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 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.
Image Credit: Shannara00 / Flickr