Eggs, Choline, & Cancer

Eggs, Choline, & Cancer
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Choline may be the reason egg consumption is associated with prostate cancer progression and death.

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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.

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 your five-year survival is practically guaranteed. But, once it really starts spreading, your chances drop to one in three. “Thus, identification of modifiable factors that affect the progression of prostate cancer” is something that deserves study. 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 increase [in the risk of] prostate cancer progression.” The only thing worse was poultry consumption—up to four times the risk of progression among high-risk men. They think it might be the meat carcinogens—the heterocyclic amines—that, for some reason, 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? It may be the choline. “A plausible mechanism that may explain [the]… association between eggs and prostate cancer progression is high dietary choline.” 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 then having it spread, and, also, having it kill you.

“Choline intake and the risk of lethal prostate cancer.” Choline consumption associated not just with getting cancer, and spreading cancer—but also, significantly increased risk of dying from it. Those that ate the most had “a 70% increased risk of lethal prostate cancer.” Another recent study found that “[m]en who consumed 2.5 or more eggs per week [that’s just like one egg every three days] had an 81% increased risk of lethal prostate cancer.” Now, it could just be the cholesterol in eggs that’s increasing fatal cancer risk; but, it could also be that choline.

Maybe that’s why meat, milk, and eggs have all been associated, at one time or another, with advanced prostate cancer—because of the choline. In fact, choline is so concentrated in cancer cells, if you follow choline uptake, you can track the spread of cancer through the body. But, why may dietary choline increase the risk of lethal prostate cancer? Remember, dietary choline is converted in the gut into trimethylamine. And so, the Harvard researchers speculated that the TMAO “from the high dietary choline [intake] may increase inflammation, and this may promote progression of prostate cancer to lethal disease.”

In the New England Journal of Medicine, that same Cleveland Clinic research team that did the famous study on carnitine repeated the study. But this time, instead of feeding people a steak, they fed people some hard-boiled eggs. And, 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 attack, and death was seen even in low-risk groups, like those with low-risk cholesterol levels. So, eating eggs may increase our risk, regardless of what our cholesterol is, because of the choline.

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 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.”

Please consider volunteering to help out on the site.

Images thanks to MrX via Wikimedia

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.

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 your five-year survival is practically guaranteed. But, once it really starts spreading, your chances drop to one in three. “Thus, identification of modifiable factors that affect the progression of prostate cancer” is something that deserves study. 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 increase [in the risk of] prostate cancer progression.” The only thing worse was poultry consumption—up to four times the risk of progression among high-risk men. They think it might be the meat carcinogens—the heterocyclic amines—that, for some reason, 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? It may be the choline. “A plausible mechanism that may explain [the]… association between eggs and prostate cancer progression is high dietary choline.” 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 then having it spread, and, also, having it kill you.

“Choline intake and the risk of lethal prostate cancer.” Choline consumption associated not just with getting cancer, and spreading cancer—but also, significantly increased risk of dying from it. Those that ate the most had “a 70% increased risk of lethal prostate cancer.” Another recent study found that “[m]en who consumed 2.5 or more eggs per week [that’s just like one egg every three days] had an 81% increased risk of lethal prostate cancer.” Now, it could just be the cholesterol in eggs that’s increasing fatal cancer risk; but, it could also be that choline.

Maybe that’s why meat, milk, and eggs have all been associated, at one time or another, with advanced prostate cancer—because of the choline. In fact, choline is so concentrated in cancer cells, if you follow choline uptake, you can track the spread of cancer through the body. But, why may dietary choline increase the risk of lethal prostate cancer? Remember, dietary choline is converted in the gut into trimethylamine. And so, the Harvard researchers speculated that the TMAO “from the high dietary choline [intake] may increase inflammation, and this may promote progression of prostate cancer to lethal disease.”

In the New England Journal of Medicine, that same Cleveland Clinic research team that did the famous study on carnitine repeated the study. But this time, instead of feeding people a steak, they fed people some hard-boiled eggs. And, 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 attack, and death was seen even in low-risk groups, like those with low-risk cholesterol levels. So, eating eggs may increase our risk, regardless of what our cholesterol is, because of the choline.

