplement?

    • Toxins

      Based on the evidence, I see no reason to consume supplemental choline, as people get it n far more then adequate amounts through diet alone.

      • http://www.animalliberationaction.org/ Brandon Becker

        I’ve vegan and input my daily food consumption into peacounter.com and found that I can meet or exceed the DRIs on all vitamins/minerals except choline. I don’t see any way I can get to the recommended 550 mg per day for men without a supplement.

        • http://www.animalliberationaction.org/ Brandon Becker

          I just saw this comment from Jack Norris, the creater of peacounter.com, who says on his blog:
          “The USDA database doesn’t include the choline amounts for most foods
          (and so neither does PeaCounter). That is a problem with the whole
          choline issue. But for items that show no choline, I extrapolate from
          other sources. Hopefully the USDA will include them in the future.”

          Therefore, I can’t rely on peacounter.com to determine how much choline I’m getting.

  • Fer M

    1 stalk of broccoli has the same amount of Choline as 1 egg according to nutritiondata.self. Is eating broccoli 2.5 times per week then also not recommended?

  • Tushar Mehta

    hello Michael

    I was reading this article and could not figure out if choline from animal products was found to be a worse offender than choline from veg products. it seems like there is a lt of choline intake from veg products too. I could not quite figure it out so defer to the bigger brain (you!).

    thanks!

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3441112/

  • JD TalBeasy

    Background: I’m 25 years old and in good athletic shape. I weight train 3-4 days a week, while doing cardio at least 6 times a week(2 sprint sessions 4 walking sessions to help increase lipolysis).
    I eat at least 7-12 servings of vegetables a day. Is it still that detrimental to my health to eat 3 whole eggs 5-6 days a week even though I eat them either with 2 pieces of Whole grain bread or 3 servings of vegetables?

    • Toxins

      Being fit, and of good weight is one aspect of good health, but it does not necessarily protect you from chronic disease. Please see Dr. Gregers summary of eggs and view the attached links. There are many ill health attributes with eggs.
      http://nutritionfacts.org/topics/eggs/

  • DanT1945

    I’m wondering, does the choline increase the results from a PSA test. My PSA is always high. Runs about 8. We have done the biopsy thing and there is no issues that can be found. I’m wondering if I eat eggs before the test would it raise the result?? Just thinking out loud.

  • Jen

    Does eating foods containing eggs, like pasta or some breads like banana nut, still have the same effect?

  • blackbart

    Huh….then why does WebMD say only good things about Choline?

    http://www.webmd.com/vitamins-supplements/ingredientmono-436-CHOLINE.aspx?activeIngredientId=436&activeIngredientName=CHOLINE

    And Wikipedia calls it an ‘essential nutrient’?

    ‘Choline must be consumed through the diet for the body to remain healthy.[6] It is used in the synthesis of the constructional components in the body’s cell membranes. Despite the perceived benefits of choline, dietary recommendations have discouraged people from eating certain high-choline foods, such as eggs and fatty meats. The 2005 National Health and Nutrition Examination Survey stated that only 2% of postmenopausal women consume the recommended intake for choline.[7]’

    http://en.wikipedia.org/wiki/Choline

  • Derek Edmunds

    It is sad to see so many believe this propaganda. You often see many nutritionists come at the cholesterol in eggs(which eggs actually contain good cholesterol that can help move out the bad) but now you’re coming at the best thing about eggs? You keep saying you “think” or “it could also” but there is absolutely no supported research directly against choline. HOWEVER, if you believe this crap maybe you should also avoid salmon, shrimp, beef, chicken, cauliflower and many other healthy foods rich in choline. Do some research people and don’t let this guy think for you..

    • Thea

      Derek Edmunds: Yes, the strong recommendation is for people to avoid salmon, shrimp, beef, and chicken if they want the best chances at being healthy. For more information about meat:

      http://nutritionfacts.org/topics/meat/

      • approveds

        Salmon is the best food you can have, and the Queen, and Prince Philip practically live on it. As did the Queen Mother. It is also the main reason they are still working, in their 90’s, when most of their subjects, if they are still alive, are in nursing homes.

        The Queen can tell you every nutrient, vitamin, mineral etc in any food, and what it can do for you. They only use alternative therapy, (apart from operations). The reason salmon is so good for you, is that the pink colour is caused by the food they feed on, as with shrimps, , which is a microalgae called ‘astaxanthin’.

        • Thea

          approveds: This is a site that covers the science of nutrition. Stories about “the Queen” and her offspring, while amusing in a way, are not compelling arguments.

          From a scientific perspective, we know that salmon is very bad for you, just like all fish. Salmon has been specifically studied quite a bit, though, so you will see that particular fish mentioned on this site. You can get an overview of the science concerning fish by looking at this page: http://nutritionfacts.org/topics/fish. If you click through the links and find yourself on a NutritionFacts video page, you can click the ‘sources cited’ button to the right of each video to dive into the actual science if you are interested.

          That topic page on fish is really just the beginning of what we know about the nutritional harms of fish and salmon. To learn more, I invite you to explore the rest of this site. For example, you might look up the problems with animal protein as it relates to cancer.

