How to Prevent Ulcerative Colitis with Diet

Preventing Ulcerative Colitis with Diet.jpg

What has driven the dramatic increase in prevalence of the inflammatory bowel disease Crohn's disease in societies that rapidly westernized--a disease practically unknown just a century ago? What has changed in our internal and external environment that has led to the appearance of this horrible disease?

Japan suffered one of the most dramatic increases, and out of all the changing dietary components, animal protein appeared to be the strongest factor. There was an exponential increase in newly diagnosed Crohn's patients and daily animal protein intake, whereas the greater the vegetable protein, the fewer the cases of Crohn's, which is consistent with data showing a more plant-based diet may be successful in both preventing and treating Crohn's disease (See Preventing Crohn's Disease With Diet and Dietary Treatment of Crohn's Disease). But what about other inflammatory bowel diseases?

In the largest study of its kind, shown in my video Preventing Ulcerative Colitis with Diet, 60,000 people were followed for more than a decade. Researchers found that high total protein intake--specifically animal protein--was associated with a significantly increased risk of the other big inflammatory bowel disease, ulcerative colitis. It wasn't just protein in general, but the "association between high protein intake and inflammatory bowel disease risk was restricted to animal protein."Since World War II, animal protein intake has increased not only in Japan but also in all developed countries. This increase in animal protein consumption is thought to explain some of the increased incidence of inflammatory bowel disease in the second half of the 20th century.

Other studies found this as well, but why? What's the difference between animal protein and plant protein? Animal proteins tend to have more sulfur containing amino acids like methionine, which bacteria in our gut can turn into the toxic rotten egg smell gas, hydrogen sulfide. Emerging evidence suggests that sulfur compounds may play a role in the development of ulcerative colitis, a chronic inflammatory disease of the colon and rectum characterized by bloody diarrhea.

The first hint as to the importance of our gut flora was in the 1970's when "analysis of stools showed that their bulk was made up of mostly bacteria, not undigested material." We're pushing out trillions of bacteria a day and they just keep multiplying and multiplying. They do wonderful things for us like create the protective compound, butyrate, from the fiber we eat, but unfortunately, the bacteria may also elaborate toxic products from food residues such as hydrogen sulfide "in response to a high-meat diet."

Hydrogen sulfide is a bacterially derived cell poison that has been implicated in ulcerative colitis. We had always assumed that sulfide generation in the colon is driven by dietary components such as sulfur-containing amino acids, but we didn't know for sure until a study from Cambridge was published. Researchers had folks eat five different diets each with escalating meat contents from vegetarian all the way up to a steak each day. They found that the more meat one ate, the more sulfide; ten times more meat meant ten times more sulfide. They concluded that "dietary protein from meat is an important substrate for sulfide generation by bacteria in the human large intestine."

Hydrogen sulfide can then act as a free radical and damage our DNA at concentrations way below what our poor colon lining is exposed to on a routine basis, which may help explain why diets higher in meat and lower in fiber may produce so-called "fecal water" that causes about twice as much DNA damage. Fecal water is like when researchers make a tea from someone's stool.

The biology of sulfur in the human gut has escaped serious attention until recently. Previously it was just thought of as the rotten egg smell in malodorous gas, but the increase in sulfur compounds in response to a supplement of animal protein is not only of interest in the field of flatology--that is, the formal study of farts--but may also be of importance in the development of ulcerative colitis.

I have several videos on our microbiome, including:

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: illustrator © 123RF.com. This image has been modified.

Original Link

How to Prevent Ulcerative Colitis with Diet

Preventing Ulcerative Colitis with Diet.jpg

What has driven the dramatic increase in prevalence of the inflammatory bowel disease Crohn's disease in societies that rapidly westernized--a disease practically unknown just a century ago? What has changed in our internal and external environment that has led to the appearance of this horrible disease?

Japan suffered one of the most dramatic increases, and out of all the changing dietary components, animal protein appeared to be the strongest factor. There was an exponential increase in newly diagnosed Crohn's patients and daily animal protein intake, whereas the greater the vegetable protein, the fewer the cases of Crohn's, which is consistent with data showing a more plant-based diet may be successful in both preventing and treating Crohn's disease (See Preventing Crohn's Disease With Diet and Dietary Treatment of Crohn's Disease). But what about other inflammatory bowel diseases?

