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Eggs and Prostate Cancer

All North American men will eventually develop prostate cancer if they live long enough, but scientists still do not know the cause or causes. Men in rural China develop prostate cancer at one twentieth the rate of North Americans (Cancer Biol Med, Jun 2012; 9(2): 128–132), so researchers look at differences in the environment for possible causes. At this time the most likely dietary culprits appear to be eggs, meat, milk and chicken. These foods are all sources of choline, lecithin, creatine and creatinine, nutrients that are converted by bacteria in your gut to TMAO, a chemical that can cause cancers. TMAO can also punch holes in arteries to start the formation of plaques that cause heart attacks (N Engl J Med 2013; 368:1575-1584). More on TMAO

Two studies show that eating two eggs per week increases blood and urine concentrations of TMAO significantly (The American Journal of Clinical Nutrition, Sep, 2014;100:3:741-3 and Am J Clin Nutr August 2014). Choline is an essential nutrient that is required for normal human liver and muscle functions and important for normal fetal development, and eggs are one of the richest sources of choline. However, a study of 47,896 men showed that a high intake of choline was associated with an increased risk of the type of prostate cancer that kills (Am J Clin Nutr, 2012 Oct;96(4):855-63).

An earlier study showed that men who eat more than two eggs a week have an 81 percent increased risk of the type of prostate cancer that can kill them, compared to men who eat less than 0.5 eggs per week (Cancer Prev Res (Phila), Dec 2011;4(12):2110-21). In another study, researchers at Harvard Medical School followed more than a thousand men with early stage prostate cancer for a couple years and found that, compared to men who ate eggs only on rare occasions, those who ate two to five eggs a week had double the risk of the prostate cancer spreading through their bodies (indicating that it is the type of prostate cancer that kills). Those who ate chicken skin (another rich source of choline) regularly had four times the risk of cancer spreading. However, they did not find any link between consuming red meat, fish or skinless poultry and prostate cancer recurrence or progression (Am J Clin Nutr, 2010 Mar;91(3):712-21). This surprised me since red meat is a rich source of choline. Perhaps the link between choline consumption and cancer risk is only an association and has no cause and effect relationship at all. This is true of all studies that find associations but not cause-and-effect.

My Recommendations
While the researchers sort out the significance of the data on choline and prostate cancer, I believe that it is prudent to limit choline-rich foods such as eggs, meat, poultry and dairy products. We do not know how much of these foods you can eat safely.

Checked 12/22/15

August 31st, 2014
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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