The Dr. Hyman Show - Does Eating Eggs Increase Your Risk Of Stroke Or Heart Disease?

Episode Date: April 21, 2023

This episode is brought to you by Rupa Health and Levels. If you’re like most people, you’re sick of being mixed-up and confounded by conflicting media reports about the latest research on which foods are good or bad for us. You know what I’m talking about: one day eggs are unhealthy, and the next day they are a miracle food. So, should we avoid or embrace eggs in our diet? In today’s episode of my series I’m calling Health Bites, I talk about research that has both led to and debunked concerns associated with eating eggs. I also talk about the production of a gut metabolite called TMAO (trimethylamine N-oxide) and how the health of our gut microbiome influences our TMAO levels. This episode is brought to you by Rupa Health and Levels. Rupa Health is a place where Functional Medicine practitioners can access more than 2,000 specialty lab tests from over 35 labs like DUTCH, Vibrant America, Genova, and Great Plains. You can check out a free, live demo with a Q&A or create an account at RupaHealth.com. By leveraging biosensors like continuous glucose monitors (CGMs), Levels provides real-time feedback on how diet and lifestyle choices impact your metabolic health. Learn more about Levels by going to levels.link/HYMAN. Here are more details from our interview (audio version / Apple Subscriber version): The research that laid the foundation for the claim that eggs cause blood clots (3:22 / 1:17)  Supplemental choline vs dietary choline (4:57 / 2:50)  Follow-up research assessing whether eggs raise TMAO levels and cause blood clots (5:23 / 3:16)  Debunking myths around eating eggs and high cholesterol (6:05 / 4:05)  How gut health influences TMAO production (8:37 / 5:43)  Research discussed in this episode Gut Microbe-Generated TMAO from Dietary Choline Is Prothrombotic in Subjects Dietary Choline Supplements, but Not Eggs, Raise Fasting TMAO Levels in Participants with Normal Renal Function: A Randomized Clinical Trial TMAO Response to a High-Fat High-Sugar Meal Challenge in Generally Healthy United States Adults

Coming up on this episode of The Doctor's Pharmacy. Having a few eggs every day is no problem. You know, the whole thing about cholesterol and eggs was debunked and the US dietary guidelines even, which is a very often conservative group, has said that it's not a nutrient of concern. Hey everyone, it's Dr. Mark here. I've been tracking my glucose with the help of levels for several years now and it's become a crucial part of optimizing my health and my diet one of the keys to an optimized diet is monitoring your glucose

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So sign up free today. You can find out more information by going to rupahealth.com. That's R-U-P-A health.com. Hey, everybody. It's Dr. Mark Hyman. Welcome to Doctors Pharmacy, a place for conversations that matter. And today, I'm bringing you a health bite, little bites of health information that can help you make small steps to improve your health over time. Now, I know you've probably been paying attention to the headlines around nutrition like I have.

And it's super confusing when it comes to so many different things. So one day, fat is bad. Then it's good. One day, meat is bad. Then it's good. And eggs are right up there with everything else. Eggs were bad because they had cholesterol. Then they were good maybe now they're bad again because they

increase something called maybe do increase something called tmao we'll talk about that that's what this podcast is about how to get your head around confusing research and how to make sense of it all and i'm going to kind of give you a little bit of a tip on how to think about it all so basically in 2017 there was a study that uh reported that dietary choline increased the risk of uh stroke heart attacks heart disease and and it did so by increasing a metabolite from gut bacteria called TMAO. TMAO is, I'll spare you the big complicated medical name, but essentially, you know, the suggestion was that when you increase choline,

which is a really important nutrient, it's important for brain function, for heart health, for so many different things that it actually increases TMAO. But the devil is in the details of this study. And it's a big difference saying that dietary choline, which is found in eggs, and supplementary choline, which is in supplements, is the same thing. They're not. There's also more complicated features, which is what's going on with your gut bacteria, which I think is a real take home here, and I'm going to kind of give a lead in on that in a minute, but basically there was a study that showed, which was super small by the way, 18 people that gave healthy middle-aged adults 450 milligrams of choline supplements every day for two months. Now what they did was they found when they measured the TMAO in the

blood, which is a blood test you can now get, that it increased almost tenfold and that markers of blood clots and platelet stickiness, which causes blood clots, also increased. And so based on this study of supplemental choline, they somehow drew the conclusion that dietary choline meaning what you get from your diet like eggs or sardines for example are going to harm you now is that true well the catch is that is that dietary choline and supplemented choline may not be the same thing and that they didn't really contextualize this whole thing now there was another study that was in 2021 follow-up study at cleveland clinic and the title was dietary choline supplements but not eggs raise fasting tmao levels in people with normal kidney function a randomized controlled trial so