In the largest study of its kind, shown in my video Preventing Ulcerative Colitis with Diet, 60,000 people were followed for more than a decade. Researchers found that high total protein intake--specifically animal protein--was associated with a significantly increased risk of the other big inflammatory bowel disease, ulcerative colitis. It wasn't just protein in general, but the "association between high protein intake and inflammatory bowel disease risk was restricted to animal protein."Since World War II, animal protein intake has increased not only in Japan but also in all developed countries. This increase in animal protein consumption is thought to explain some of the increased incidence of inflammatory bowel disease in the second half of the 20th century.

Other studies found this as well, but why? What's the difference between animal protein and plant protein? Animal proteins tend to have more sulfur containing amino acids like methionine, which bacteria in our gut can turn into the toxic rotten egg smell gas, hydrogen sulfide. Emerging evidence suggests that sulfur compounds may play a role in the development of ulcerative colitis, a chronic inflammatory disease of the colon and rectum characterized by bloody diarrhea.

The first hint as to the importance of our gut flora was in the 1970's when "analysis of stools showed that their bulk was made up of mostly bacteria, not undigested material." We're pushing out trillions of bacteria a day and they just keep multiplying and multiplying. They do wonderful things for us like create the protective compound, butyrate, from the fiber we eat, but unfortunately, the bacteria may also elaborate toxic products from food residues such as hydrogen sulfide "in response to a high-meat diet."

Hydrogen sulfide is a bacterially derived cell poison that has been implicated in ulcerative colitis. We had always assumed that sulfide generation in the colon is driven by dietary components such as sulfur-containing amino acids, but we didn't know for sure until a study from Cambridge was published. Researchers had folks eat five different diets each with escalating meat contents from vegetarian all the way up to a steak each day. They found that the more meat one ate, the more sulfide; ten times more meat meant ten times more sulfide. They concluded that "dietary protein from meat is an important substrate for sulfide generation by bacteria in the human large intestine."

Hydrogen sulfide can then act as a free radical and damage our DNA at concentrations way below what our poor colon lining is exposed to on a routine basis, which may help explain why diets higher in meat and lower in fiber may produce so-called "fecal water" that causes about twice as much DNA damage. Fecal water is like when researchers make a tea from someone's stool.

The biology of sulfur in the human gut has escaped serious attention until recently. Previously it was just thought of as the rotten egg smell in malodorous gas, but the increase in sulfur compounds in response to a supplement of animal protein is not only of interest in the field of flatology--that is, the formal study of farts--but may also be of importance in the development of ulcerative colitis.

I have several videos on our microbiome, including:

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: illustrator © 123RF.com. This image has been modified.

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Where Do You Get Your Fiber?

NF-Sep29 Do Vegetarians get enough Protein?.jpg

Vegetarians and vegans are all too familiar with the question: Where do you get your protein?

Well, we can finally put to rest the question of whether vegetarians get enough protein thanks to a large study that compared the nutrient profiles of about 30,000 non-vegetarians to 20,000 vegetarians and about 5,000 vegans, 5,000 flexitarians (vegetarian most of the time), and 5,000 pescetarians (no meat except fish). The average requirement is 42 grams of protein a day. As you can see in the graph in the video, Do Vegetarians Get Enough Protein, meat eaters get way more than they need, and so does everyone else. Vegetarians and vegans average 70% more protein than the recommendation every day.

It's surprising that there's so much fuss about protein in this country when less than 3% of adults don't make the cut, presumably because they're on extreme calorie-restricted diets and aren't eating enough food period. But 97% of Americans get enough protein.

There is a nutrient, though, for which 97% of Americans are deficient. That nutrient is fiber.

Less than 3% of Americans get even the recommended minimum adequate intake of fiber. That's something we really have to work on.

On average, we get only about 15 grams a day. The minimum daily requirement is 31.5, so we get less than half the minimum. Men are particularly deficient. If we break down intake by age and gender, after studying the diets of 12,761 Americans, the percent of men between ages 14 and 50 getting the minimum adequate intake is zero. (The only nutrient Americans may be more deficient in than fiber is potassium. See 98% of American Diets Potassium Deficient.)

This deficit is stunning in that dietary fiber has been protectively associated in population studies with the risk of diabetes, metabolic syndrome, cardiovascular disease, obesity, and various cancers as well high cholesterol, blood pressure, and blood sugars. Therefore, it is not surprising that fiber is listed as a nutrient of concern reported by the Dietary Guidelines Advisory Committee. Protein is not.

One problem is that most people have no idea what's in their food; more than half of Americans think steak is a significant fiber source. By definition, fiber is only found in plants. There is no fiber in meat, dairy or eggs, and little or no fiber in junk food. Therein lies the problem. Americans should be eating more beans, vegetables, fruits, and whole grains--but how are they doing?