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 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.”

Please consider volunteering to help out on the site.

Images thanks to MrX via Wikimedia

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. I cover more about this in Carnitine, Choline, Cancer, & Cholesterol: The TMAO Connection. In Eggs & Choline: Something Fishy, I talk about what trimethylamine might do to one’s body odor.

For even more on TMAO, see: 

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 Prostate Cancer Survival: The A/V Ratio.

For more on the heterocyclic amines in chicken and eggs, see:

To prevent prostate cancer in the first place, see:

What about reversing cancer progression? Learn about Dr. Ornish’s work in Cancer Reversal through Diet?, followed up by the Pritikin Foundation (see Ex Vivo Cancer Proliferation Bioassay). Flax may help, as well (see Flax Seeds vs. Prostate Cancer).

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

If you haven’t yet, you can subscribe to my videos for free by clicking here.

106 responses to “Eggs, Choline, & Cancer

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  1. 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!

  2. 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

      1. Gut bacteria in meat eaters was found to convert carnitine and choline into TMAO and increases your risk of heart disease and cancers.. Check out this vid from Dr.Greger!
        http://nutritionfacts.org/video/carnitine-choline-cancer-and-cholesterol-the-tmao-connection/

        The same gut bacteria are not fostered in people eating mostly plant based. But you can develop that gut flora that does that conversion of choline to TMAO if you start/keep eating meat as opposed to having gut bacteria that prefers all the fibre for example in plant based diets.. All covered in the video! Check it out! :)

    1. 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.

  3. 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.

    1. 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

    2. Gut bacteria in meat eaters was found to convert carnitine and choline into TMAO and increases your risk of heart disease and cancers.. Check out this vid from Dr.Greger!
      http://nutritionfacts.org/video/carnitine-choline-cancer-and-cholesterol-the-tmao-connection/

      The same gut bacteria are not fostered in people eating mostly plant based. But you can develop that gut flora that does that conversion of choline to TMAO if you start/keep eating meat as opposed to having gut bacteria that prefers all the fibre for example in plant based diets.. All covered in the video! Check it out! :)

  4. So – stay away from choline if you are concerned about prostate cancer?

    Do the benefits outweigh the risks?

    Source list found at

    http://www.whfoods.com/genpage.php?tname=nutrient&dbid=50

    What can high-choline foods do for you?

    Keep your cell membranes, the gates through which nutrients enter and wastes leave your cells, functioning properly

    Allow your nerves to communicate with your muscles

    Prevent the build-up of homocysteine in your blood. Homocysteine is a
    harmful compound that is associated with cardiovascular disease and
    osteoporosis.

    Reduce chronic inflammation
    ——————————————
    What events can indicate a need for more high-choline foods?

    Fatigue

    Insomnia

    Poor ability of the kidneys to concentrate urine

    Accumulation of fats in the blood

    Nerve-muscle problems
    ——————————————–
    World’s
    Healthiest Foods rich in
    choline

    FoodCals%Daily Value

    Eggs,
    pasture-raised7826.5%

    Chicken18722.7%

    Turkey15322.5%

    Scallops12721.6%

    Shrimp11221.5%

    Beef,
    grass-fed17517.3%

    Sardines18916%

    Collard
    Greens4914.2%

    Swiss
    Chard3511.8%

    Cauliflower2711.1%

    1. Gut bacteria in meat eaters was found to convert carnitine and choline into TMAO and increases your risk of heart disease and cancers.. Check out this vid from Dr.Greger!
      http://nutritionfacts.org/video/carnitine-choline-cancer-and-cholesterol-the-tmao-connection/

      The same gut bacteria are not fostered in people eating mostly plant based. But you can develop that gut flora that does that conversion of choline to TMAO if you start/keep eating meat as opposed to having gut bacteria that prefers all the fibre for example in plant based diets.. All covered in the video! Check it out! :)

      1. Tharun, TMA is produced by gut bacteria, but TMAO, the oxidized metabolite, is produced by the liver, then dumped back into the bloodstream to attach itself to the endothelium. Almost like Velcro™, TMAO deposits grab circulating cholesterol, and began plaque formation. By that mechanism, TMAO greatly enhances the rate of plaque formation.

