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.
Eggs and Choline: Something Fishy
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
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 that 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 advertisement 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, 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, warning about “inadequate intake of choline” having “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 odour.” The other 99% of us, though, can turn the fishy choline compound into trimethylamine oxide, which is a hundred times less stinky. We used to think the extra choline was okay for the 99%, but not anymore.
Researchers at the Cleveland Clinic found 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 buildup in peoples’ arteries, and set us up for heart disease, stroke, death, and, if that’s not bad enough, open-heart 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) can instead reverse our #1 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.
Please consider volunteering to help out on the site.
- N. D. Ferrari III, L. S. Nield. Smelling like dead fish: A case of trimethylaminuria in an adolescent. Clin Pediatr (Phila) 2006 45(9):864 - 866.
- M. Johansson, B. Van Guelpen, S. E. Vollset, J. Hultdin, A. Bergh, T. Key, O. Midttun, G. Hallmans, P. M. Ueland, P. Stattin. One-carbon metabolism and prostate cancer risk: Prospective investigation of seven circulating B vitamins and metabolites. Cancer Epidemiol. Biomarkers Prev. 2009 18(5):1538 - 1543.
- C. Nanni, E. Zamagni, M. Cavo, D. Rubello, P. Tacchetti, C. Pettinato, M. Farsad, P. Castellucci, V. Ambrosini, G. C. Montini, A. Al-Nahhas, R. Franchi, S. Fanti. 11C-choline vs. F-FDG PET/CT in assessing bone involvement in patients with multiple myeloma. World J Surg Oncol 2007 5:68.
- E. L. Richman, S. A. Kenfield, M. J. Stampfer, E. L. Giovannucci, S. H. Zeisel, W. C. Willett, J. M. Chan. Choline intake and risk of lethal prostate cancer: Incidence and survival. Am. J. Clin. Nutr. 2012 96(4):855 - 863.
- H. U. Rehman. Fish odour syndrome. Postgrad Med J. 1999 75(886):451 - 452.
- Z. Wang, E. Klipfell, B. J. Bennett, R. Koeth, B. S. Levison, B. Dugar, A. E. Feldstein, E. B. Britt, X. Fu, Y.-M. Chung, Y. Wu, P. Schauer, J. D. Smith, H. Allayee, W. H. W. Tang, J. A. DiDonato, A. J. Lusis, S. L. Hazen. Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease. Nature 2011 472(7341):57 - 63.
- K. Rak, D. J. Rader. Cardiovascular disease: The diet-microbe morbid union. Nature 2011 472(7341):40 - 41.
- M. G. Busby, L. Fischer, K.A. da Costa, D. Thompson, M.H. Mar, S. H. Zeisel. Choline- and betaine-defined diets for use in clinical research and for the management of trimethylaminuria. J Am Diet Assoc 2004 104(12):1836 - 1845.
- J. E. Lee, E. Giovannucci, C. S. Fuchs, W. C. Willett, S. H. Zeisel, E. Cho. Choline and betaine intake and the risk of colorectal cancer in men. Cancer Epidemiol. Biomarkers Prev. 2010 19(3):884 - 887.
- Choline: There's something fishy about this vitamin. Harv Health Lett 2004 30(1):3.
- E. Ackerstaff, B. R. Pflug, J. B. Nelson, Z. M. Bhujwalla. Detection of increased choline compounds with proton nuclear magnetic resonance spectroscopy subsequent to malignant transformation of human prostatic epithelial cells. Cancer Res. 2001 61(9):3599 - 3603.
Images thanks to MrX via Wikimedia
- ácidos biliares
- ácidos grasos omega-3
- alimentación a base de vegetales
- apoplejía
- carne
- carne roja
- cirugía
- colesterol
- colina
- comida de mar
- Comité Estadounidense del Huevo
- degeneración macular
- dieta Atkins
- Dr. Dean Ornish
- enfermedad cardiaca
- enfermedad cardiovascular
- flora intestinal
- folato
- grasa
- grasa de origen animal
- grasa saturada
- halitosis
- hierro
- huevos
- influencia de la industria
- lácteos
- leche
- Ley de Libertad de Información
- luteína
- mal aliento
- microbioma
- mortalidad
- olor corporal
- pavo
- pescado
- pollo
- productos avícolas
- productos de origen animal
- proteína
- proteína de origen animal
- salud ocular
- salud vaginal
- USDA
- veganos
- vegetarianos
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
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 that 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 advertisement 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, 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, warning about “inadequate intake of choline” having “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 odour.” The other 99% of us, though, can turn the fishy choline compound into trimethylamine oxide, which is a hundred times less stinky. We used to think the extra choline was okay for the 99%, but not anymore.