96% of Americans don't eat the minimum recommended daily amount of beans, 96% don't eat the measly minimum for greens, and 99% don't get enough whole grains. Nearly the entire U.S. population fails to eat enough whole plant foods.

Even semi-vegetarians make the fiber minimum, though. Those eating completely plant-based diets triple the average American intake. When closing the fiber gap, you'll want to do it gradually though, no more than about five extra grams a day each week until you can work your way up. But it's worth it. "Plant-derived diets tend to contribute significantly less fat, saturated fat, cholesterol, and food-borne pathogens, while at the same time offering more fiber, folate, vitamin C, and phytochemicals, all essential factors for disease prevention, optimal health, and well being." And the more whole plant foods the better. If we compare the nutritional quality of vegan versus vegetarian, semi-vegetarian, pesco-vegetarian and omnivorous diets, traditional healthy diet indexing systems consistently indicate that the most plant-based diet is the healthiest one.

For more on how S.A.D. the Standard American Diet is, see Nation's Diet in Crisis.

Americans eating meat-free diets average higher intakes of nearly every nutrient. See my video Nutrient-Dense Approach to Weight Management.

Isn't animal protein higher quality protein though? See my videos:

For more on protein, see: Plant Protein Preferable and Prostate Cancer Survival: The A/V Ratio.

And for a few on fiber:

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, From Table to Able, and Food as Medicine.

Image Credit: Nathan Rupert / Flickr

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What is ‘Meat Glue’?

NF-Apr16 What is

The so-called "meat glue enzyme" transglutaminase is used by the meat industry to add value to meat by gluing together smaller scraps into a larger chunk. And it's not just used to make fake steak--the American Meat Institute estimates that it's used in about "eight million pounds of meat every year in the United States." Transglutaminase can be used to cross-link pieces of any type of meat, fish, or meat product, and hence can be used to produce large chunks of virtually intact looking meat or fish out of small meat or fish cuttings. When researchers actually tested for transglutaminase in 20 samples of meat from the supermarket, they found meat glue in only two of the samples--in a sample of salmon and a sample of turkey (See Is Meat Glue Safe?)

Where does meat glue come from? For decades, the sole commercial source of transglutaminase was from the livers of guinea pigs. Now it can be sourced much cheaper. However, the future of meat glue remains uncertain because of "communication difficulties."

One of the reasons the industry uses meat glue enzymes is because, "restructured meat can be made from underutilized portions of the carcasses." For example, you can get away with adding up to 5% tendons to beef, and some people can't tell the difference.

This has raised food safety concerns. There is a "risk that otherwise discarded leftovers of questionable microbial quality could find their way into the reconstituted meat."

One can actually take a microscope and see introduced E. coli O157:H7 along the glue lines where meat pieces were enzymatically attached, which shows that the restructuring process can translocate fecal matter surface contamination into the interior of the meat.

Furthermore, people who have problems with gluten may develop problems when ingesting meat treated with the meat glue enzyme, since it functions as an auto-antigen capable of inducing an autoimmune reaction. (Many gluten reactions may not actually be to gluten, though. See my video Is Gluten Sensitivity Real? and most need not worry about gluten sensitivity. See my video Is Gluten Bad For You?).

Some meat additives, however, may actually improve food safety. See Meat Additives to Diminish Toxicity, Viral Meat Spray and Maggot Meat Spray.

More on E. coli O157:H7 in my video, Meat May Exceed Daily Allowance of Irony. For those interested in the politics of this "Jack-in-the-Box" strain, see my blogs E. coli O145 Ban Opposed by Meat Industry and Supreme Court case: meat industry sues to keep downed animals in food supply. From a population perspective, the E. coli in chicken is more of a concern. See my video Avoiding Chicken To Avoid Bladder Infections.

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, and From Table to Able.

Image Credit: Wheeler Cowperthwaite / Flickr

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Why the Egg-Cancer Link?

NF-Aug21 Why the Egg Cancer-link?.jpg

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 the five-year survival is practically guaranteed, but once it really starts spreading, chances drop to one in three. "Thus, identification of modifiable factors that affect the progression of prostate cancer is something that deserves study," noted Dr. Erin Richard and colleagues at Harvard. So, they 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 spreading 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 increased risk of prostate cancer progression. The only thing worse was poultry consumption, with up to four times the risk of progression among high-risk men. They think it might be the cooked meat carcinogens that for some reason build up more in chicken and turkey muscle than in other meats. For more on these so-called heterocyclic amines, see my videos: Heterocyclic Amines in Eggs, Cheese, and Creatine?, Estrogenic Cooked Meat Carcinogens, and PhIP: The Three Strikes Breast Carcinogen.