    1. From what I have heard, most people (at least Americans) are deficient in choline. If we are to believe that the AI of choline for men is 550mg/day, then only about 10% of Americans are getting an adequate intake. If there is a problem when consuming an AI of this nutrient, it’s imperative that health professionals resolve this issue.

      1. JonGrant: Not to come between your conversation with Rami, but I thought you would be interested in the quote below. To preface, I don’t know if I believe claims about Americans in general being deficient in choline. It may be true, but I haven’t seen any evidence of that that I find compelling.
        .
        Dr. Greger has recommended the book, Becoming Vegan, for when people have questions about specific nutrients. The Express Edition of the book has this to say on page 118:
        .
        “Choline has hopped back and forth across the line between vitamin–and therefore essential–and nonvitamin. That’s because the body can produce sufficient choline unless a person’s diet is short on folate, vitamin B12, and the amino acid methoionine. … Women should get 425 mg choline per day, and men should get 500 mg. … There are plenty of good sources of choline. A few that are particularly rich are beans, broccoli, peas, quinoa, and soy foods.”
        .
        In other words, even if you are relying on getting choline from your diet, there are safe and healthy and plentiful foods for consuming it. And then there is the idea that our bodies can make choline as needed (unless we aren’t getting adequate nutrients that are necessary for that process). I just don’t see how it would be that America is suffering from a big deficiency problem. What do you think?

      2. My perspective regarding the “rda” requirements for choline is that it is total bs. It seems it’s another manufactured epidemic. It if that were true, 90% of the populations would be walking around like zombies. Again, if everyone did have deficiencies, vegans still live the longest and the healthiest. I’ve read again and again that “lots” of grains beans nuts fruits is the prescription for nearly everything under the sun and when I say lots I mean lots…….B12 and Omega 3’s and perhaps iodine supplements are the only extras. I’m not including choline supplements just yet unless the vegan scientists concur.

    1. Gut bacteria in meat eaters was found to convert carnitine and choline into TMAO and increases your risk of heart disease and cancers.. Check out this vid from Dr.Greger!
      http://nutritionfacts.org/video/carnitine-choline-cancer-and-cholesterol-the-tmao-connection/

      The same gut bacteria are not fostered in people eating mostly plant based. But you can develop that gut flora that does that conversion of choline to TMAO if you start/keep eating meat as opposed to having gut bacteria that prefers all the fibre for example in plant based diets.. All covered in the video! Check it out! :)

    1. Gut bacteria in meat eaters was found to convert carnitine and choline into TMAO and increases your risk of heart disease and cancers.. Check out this vid from Dr.Greger! It has the answers you’re looking for!
      http://nutritionfacts.org/video/carnitine-choline-cancer-and-cholesterol-the-tmao-connection/

      The same gut bacteria are not fostered in people eating mostly plant based. But you can develop that gut flora that does that conversion of choline to TMAO if you start/keep eating meat as opposed to having gut bacteria that prefers all the fibre for example in plant based diets.. All covered in the video! Check it out! :)

    1. 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.

      1. 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.

        1. 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.

    2. Gut bacteria in meat eaters was found to convert carnitine and choline into TMAO and increases your risk of heart disease and cancers.. Check out this vid from Dr.Greger! It has the answers you’re looking for!
      http://nutritionfacts.org/video/carnitine-choline-cancer-and-cholesterol-the-tmao-connection/

      The same gut bacteria are not fostered in people eating mostly plant based. But you can develop that gut flora that does that conversion of choline to TMAO if you start/keep eating meat as opposed to having gut bacteria that prefers all the fibre for example in plant based diets.. All covered in the video! Check it out! :)

  5. 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?