Researchers at the Cleveland Clinic found 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 buildup in peoples’ arteries, and set us up for heart disease, stroke, death, and, if that’s not bad enough, open-heart 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) can instead reverse our #1 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.
Please consider volunteering to help out on the site.
- N. D. Ferrari III, L. S. Nield. Smelling like dead fish: A case of trimethylaminuria in an adolescent. Clin Pediatr (Phila) 2006 45(9):864 - 866.
- M. Johansson, B. Van Guelpen, S. E. Vollset, J. Hultdin, A. Bergh, T. Key, O. Midttun, G. Hallmans, P. M. Ueland, P. Stattin. One-carbon metabolism and prostate cancer risk: Prospective investigation of seven circulating B vitamins and metabolites. Cancer Epidemiol. Biomarkers Prev. 2009 18(5):1538 - 1543.
- C. Nanni, E. Zamagni, M. Cavo, D. Rubello, P. Tacchetti, C. Pettinato, M. Farsad, P. Castellucci, V. Ambrosini, G. C. Montini, A. Al-Nahhas, R. Franchi, S. Fanti. 11C-choline vs. F-FDG PET/CT in assessing bone involvement in patients with multiple myeloma. World J Surg Oncol 2007 5:68.
- E. L. Richman, S. A. Kenfield, M. J. Stampfer, E. L. Giovannucci, S. H. Zeisel, W. C. Willett, J. M. Chan. Choline intake and risk of lethal prostate cancer: Incidence and survival. Am. J. Clin. Nutr. 2012 96(4):855 - 863.
- H. U. Rehman. Fish odour syndrome. Postgrad Med J. 1999 75(886):451 - 452.
- Z. Wang, E. Klipfell, B. J. Bennett, R. Koeth, B. S. Levison, B. Dugar, A. E. Feldstein, E. B. Britt, X. Fu, Y.-M. Chung, Y. Wu, P. Schauer, J. D. Smith, H. Allayee, W. H. W. Tang, J. A. DiDonato, A. J. Lusis, S. L. Hazen. Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease. Nature 2011 472(7341):57 - 63.
- K. Rak, D. J. Rader. Cardiovascular disease: The diet-microbe morbid union. Nature 2011 472(7341):40 - 41.
- M. G. Busby, L. Fischer, K.A. da Costa, D. Thompson, M.H. Mar, S. H. Zeisel. Choline- and betaine-defined diets for use in clinical research and for the management of trimethylaminuria. J Am Diet Assoc 2004 104(12):1836 - 1845.
- J. E. Lee, E. Giovannucci, C. S. Fuchs, W. C. Willett, S. H. Zeisel, E. Cho. Choline and betaine intake and the risk of colorectal cancer in men. Cancer Epidemiol. Biomarkers Prev. 2010 19(3):884 - 887.
- Choline: There's something fishy about this vitamin. Harv Health Lett 2004 30(1):3.
- E. Ackerstaff, B. R. Pflug, J. B. Nelson, Z. M. Bhujwalla. Detection of increased choline compounds with proton nuclear magnetic resonance spectroscopy subsequent to malignant transformation of human prostatic epithelial cells. Cancer Res. 2001 61(9):3599 - 3603.
Images thanks to MrX via Wikimedia
- ácidos biliares
- ácidos grasos omega-3
- alimentación a base de vegetales
- apoplejía
- carne
- carne roja
- cirugía
- colesterol
- colina
- comida de mar
- Comité Estadounidense del Huevo
- degeneración macular
- dieta Atkins
- Dr. Dean Ornish
- enfermedad cardiaca
- enfermedad cardiovascular
- flora intestinal
- folato
- grasa
- grasa de origen animal
- grasa saturada
- halitosis
- hierro
- huevos
- influencia de la industria
- lácteos
- leche
- Ley de Libertad de Información
- luteína
- mal aliento
- microbioma
- mortalidad
- olor corporal
- pavo
- pescado
- pollo
- productos avícolas
- productos de origen animal
- proteína
- proteína de origen animal
- salud ocular
- salud vaginal
- USDA
- veganos
- vegetarianos
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Eggs and Choline: Something Fishy
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URLNota del Doctor
I previously did a more in-depth dive into the choline issue in Carnitine, Choline, Cancer, & Cholesterol: The TMAO Connection. For more on eggs and cholesterol, see Egg Cholesterol in the Diet and Avoiding Cholesterol Is a No-Brainer.
More Freedom of Information Act juiciness in Eggs and Cholesterol: Patently False & 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 & Diet.
For more context, check out my associated blog post: How Eggs Can Impact Body Odor.
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