But what about the eggs? Why would less than once-a-day egg consumption double the risk of cancer progression? "A plausible mechanism that may explain the association between eggs and prostate cancer progression is high dietary choline," the researchers suggested. 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 having it spread.

Studies have associated choline consumption not just with getting cancer and spreading cancer, but also with significantly increased risk of dying from it. Those who ate the most had a 70% increased risk of lethal prostate cancer. Another recent study found that men who consumed two and a half or more eggs per week -- that's just like one egg every three days -- had an 81 percent increased risk of lethal prostate cancer.

Maybe that's why meat, milk, and eggs have all been associated with advanced prostate cancer--because of the choline. Choline is so concentrated in cancer cells that doctors can follow choline uptake to track the spread of cancer throughout the body. But why may dietary choline increase the risk of lethal prostate cancer? Dietary choline is converted in the gut to trimethylamine (see my video Carnitine, Choline, Cancer and Cholesterol: The TMAO Connection), so the Harvard researchers speculated that the TMAO from the high dietary choline intake may increase inflammation, which may promote progression of prostate cancer to a lethal disease.

In one of my videos, Eggs and Choline: Something Fishy, I talked about what trimethylamine might do to one's body odor.

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

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 (which you can view in my video, Eggs, Choline, and Cancer) 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," he said, "as we continue to promote choline as another good reason to consume eggs."

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 video Prostate Cancer Survival: The A/V Ratio.

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).

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, and From Table to Able.

Image Credit: Christopher Craig / Flickr

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Does Animal Protein Cause Osteoporosis?

NF-July29 Alkaline Diets, Meat, and Calcium Loss.jpg

For most of the last century, a prevailing theory within the field of nutrition was that by eating acid-forming foods such as meat, we were, in essence, at risk of peeing our bones down the toilet. And no wonder! Experiments dating back to 1920 showed over and over that if we add meat to our diet we get a big spike in the amount of calcium being lost in the urine.

And this made total sense. We had known since 1912 that meat was acid-forming within the body, and how do we buffer acid? What are in antacid (anti-acid) pills like Tums? Calcium compounds.

Meat and eggs have a lot of sulphur-containing amino acids (two to five times more than grains and beans) that are metabolized into sulphuric acid, which the body buffers with calcium compounds. And where is calcium stored in the body? The skeleton. So the thinking was that every time we ate a steak, our body would pull calcium from our bones, bit by bit, and over time this could lead to osteoporosis. Based on 26 such studies, for every 40 grams of protein we add to our daily diet, we pee out an extra 50 mg of calcium. We only have about two pounds of calcium in our skeleton, so the loss of 50 grams a day would mean losing close to 2% of our bone calcium every year. By the end of the 20th century, there was little doubt that acid-forming diets would dissolve our bones away.

But if we actually look at the studies done on protein intake and bone health, that's not what we find. So, where's the flaw in the logic? Meat leads to acid, which leads to calcium loss, which leads to bone loss, right?

Well, it's uncontroversial that protein results in greater calcium excretion, but we've just been assuming it's coming from the bone--where else could the extra calcium dumped in our urine be coming from but our bones?

One study appeared to solve the mystery. An intrepid group of researchers tried feeding a group of volunteers radioactive calcium and then put them on a high protein diet. What happens when we put people on a high protein diet? The amount of calcium in their urine shoots up, and indeed that's just what happened. But here's the big question, was that extra calcium in their urine radioactive or not? To everyone's surprise, it was radioactive. This meant that the excess calcium in their urine was coming from their diet, not from their bones.

What seemed to be happening is that the excess protein consumption boosted calcium absorption, from down around 19% up to 26%. All of a sudden there was all this extra calcium in the blood, so presumably the kidneys are like "whoa, what are we going to do with it all?" So they dump it into the urine. 90% of the extra calcium in the urine after eating a steak doesn't appear to be coming from our bones but from our diet. We're not sure why protein boosts calcium absorption. Maybe protein increases the solubility of calcium by stimulating stomach acid production? Whatever the reason, there was indeed more calcium lost, but also more calcium gained such that in the end, most of that extra calcium is accounted for. In effect, more calcium is lost in the urine stream, but it may be compensated by less loss of calcium through the fecal stream.