    1. Gut bacteria in meat eaters was found to convert carnitine and choline into TMAO and increases your risk of heart disease and cancers.. Check out this vid from Dr.Greger! It has the answers you’re looking for!
      http://nutritionfacts.org/video/carnitine-choline-cancer-and-cholesterol-the-tmao-connection/

      The same gut bacteria are not fostered in people eating mostly plant based. But you can develop that gut flora that does that conversion of choline to TMAO if you start/keep eating meat as opposed to having gut bacteria that prefers all the fibre for example in plant based diets.. All covered in the video! Check it out! :)

  6. 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?

  7. 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.

  8. 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

    1. Thats funny, the Standard American Diet is comprised of people eating meat, cheese, dairy, and/or eggs three times a day everyday. Choline deficient??? hahaha Maybe we should eat it 6 times a day then. Sound good?

  9. 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..

      1. 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’.

        1. 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.

          1. 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.

  10. 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….

    1. 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.

      1. 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.

        1. 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.

          1. 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.

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

  11. 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.

  12. 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

    1. The association with decreased breast cancer risk was described as being of “borderline significance” only. Further, the second highest quintile for choline consumption was reported as having increased risk of breast cancer compared to the lowest quintile.

    1. 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

  13. 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.

  14. 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

    1. Sam: You wrote that Asians eat a lot of tuna. You did not cite a source for this information, nor quantify what “a lot” means. I have something for you think about:
      .
      The healthiest Asian population is the traditional Okinawans. They are known for having a large number of 100+ year olds, who are doing very well health-wise. The following post from Rami shows the break down of the traditional Okinawan diet: http://nutritionfacts.org/video/paleolithic-lessons/#comment-845250941

      In that post, you can see that only 1 percent of their calories came from fish. If you add up all sources of animal products, you still end up with less than 4% of calories. I would not define that amount as “a lot”.

      It’s interesting to note that 69% of their calories came from sweet potatoes and if you want to look at macronutrients, 85% of their calories were from carbohydrates. Interesting stuff!

        1. Sam: I would have just referred you to the link you already found. (Good for you for finding that page.)

          The questions to ask would be: Is the guy accurate/correct? Were reliable tests done? And: What exactly was his diet? Because “vegan” does not tell us much. I’m not asking to analyze his diet. I’m just saying that if this guy you mention wants to figure out the issue, those are the areas he might look into.

      1. Thea, here is the reference you were asking about:
        http://www.huffingtonpost.com/dan-buettner/okinawa-blue-zone_b_7012042.html

        “Before 1940 Okinawans also consumed fish at least three times per week together withseven servings of vegetables and maybe one or two servings of grain perday. They also ate two servings of flavonoid-rich soy, usually in the form of tofu. They didn’t eat much fruit; they enjoyed a few eggs a
        week. Dairy and meat represented only about 3 percent of their calories.
        On special occasions, usually during the Lunar New Year, people
        butchered the family pig and feasted on pork.

        The meat in their diet gave me pause. When I first struck off on my Blue Zones research in 2000, I was absolutely convinced that I’d find that a vegan diet yielded the greatest health and life expectancy. So when I
        discovered that older Okinawans not only ate pork but loved it, I
        thought their example must be an outlier — that they were living long despite pork. Pork is high in saturated fat, which, when consumed in excess, often leads to heart disease. But again, we learn a few lessons.
        Okinawans stewed the pork for days, cooking out and skimming off the
        fat. What they ate, in the end, was the high-protein collagen.”

        1. Sam: Thanks for the reference. If you look analyze the article, you can see even with his own numbers, the Okinawans were eating minuscule amounts of animal products. Then he throws in statements that appear to contradicts the data he displays, but those statements are not backed up by data/studies.

          For example, “fish 3 times a week”. I wonder where that comes from. If true, it would have had to have been *tiny* amounts of fish. Even one ounce of fish seems to exceed the amounts a traditional Okinawan ate in a day if you go a by a study done in 1919. And fish would not be the only protein source. There would have been a lot of protein from all the other foods. So, the amount of protein the person could have gotten from fish would be extremely small.