          One more thought for you: It tickled my funny bone that you mention a microalgae in salmon as being the reason why you think that salmon is healthy. In other words, you think that plants (algae) that get inside the fish is the primary benefit for eating the fish. Funniness aside, consider that food is a package deal. When you eat salmon, you not only get the pink plant benefit, but you also get all the (huge) negatives that come with eating salmon: animal protein, contaminants, saturated fat, cholesterol, and probably others that are not coming to mind right now. We know from many different types of scientific studies that those bad things from salmon override any good things. So, why not get the good things directly (plants) and skip the bad things that comes with the fish package.

          Good luck.

          • approveds

            Are you a vegan, is this site a ‘Vegan Site’, if so it would explain your answers, which have very little to do with science? I understand the Vegan argument, and it has many merits, but it is not real science.

  • Brian R Gard

    Giving up eggs was easy, feel a lot better, I do not know what is wrong with people Whole Plant Foods is the only way to go….

    • approveds

      I have eaten at least four eggs per day since I was ten, sometimes 12 eggs per day. My cholesterol is low, and I am slim.

      • Thea

        approvedds: A lot of people who eat he way you do claim their cholesterol is low, but when they report the actual numbers for total cholesterol and LDL, in fact, the numbers are high. Do you know your actual numbers?

        Anyway, I hope you are the exception and are able to eat so much unhealthy things and still do OK. Just like there are some people who smoke and still do fine. You may have hit the gene lottery.

        • approveds

          You are wrong again, eggs are one of the best foods you can have. They contain lecithin, which breaks down cholesterol. as you know your total cholesterol contains good, and bad cholesterol. I am not an exception, I know more about diet than most people, and it is nothing to do with genes.

          • Thea

            approveds: From your replies, it appears that you have a lot more you could learn about diet if you want to know what the science has to say about it. I invite you to actually look at the information on this site, including topics that cover cholesterol and eggs.

            Hey, did you know that people who have a total cholesterol under 150 *and* an LCD under 70 are virtually heart-attack proof? There really is a safe level of cholesterol cholesterol to have. You can learn more about this topic on this site.

            Good luck.

          • approveds

            Most science now is moving towards the view that high cholesterol levels have nothing to do with health, heart or cancer.

  • link
  • crosswind

    Thanks for posting about TMAO. It’s linked to FMO3 gene mutation. a genetic disorder. 23andme does not test for this gene yet, but they said maybe they will in the future. It’s pretty obvious if we have this mutation, when we eat high choline & carnitine foods. I wonder if heavy metals lke mercury toxicity can trigger this gene. i never noticed an issue until about age 40, when i was diagnosed with MTHFR, CBS, COMT, MAO, double DAO & others. Either Addressing methylation or the overload of metals must have triggered. So, I’m eating low choline now & take charcoal for mold biotoxins & other serious detoxing.

  • plumr

    I have prostate cancer, and my main staple of my diet is eggs. have put on 30 lbs [which I needed]. my psa went from 90 to 1.3 in 6 months

    • Joseph Gonzales R.D.

      Glad to see the PSA fall and you were able to gain weight!

  • Will

    I am a huge fan of your website and am interested in breast cancer, so I looked at another study about choline and saw that greater consumption deceased breast cancer. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2430758/#!po=50.0000

  • approveds

    All this information about eggs on this site is complete nonsense. Eggs do not increase you cholesterol, of increase risk of cancers.

    • Prof Dr S Bakhtiar Choudhary,

      Dear friends, My grand father, and his brothers all lived 100 years, ate daily a whole egg; I suppose just choline is not going to cause cancer or Progression. There are many etiological backgrounds for this. Contrary to this, Yolk is a very rich source of many vitamins and minerals; Eating an egg a day is no problem, mind it choline heat labile and gets denatured soon when you cook. So do not have eat raw egg. dont eat eggs at a time.. enjoy

      • approveds

        Brilliant, eggs are the best food in the World, followed by salmon, and watercress.

  • approveds

    If you want to be healthy, and still be working in your 90’s, then I suggest looking at the diet of the Queen and Prince Philip. They are a living experiment in nutrition. Most of the so called ‘experts’, will not even live into their 90’s let alone be working.

  • Sam

    Not everyone is the same genetically, here is an interesting article that backs up a claim that people with folate mutations require

    additional choline…

    “Overall, our findings indicate that loss-of-function variants in folate-metabolizing
    enzymes strain cellular PC production, possibly via impaired folate-dependent phosphatidylethanolamine-N-methyltransferase (PEMT)-PC synthesis, and suggest that women with these risk genotypes may benefit from choline intakes
    exceeding current recommendations.”

    “Genetic impairments in folate enzymes increase dependence on dietary choline for phosphatidylcholine production at the expense of betaine synthesis.”

    http://www.fasebj.org/content/early/2016/06/28/fj.201500138RR.abstract?maxtoshow=&hits=1&RESULTFORMAT=&title=Folate&andorexacttitle=and&andorexacttitleabs=and&andorexactfulltext=and&searchid=1&usestrictdates=yes&resourcetype=HWCIT&ct

  • Sam

    One more note, Asians eat a lot of tuna, which is meat and is reach in choline.