This was repeated with even more extreme diets--an acid-forming five-burgers-a-day-worth-of-animal protein diet that limited fruits and vegetables versus an alkaline diet emphasizing fruits and vegetables. More calcium in the urine on burgers, but significantly greater calcium absorption, such that at the end it was pretty much a wash.

Other studies have also since supported this interpretation. Here's an ingenious one: Feed people a high animal protein diet but add in an alkali salt to neutralize the acid. The old thinking would predict that there would be no calcium loss since there is no excess acid to buffer, but no, even though the acid load was neutralized, there was still the excess urinary calcium, consistent with the radioactive isotope study, challenging the "long-standing dogma that animal protein consumption results in a mild acidosis promoting the increased excretion of calcium."

So if our body isn't buffering the acid formed from our diet with our bones, how is it neutralizing the acid? Maybe with our muscles. Alkaline diets may protect our muscle mass! I cover that in my video Testing Your Diet with Pee and Purple Cabbage.

Now the boost in calcium absorption can only compensate if we're taking enough in. For example, dietary acid load may be associated with lower bone mineral density in those getting under 800mg a day. Plant Protein is Preferable to animal protein for a variety of reasons (tends to have less methionine, is less IGF-1 promoting, etc.), but it's not clear how much of an advantage it has when it comes to bone health.

I previously touched on this topic in my video Is Protein Bad to the Bone? But I promised I'd take a deeper dive, hence my video Alkaline Diets, Meat & Calcium Loss.

-Michael Greger, M.D.

Note to chemistry geeks: Yes, I know it's the calcium salt anions that actually do the buffering (carbonate in Tums and phosphate in bones), but I'm trying my best to simplify for a largely lay audience. I'll make it up to you with some kitchen chemistry (actually bathroom chemistry!) in my Testing Your Diet video.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death and More Than an Apple a Day.

Image Credit: PD Art / Wikimedia Commons

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Egg Industry Caught Making False Claims

 

 

 

 

 

 

 

 

Egg Industry Caught Making False Claims

On the basis of concerns from the American Heart Association and consumer groups, the Federal Trade Commission carried out successful legal action—upheld by the Supreme Court—to compel the egg industry to cease and desist from false and misleading advertising that eggs had no harmful effects on health.

Over the years, cholesterol concerns resulted in severe economic loss through a reduction in egg consumption, so the egg industry created a “National Commission on Egg Nutrition” to combat the public health warnings with ads that said things like “There is no scientific evidence whatsoever that eating eggs in any way increases the risk of heart attack.” The U.S. Court of Appeals found such outright deception patently false and misleading.

Even the tobacco industry wasn’t that brazen, trying only to introduce the element of doubt, arguing that the relationship between smoking and health remains an open question. In contrast, the egg ads made seven claims, each of which was determined by the courts to be blatantly false. The Court determined the egg industry ads were "false, misleading, and deceptive." Legal scholars note that, like Big Tobacco, the egg industry did more than just espouse one side of a genuine controversy, but flatly denied the existence of scientific evidence.

Over the last 36 years, the American Egg Board has spent hundreds of millions of dollars to convince people eggs are not going to kill them—and it’s working. From one of their internal strategy documents that I was able to get a hold of: “In combination with aggressive nutrition science and public relations efforts, research shows that the advertising has been effective in decreasing consumers concerns over eggs and cholesterol/heart health.”

Currently, they’re targeting moms. Their approach is to “surround moms wherever they are.” They pay integration fees for egg product placement in TV shows. To integrate eggs into The Biggest Loser, for example, could be a million dollars, according to their internal documents. Getting some kids storytime reading program to integrate eggs may only take half a million, though. The American Egg Board keeps track of who is, and is not, a “friend-of-eggs.” They even pay scientists $1500 to sit and answer questions like, “What studies can help disassociate eggs from cardiovascular disease?”

From the beginning, their arch nemesis was the American Heart Association, with whom they fought a major battle over cholesterol. In documents retrieved through the Freedom of Information Act featured in my 6-min video Eggs and Cholesterol: Patently False and Misleading Claims, you can see even the USDA repeatedly chastises the egg industry for misrepresenting the American Heart Association position. In a draft letter to magazine editors, the egg industry tried to say that the “American Heart Association changed its recommendations to approve an egg a day in 2000 and eventually eliminated its number restrictions on eggs in 2002,” to which the head of USDA’s poultry research and promotion programs had to explain that the “change” in 2000 wasn’t a change at all. Nothing in the guidelines or recommendations was changed. What happened was that in response to a question posed by someone planted in the audience, Heart Association reps acknowledged that even though eggs are among the most concentrated source of cholesterol in the diet, an individual egg has under 300mg of cholesterol and could technically fit under the 300 mg daily limit. In 2002, they eliminated the specific mention of eggs for consistency sake, but the American Heart Association insists that they haven’t changed their position and continue to warn consumers about eggs.