          Study done in 1919? Check out the 1:40 mark in this video: http://plantpositive.squarespace.com/blog/2012/3/25/tpns-32-ancient-and-out-of-fashion.html Then, if you want to understand the numbers I’m discussing, bring up say 1 ounce of a fish (cod or salmon) on the Nutrition Self website to see how much protein and fat the animal product has in grams: http://nutritiondata.self.com/

          So, we have a study done in 1919 and a study done in 1949 showing that animal products were a very small part of the traditional Okinawan diet. Where the author of your article went with that information is baffling to me.

      2. “The second demonstrated that high intakesof milk and fats and oils had favourable effects on ten-year survivorship in 422 urban residents aged sixty-nine to seventy-one. The survivors revealed a longitudinal increase in intakes of animal foods such as eggs, milk, fish and meat over the ten years. In the third study, nutrient intakes were compared between a sample from Okinawa Prefecture where life expectancies at birth and sixty-five were the longest in Japan, and a sample from Akita Prefecture where the life expectancies were much shorter. It found that the proportion of energy from proteins and fats were significantly higher in the former than in the latter. ”

        Shibata H., Nagai H., Haga H., Yasumura S., Suzuki T., Suyama Y. Nutrition for the Japanese elderly. Nutr & Health.

        “Okinawans eat about 100 grams of meat per day-compared to 70
        in Japan and just over 20 in China-and at least an equal amount of fish,
        for a total of about 200 grams per day, compared to 280 grams per
        personper day of meat and fish in America. ”

        Deborah Franklyn, “Take a Lesson from the People of Okinawa,” Health, September 1996, pp 57-63

        http://stan-heretic.blogspot.com/2009/10/beware-of-okinawa-diet-scam.html

        1. Sam: This has to be a study of modern people since as we have discussed, the traditional Okinawa diet, the one responsible for the exceptional health of their elders has very little meat. However, we know that modern people’s diets have changed dramatically. I don’t have the time to review that study to analyze it, but maybe someone else will do that for you.

  15. I would like to know if eggs with yolks still runny and meats that are not well done but rather medium rare show up differently. Same with the blood type diet approach. It seems to me to chemistry of foods change when they are cooked versus not….and that the reason chicken and eggs show up as so damaging may be because we must cook them hard in order to avoid bacterial problems. I am looking at Hair Analysis material that says eggs (runny yolks) and meat are important to bring body biochemistry back to balance. Please comment. I so appreciate your excellent videos and research and explanations.

  16. No one has answered the question – “does plant based choline cause the same effects,in which case, should you reduce overall intake”

    1. yes, they did. way back. scroll thru the answers from the start as I did. They wont keep answering the same questions time and again!

  17. But there is this… https://www.sciencenews.org/article/treat-heart-start-gut
    a compound — which the researchers found occurs naturally in some olive oils and red wines
    and this
    Choline is an essential nutrient. It helps keep the cells and nerves working normally. While choline is important for good health, most people seem to get enough from food. Vegans may have a higher risk of low choline levels. http://www.webmd.com/vitamins-and-supplements/choline
    I eat WFPB am I at any risk? Please reply without a vegan bias.

  18. I shared this post on Facebook and someone made the following comment… “From what I have read, and I’m not expert, eggs have as much or sometimes less choline than cauliflower, broccoli and soybeans. Why would the study suggest it was the choline from the eggs? Obviously, it’s not the choline, it has to be something else in connection with egg consumption.” I don’t have an answer and was wondering if I could get some help here with this one. (Thanks, love the videos)

    1. fern: Dr. Greger has recommended the book, Becoming Vegan, for when people have questions about specific nutrients. The Express Edition of the book has this to say on page 118:
      .
      “Choline has hopped back and forth across the line between vitamin–and therefore essential–and nonvitamin. That’s because the body can produce sufficient choline unless a persn’ diet is short on folate, vitamin B12, and the amino acid methoionine. … Women should bet 425 mg choline per day, and men should bet 500 mg. … There are plenty of good sources of choline. A few that are particularly rich are beans, broccoli, peas, quinoa, and soy foods.”
      .
      In other words, even if you are relying on getting choline from your diet, there are safe and healthy foods for consuming it. One does not have to resort to eating eggs or any other animal product.