this is a really important follow-up study. And they basically prescribed choline supplements or eggs to people who are healthy and found that choline supplements, but not eggs, were associated with increased TMAO and blood clotting. And the participants in the egg group ate four eggs a day, which nobody does, for four weeks with no markers of blood clotting or increased risk of TMAO. So having a few eggs every day is no problem. And also for cholesterol, by the way. The whole thing about cholesterol and eggs was debunked. And we know from, for example, now the US dietary guidelines even,

which is a very often conservative group, has said that it's not a nutrient of concern in our diet. That if you eat an egg with, let's say, 200 milligrams of cholesterol, it's not going to raise your blood cholesterol. And it's not going to impact your risk of heart attacks. Why? Because you have five liters of blood. Let's say you have 200 milligrams per deciliter of blood. That's 2,000 milligrams per liter.

That's five liters. So that's 10,000 milligrams of cholesterol. And you throw a couple hundred milligrams in there it doesn't really do much right so it's it's uh that's that's kind of another whole conversation i've written a lot about that now let's talk about choline um because um choline is really important it's part of your brain cells. It's part of every cell membrane. Phosphoryl choline is a part of your fatty acid profiles.

It makes up your cell membranes. It's important for communication. It's important for detoxification, for liver function, and super important. So dietary choline really is not associated with any increases in risk. Now, what is going on with supplemental choline? How does that work? You know, um, the, the problem is that, that dietary choline, um, uh, is super helpful, but, uh, when you, when you take something in a pharmacologic dose or super high dose, you can kind of screw

things up in terms of your biochemistry. So you have to be paying attention to that. But also, let's talk about TMAO a little bit more. TMAO essentially is a compound that is produced from gut metabolites. Now, we know that it's produced when you eat meat or when you have dietary choline, I mean, supplemental choline, or even when you eat meat or when you have you know dietary choline i mean supplemental choline or even if you eat fish now we know from all the studies on fish consumption that fish is healthy that it's associated with lower risk of heart attack lower risk of stroke that has more

omega-3 fats there's a lot of benefits to it and yet fish also dramatically increases tmao which is contradicted sort of overall science around this. But the truth is that eating foods is part of the story, but it's what's going on in your gut microbiome that is the other big part of the story. The microbiome is such an important part of our overall health. And if you have a bad microbiome, you're going to produce more toxic metabolites. So the key is not necessarily not eating things like fish or meat or eggs, which can increase TMAO, but actually changing your microbiome to a healthier microbiome so you don't produce as much TMAO. And that can be done through the typical ways we do this, through eating a high

fiber diet, through probiotic and prebiotic foods, through polyphenols, all the things we talked about. So basically, TMAO is more reflective of gut health and gut bacteria than what you're doing. So for example, if you have a high fat, high sugar meal that's typically eaten in America, processed fat, it increases TMAO. And so, you know, really want to get rid of all that crap in your diet. You want to get to have a healthy microbiome and you want to understand that choline and phosphorylcholine are essential parts of our biochemistry and our health and our brain function and our liver detoxification. And if you don't have it, you know, it could potentially be a problem. So it's a really complicated thing. There's a lot

of written about this. I've written a little bit about this as well. So I think we kind of have to not get all bunged up on this. And I think we should be aware that it's really important that dietary choline, which is in eggs and liver and meat, fish, as I mentioned, is basically converted into TMO in the liver because of bad bacteria. So we need to get rid of the bad bacteria in our gut. We need to eat a healthy diet. And basically, I think I'm not so worried about it. So I don't think choline food, rich foods will increase your risk of any issue around heart disease. You can measure TMO in your blood if you want. But I think the story around TMO is a little more complicated. And I hope,

you know, you've kind of come away with understanding that basically, fix your gut bacteria, don't worry about dietary choline and you need it and eat sardines and eat eggs. It's the basic bottom line. So hopefully this has been a helpful health bite, literally, and hope you've enjoyed it. If you love this little health bite show with your friends and family on social media, I'm sure they'd love to hear more about this and leave a comment. What have you learned about your own health and your risk factors have you checked your tmao what's worked what's not worked and let us hear about it we'd love to know and we'll see you next time on the doctor's pharmacy hey everybody it's dr hyman thanks for tuning into the doctor's pharmacy I hope you're loving this podcast it's one of my favorite things to do and introduce to you all the experts that I know

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and that my team uses to optimize and enhance our health. And I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays. Nothing else, I promise. And all you do is go to drhyman.com forward slash pics to sign up. That's drhyman.com forward slash pics, P-I-C-K-S, and sign up for the newsletter and I'll share with you my favorite stuff that I use to enhance my health and get healthier and better and live younger longer. Hi, everyone. I hope you enjoyed this week's episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical

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