Eggs, Lecithin, Choline & TMAO

By Ben Fuchs | Pharmacist Ben

Summary:
1) Gut bacteria can convert eggs and lecithin into chemicals that are associated with heart disease.
2) These chemicals are also produced by the body they have a long and proven reputation for NON toxicity and perform many vital functions especially for the heart.
3) While elevated blood levels of these substances are associated with heart disease, the body has very efficient mechanisms for clearing them out.
4) If your blood levels of this chemicals are elevated, don’t blame the foods which can very helpful, healthy and nutritionally valuable.
5) If your blood levels of these chemicals are elevated you probably are dealing with a digestive health issue or a detoxification issue and not a food issue.

Earlier this week a study was published in the New England Journal of Medline that has raised quite an internet ruckus.  According to the article, gut bacteria can metabolize substances found in eggs like lecithin, and choline into precursor of something called TMAO which again supposedly is linked to heart disease.  And now the mainstream media, as they tend to do, are making the leap to “eggs and lecithin consumption is associated with heart disease”.

The NEJM study follows fast on the heels of another study, this one released by the Cleveland Clinic that implicated carnitine, an amino acid found in red meat in the production of TMAO.  As with the egg and lecithin study researchers as well as the media again the hastily linked the carnitine derived TMAO with heart disease.

Here’s the problem with drawing these types of conclusions.  First of all, they leave out the important and relevant fact that these substances, (e.g. carnitine, lecithin, choline) that are supposedly so dangerous for the health of your heart in addition to being found in foods,  ARE MADE BY YOUR BODY!   And , researchers advocating  abstinence seem to be unaware of the fact that there is voluminous literature published over the course of at least 50 years that lend credence to these biochemicals  as not only being gentle and benign, but really being very, very important.  They perform numerous vital functions in the body and are beneficial for overall health as well as cardiovascular health.

Is it conceivable, even likely that blood levels of chemicals like TMAO are increased by the ingestion of certain foods and perhaps supplements like choline and carnitine?  Yes.  And no one disputes the possibility, based on their chemistry, that when these chemicals build up in the blood, toxicity, especially heart toxicity, can result (remember however: possible does NOT mean proven!)

The link between the offending cardiotoxic chemical TMAO and eggs and lecithin and choline and meat are bacteria that live in our large intestine.  The critters, generically referred to as “probiotics” feed on these types of foods and readily convert them into precursors which the body then metabolizes into TMAO precursors

Bacteria like fatty nutrients as much as we do!  And bacteria produce waste materials as a function of their digestion of foods just like we do.  Our gut bacteria eat the food we eat and then they poop!  Bacteria poop!  This makes all food is a potential problem.  Eating and digesting can, even under normal healthy circumstances result in the production of these kinds of wastes.  This is why we want to be careful about what and how we eat.  But we do need to eat.

We have trillions of bacterial cells that live with us. And they are our friends!  They make vitamins and purify our blood and help us digest our food.  They make good fats for our digestive tract and the fight yeast and other bacteria and cancer.   And, they need to eat too.   And, they eat what we eat.  In other words, anything we eat is likely to feed these little critters. And one of the things bacteria produce as a result processing and digesting eggs and other foods are TMAO precursors.  They’re the bacterial version of feces.  And like all waste, it’s not supposed to hanging around.  That’s why the body has mechanisms for dealing with these types of chemicals.   The liver has enzymes for processing it and most of it is eliminated very effectively through urine.

The bottom line is if blood levels of TMAO are elevated, eggs are not the issue.  Nor is lecithin or choline or carnitine or any other vitamin or nutrient biochemical.  The issue is bad blood chemistry following a breakdown in digestive tract health that leads to an accumulation of food derived WASTE; it’s not the fault of the food.  If your metabolic and detoxification systems are whacked out and you are accumulating TMAO in the blood, solving the problem by avoiding eggs and lecithin and choline is simplistic and silly.   These supposed bad guys like lecithin and eggs, are not only innocent bystanders, they are motherlodes of nutrients that make your heart strong and health.  Substances like Vitamin A and D and Zinc, the b-complex, choline, essential fats and precious phospholipids.  And meat carnitine is one of the most important, heart- strengthening amino acids you can ingest.  Please, don’t blame these healthy foods.  It’s not their fault. What we need to be doing instead of staying away from these powerful and important foods and supplements is fixing our guts, fixing our digestive systems.

Is elevated TMAO problematic?  Perhaps. The chemistry is right for it.  These kinds of chemicals are unstable and need to be eliminated from the body.  That’s why you have a liver and that’s why you should be careful about how you eat.  But this is a far cry from the claim that eggs or lecithin cause or are even associated with heart disease.