      .
      Does that help?

  19. I have been studying many videos here and recommending the site to many clients.
    My Question revolves around amino acid denaturing with heat. A soft boiled egg contains useable lysine. Boil the egg for another minute to hard state, the lysine is not useable. Lysine is needed for the body to make use of the next 5 most important essential aminoes so that other aminoes can be made by the body. Lysine is denatured at about 110 degrees. As the heat rises to 118 we lose enzymes. At 118 and beyond we lose aminoes. Their little “fingers” get destroyed and the can no longer do their job. Through this heating process we are progressively unable to take our proteins thru the peptide poly-peptide conversion. If our proteins enter the small intestines without this conversion, they begin to produce toxins such as cadaverine, putrescine, indole, skatole, to name a few.
    I’m wondering if these toxins also play a part in some of the markers we’re seeing in these studies.
    I haven’t seen any studies on raw versus cooked protein sources.

    1. Everything in moderation is vague and terrible advice. It’s a nice idea in theory but your idea of moderation can be different to my idea of moderation versus someone who smokes all day or is obese/overweight (much of the population) and for people who don’t meet the dietary guidelines (most people).. “Moderation” is killing people. For example – moderate decreases in cholesterol (from all that meat, dairy, eggs, oils) lead to moderate levels of heart disease/attacks and would still kill millions of people..

      Here’s a vid going through the research: http://nutritionfacts.org/video/everything-in-moderation-even-heart-disease/

      Here’s the transcript for the video. Keen to hear your thoughts!
      “But, as Dr. Esselstyn wrote in Cleveland Clinic Journal of Medicine, in cholesterol lowering, moderation kills. Even if all Americans kept their total cholesterol below 200 mg/dL, millions would develop coronary artery disease. Strong evidence showed we need to keep our total cholesterol under 150 to stem America’s epidemic of coronary artery disease. What kind of evidence? Well, in many cultures, coronary artery disease is practically unheard of when total serum cholesterol levels are under 150 mg/dL. And here in the U.S., in the famous Framingham Heart Study, few of those with levels below 150 developed heart disease, and none died of it.

      Here’s data from the 26-year follow-up of the Framingham Heart Study: the cholesterol levels of people that get heart attacks and the cholesterol levels of those who don’t. Because we now know that 35% of heart attacks occur in people with total cholesterol levels between 150 and 200, and a target level of only 200 guarantees that millions of US citizens will perish of coronary disease.

      We cannot continue to have public and private organizations on the forefront of health leadership recommend to the public a dietary plan that guarantees that millions will perish from the very disease the guidelines were supposed to prevent. With its lack of fiber and antioxidants and its emphasis on animal protein, fat, and extreme free-radical production, the US diet is largely responsible for our bitter harvest of chronic diseases.

      If the coronary artery disease epidemic is seen as a raging fire, and cholesterol and fats are the fuels, the American Heart Association has merely recommended cutting the flow of fuel. The only tenable solution is to cut off the fuel supply altogether–by reducing cholesterol levels to those proven to prevent coronary disease.”