The guidelines on the AHA website at the time explained that since one egg has 213 and the limit for people with normal cholesterol is 300 you could fit an egg in if you cut down on all other animal products. If you have an egg for breakfast, for example, and some coffee, some skinless turkey breast for lunch, etc., you could end up at over 500 by the end of the day, nearly twice the recommended limit. So if you are going to eat an egg, the Heart Association instructed, we would need to "substitute vegetables for some of the meat, drink our coffee black, and watch for hidden eggs in baked goods." Furthermore, the limit for folks with high cholesterol is 200mg a day, which may not even allow a single egg a day.

This is how the senior director of nutrition education at the American Egg Board’s Egg Nutrition Center characterized the American Heart Association guidelines: “Maybe I’m being overly sensitive, but this reads like: ‘If you insist on having those deadly high cholesterol eggs your penalty will be to eat vegetables and you can’t even have the yummy steak and creamy coffee you love. Really it’s not worth eating eggs. Oh, and if you think you’ll be able to enjoy some delicious baked goods, forget it, the deadly eggs are there too!’”

I shared some of my other Freedom of Information Act finds in my other egg videos, Eggs vs. Cigarettes in Atherosclerosis, and my personal favorite, Who Says Eggs Aren’t Healthy or Safe?

I’ve also explored the presence of carcinogenic chemicals in eggs (Heterocyclic Amines in Eggs, Cheese, and Creatine?), carcinogenic viruses (Carcinogenic Retrovirus Found in Eggs), industrial pollutants (Food Sources of Perfluorochemicals and Food Sources of PCB Chemical Pollutants), the egg-borne annual epidemic of Salmonella (Total Recall), arachidonic acid (Chicken, Eggs, and Inflammation), misleading claims about eyesight nutrients (Egg Industry Blind Spot), and, of course, cholesterol (Egg Cholesterol in the Diet and What Women Should Eat to Live Longer).

To my surprise, though, eggs are actually not the most concentrated dietary source of cholesterol. See Avoiding Cholesterol Is a No Brainer.

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death and More Than an Apple a Day.

Image credit: Nick Wheeler/ Flickr

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Why Are Eggs Linked to Cancer Progression?

 

 

 

 

 

 

 

 

Why Are Eggs Linked to Cancer Progression?

About 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 our 5-year survival is practically guaranteed, but once it really starts spreading our chances drop to 1 in 3. 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 increased risk of prostate cancer progression. The only thing worse was poultry (with skin) consumption, which showed up to 4 times the risk of progression among high-risk men. Researchers believe the higher risk might be caused by the cooked meat carcinogens (heterocyclic amines) that 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? The Harvard paper suggests that the choline in eggs may increase inflammation.

As I explained in my video Carnitine, Choline, Cancer and Cholesterol: The TMAO Connection, eggs are the most concentrated common source of choline in the American diet, which may increase the risk of cancer emergence, spread, and lethality. Another Harvard study, entitled Choline Intake and the Risk of Lethal Prostate Cancer, found that those with the highest choline intake had a 70% increased risk of fatal prostate cancer. Another recent study found that men who consumed 2 and a half or more eggs per week—that’s just like one egg every three days—had an 81% increased risk of lethal prostate cancer.

In the New England Journal of Medicine the same Cleveland Clinic research team that performed the famous study on carnitine (see my last post Avoid Carnitine and Lethicin Supplements), tried feeding people hard-boiled eggs instead of steak. As they suspected, the egg-eaters experienced a spike of the same TMAO compound associated with red meat consumption (and strokes, heart attack, and death).

It’s ironic that the choline content of eggs is something the egg industry actually boasts about. And they are aware of the cancer connection. Through the Freedom of Information Act I was able to get my hands on an email (displayed in my 9-min video Carnitine, Choline, Cancer and Cholesterol: The TMAO Connection) 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.”

For another behind-the-curtain peek at the egg industry, see Eggs vs. Cigarettes in Atherosclerosis and Egg Industry Blind Spot.

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death and More Than an Apple a Day.

Image credit: Christopher Craig / Flickr

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