  20. I don’t know if anybody here cares to know but I was eating about 100-150 WHITE eggs / month. 5 WHITE EGGS RAW in a seating after playing soccer for 2 hours..I am 63 by the way….. My PSA started going up significantly from 16 in July/16 thru Set/2016 to 25 when I stopped cold eating egg after being diagnosed with gleason 8 Prostate cancer….After 40 days w/o eggs and of course a number of other things I have done to improve my diet, my PSA is going down. So, I don’t if eggs did it, but I’ll leave it to the biologists to figure it out…You guys out there with the same problem as me, stay away from eggs….georgefrrr@gmail.com

  21. I ate a lot of eggs and poultry early in life and my Gleason 8, invasive, node positive, metastatic prostate cancer started at 35. Because I could not have an MRI due to an old ferromagnetic brain aneurysm clip at age 28 after the aneurysm ruptured, the spread of cancer was not detected before my radical prostate resection at Johns Hopkins, followed by 5 years of treatment at Dana Farber. The medical/surgical treatment was important but being alive at 67 with a undetectable PSA had a lot to do with a vegan diet, with no eggs, poultry, dairy, and other meats. Some people act cavalier at having prostate cancer: “I’ll have my fun and die.” However, they are unaware of the suffering of urinary incontinence(which I resolved with exercises) and permanent sexual impotence.

  22. For those confused.. Gut bacteria in meat eaters was found to convert carnitine and choline into TMAO and increases your risk of heart disease and cancers.. Check out this vid from Dr.Greger!
    http://nutritionfacts.org/video/carnitine-choline-cancer-and-cholesterol-the-tmao-connection/

    The same gut bacteria are not fostered in people eating mostly plant based. But you can develop that gut flora that does that conversion of choline to TMAO if you start/keep eating meat as opposed to having gut bacteria that prefers all the fibre for example in plant based diets.. All covered in the video! Check it out! :)

  23. I’m beyond confused on this one. Was reading an “article” on Facebook about 117 year old woman who contributes her longevity to eating 3 eggs everyday so naturally, I came to this site to read up on eggs. Then I googled and found a research paper from the NIH which, if I’m reading it correctly, seems to indeed suggest that there is a lower risk of breast cancer with higher amounts of Choline intake. Here’s the link to the paper:

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2430758/

    Can someone please explain? Dr. Greger?

    Thanks!

    1. ronen: What is your point? Are you familiar with the phrase “the dose makes the poison”? We need water to survive, but too much water will kill us. The dose/amount of a substance can either make it good for us or is poison… Make sense?

      1. But the aggregate amount of choline that one gets from recommended intake of whole vegetable sources is equivalent to an egg.

        E.g. 7-10 servings of vegetables, containing:
        brussels sprouts, broccoli, spinach, etc., all with significant choline.

  24. I am struggling with this, Dr. Greger is my go to mentor along with Ray Kurzweil. And among the 100 supplements Kurzweil takes the 1 of 3 most important he suggest is phosphatidylcholine. Same thing as the choline in eggs? Help!

  25. Does Dr Gregor have any insight/research into Glutamine and trip neg breast cancer? Recent studies show Glutamine accelerates cell growth in Trip Neg Breast cancer.. would love to know if tjis is indeed true?

    1. Thanks for your comment Linda.

      I found a study published in 2016, which states that:

      Alanine, serine, cysteine-preferring transporter 2 (ASCT2; SLC1A5) is a cell surface solute-carrying transporter that mediates uptake of neutral amino acids including glutamine. Although a non- essential amino acid in normal cells, the demand for glutamine is dramatically increased throughout malignant transformation to support increased metabolic demands; namely, provision of catabolic substrates for ATP production and anabolic substrates for macromolecule biosynthesis.The intracellular glutamine pool is also critical for sustained activation of mTORC1 signalling, a master regulator of cell growth and protein translation, as well as prevention of apoptosis

      To understand what the above research involved, please find an easy to understand summary here.

      Hope this answer helps.

      1. Thank you so much for taking the time to respond. That was very helpful. I noted that although Glutamine in foods can be avoided such as Dairy meat etc… it is also a natural amnio acid in the body. Lucky I am vegan ! Thanks again. Linda

  26. Should vegans be worried about having a choline deficiency? The RDI is 425mg for an adult female and (I think) 500mg/day for an adult male. However, using something like chronometer or SuperTracker seems to yield that a lot of vegans are not getting enough choline and this could have adverse health effects. However, some research suggests that 300mg/day of choline is more than enough… Does anyone have thoughts, comments on this? Does anyone supplement choline? If so what brands do you like?

    1. Thank you for contacting NutritionFacts. I don’t have any number of how much choline you need, but eating a healthy, whole food plant based diet has only been shown to reduce and reverse disease. If you are eating everything on Dr. Greger’s daily dozen, you can only expect health benefits:
      https://nutritionfacts.org/video/dr-gregers-daily-dozen-checklist/
      https://nutritionfacts.org/video/what-diet-should-physicians-recommend/

      There are plant based sources of choline- peanuts, beats, wheat.

      As far as supplements, the only supplements Dr. Greger recommends are vitamin B12, vitamin D if you are not able to get daily direct sunlight, and possibly an omega 3:
      https://nutritionfacts.org/video/dangers-of-dietary-supplement-deregulation/

      NurseKelly
      NutritionFacts Moderator

  27. Can you please explain what research supports claims that egg consumption increases risk of prostate caner? Dr. Greger said that men who consume 2.5 eggs per week or more have an increased risk of dying from prostate cancer of up to 81%. This is a twisted and misleading representation of the facts considering that egg consumption between 0.5 and 1.4 eggs per week yields this result, but if you eat between 1.4 and 2.5, the risk is lower. This makes no sense. Not only that, but the study you’re referring to asks people to fill out food questionnaire every 4 years…not sure how many people can remember past 1 week, much less 4 years. On a separate note, this study does not seem to isolate egg consumption from other animal products, hence you can’t draw these conclusions. Please let me know where I am mistaken. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3232297/

  28. I started consuming eggs for developing muscles since I hardly had any. I don’t eat meat also. After I found the link of choline in eggs and prostate cancer I stopped buying eggs altogether. But while I consumed eggs the idiopathic fungal infection on the skin in my back disappeared. I don’t miss eggs at all because I did not like the taste of eggs anyway.

  29. I’m confused as to why choline is being attacked. Choline is necessary for the structure and function of all cells. Dietary deficiency of choline in humans results in fatty liver, liver damage, and muscle damage. Also, a peer-reviewed study published by the National Institute of Health shows that breast cancer risk was reduced 24% among women with a high dietary intake of choline.

    ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2430758/ ) ( A similar study: http://onlinelibrary.wiley.com/doi/10.1111/cas.12064/abstract )

  30. Are there any studies that can specifically be used to support the claim that Choline obtained from plant sources will have the same learning/memory benefits as someone who simply introduces eggs into their diet? A dietitian referred me to the following study:

    https://academic.oup.com/ajcn/article/105/2/476/4633950

    I assumed such a study might either be cherry-picking or was maybe funded by the egg industry, but I was unable to tell. This seems to be the most referenced study (involving a bunch of men from Finland) to support the claim that eggs are beneficial.

    I was hoping to find a video on the site that might reference this study and put it in context but was unable to locate one.

    As an aside, I often feed my children plant-based meals, but they can get rather picky. I’m wondering if it would be in their best interests to feed them an egg once in a while if they are unwilling to eat other plant foods that contain Choline. Thoughts on this would be appreciated as well!

    Thanks overall!! I love this site and am appreciative for what Dr. Greger and his team have done for my personal health!

    1. Joe,
      Thank you for your questions and for sharing a link to the study. This study is a correlation study and did not control for many confounding factors. It would be interesting to see a study comparing WFPB to the egg group as you suggested. I’m not aware of any such studies, however, you may be interested in checking out the numerous videos correlating Whole Food eating to improved cognition.https://nutritionfacts.org/topics/choline/
      Since animal foods are high in choline, eating a meat based diet may result in too much choline as this video suggests. Excess choline may not increase dementia, but may increase heart disease and cancer. Eating a variety of whole plant foods you can easily get adequate choline, maybe a more optimal amount with the safety of not getting excess choline. Check out the following link for more information on choline content of plant foods and suggestions for planning meals for optimal choline.
      https://vegetariannutrition.net/docs/Choline-Vegetarian-Nutrition.pdf

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