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Garrett Smith Egg/choline twitter thread
Creating a new thread as this tweet keeps being retweeted and used as evidence that eggs are bad for you. (2) Nutrition Detective 🔍 - Dr. Garrett Smith on Twitter: "Why Too Many EGGS May Be Shortening Your Life (HINT: It's NOT The Cholesterol!) Eggs are a fave food in Twitter-land, w ppl claiming they're 1 of the healthiest foods If you're open-minded, you need to see this research Then ask why you've never seen it before / thread / 👇" / Twitter
My Vitamin A Toxicity group response to Twitter egg/choline thread.
1. The Japanese consume the most eggs per capita in the world. They also have one of the best records for longevity. But is one egg a day significant enough to lay a claim for good or bad. 2. Epidemiological studies are fraught with difficulties. Trying to detect the difference from 1 egg a day. A person eating lots of eggs may be eating liver or all plant food or eating lots of pancakes. 3. Eating more than 4 eggs a week reduce chances of fatty liver disease for men considerably in the Iranian study. 4. Rats were fed 5 grams of lecithin. A rat could weigh 70 grams. A human could weigh 70 kilograms. A factor of 1,000. An egg contains 1.5 grams of lecithin. This is like feeding a human over 3,000 eggs. 5. A person eating 800 grams of beef plus 150 grams of beans and a tablespoon of butter per day (355 IUs of Vitamin A) will consume more choline than a person on 300 grams of beef plus 4 eggs. Very roughly someone on over 600 grams of beef and beans will consume similar choline to a person on 400 grams of meat and 3 eggs. The less eggs the low meat person eats then the likelihood a higher beef person will get more choline. Associating high choline with all cause mortality ropes in a lot of people doing Vitamin A reduction. 6. High choline intake could include beef liver which is over 50 times higher Vitamin A than eggs per 100 grams. You may need to pick studies that identify eggs, meat and liver separately as the Vitamin A levels are very different. Poorer ethnic populations may eat more eggs AND liver. Red meat may include liver. Liver is the highest choline containing food NOT eggs. 7. Bile salts include phosphatidylcholine and sphingomyelin (both high in eggs). 8. What level of choline results in problems ? I'm certainly not advocating more than 1 gram of choline. Problems have only been identified at 3.5 grams or more a day for adults. All high beef eaters are roped into the equation if you're saying above 550 mgs per day. I'm also not advocating more than 5 eggs a day as it's early in the experiment although low meat eaters may want to experiment. 9. It's a strange notion that a person eating one egg a day with 250 IUs of Vitamin A is going to have difficulty detoxing it while a person eating one tablespoon of butter with 355 IUs is okay to eat as they want. Because there's choline in the eggs ? There's some choline in butter too. The person eating 2 eggs a day at 500 IUs is not much more than the tablespoon of butter and less than 2 tablespoons of butter at 710 IUs. Beef patty and butter on a roll okay but egg bad. Illogical. 10. A healthy person could on average at a pure guess be detoxing 15,000 IUs a day. We know people have got worse health problems from 30,000 IUs of Vitamin A supplements a day for 4 years so when does 300 IUs a day extra cause a problem with this anti-egg theory ? 400 years from now !
Jessica's response:
Here's my response to looking at the initial studies on eggs. I haven't even gotten to the choline stuff, but none of his thread addresses the studies I've already posted in my thread about the benefits of choline.
His first study, the LRAT study is problematic in that studies that use LRAT knockout mice show that they develop ocular abnormalities: abnormally short cone development, etc., which strongly suggests to me that the Lecithin molecule is actually detoxifying the ocular retinols. One question Smith has never answered about choline "shoving A into the liver" is: where would we rather have retinols? Floating in the blood causing tissue damage or in the liver, ready for the process of detoxification?
On to the egg studies:
Very unconvincing evidence when you actually examine and read the studies cited and realize they are epidemiological and rely on self reporting diets. Be that as it may, conclusions are still contradictory and inconsistent with eggs being the agent of disaster:
Third study in the thread, for example, concludes: "Of note, after more correction for triglycerides, hypertension and diabetes, the significant link between egg consumption and LTs (liver tests) and/or NAFLD attenuated and DISAPPEARED." (all caps and bolds are mine)
4th study found that 4+ eggs a week DID NOT have an association with NAFLD, while 2-3 did. Strongly suggests other lifestyle factors involved.
Conclusion of first study on egg-diabetes connection : "Our findings in Swedish men do NOT support an association between egg consumption and risk of type 2 diabetes. In a meta-analysis, frequent egg consumption was associated with a higher risk of type 2 diabetes in US studies only. Egg consumption habits and associated overall dietary patterns may differ between populations and could potentially explain the discrepancies between reported results. Given the inconsistent results, this relationship warrants further study." Inconclusive and inconsistent.
Conclusion of 2nd egg-diabetes study: "Results from the updated meta-analysis show no overall association between moderate egg consumption and risk of T2D (type 2 diabetes ). Whether the heterogeneity of the associations among US, European, and Asian cohorts reflects differences in egg consumption habits warrants further investigation."
Egg-TMAO study says: "There was considerable variation between individuals in the TMAO response" and concludes : "Additional study is needed to both confirm the association between TMAO and atherosclerosis and identify factors, microbiota and genetic, that influence the generation of TMAO before policy and medical recommendations are made that suggest reduced dietary choline intake." Meaning gut microbiome could be the confounding factor in TMAO, not choline itself.
1st study on eggs and cardiovascular disease doesn't distinguish between eggs and other sources of cholesterol and lumps them together so it can't even be trusted.
Conclusion of 2nd study re: eggs and cardiovascular disease: "Daily egg consumption was NOT associated with risk of MI (myocardial infarction, eg, heart attacks) or any stroke type in either men or women or with HF (heart failure) in women. Consumption of eggs ≥1 time/d, but not less frequent consumption, was associated with an elevated risk of HF in men." Inconsistent results, if eggs cause heart failure, why not in women? Suggests another factor at play.
Conclusion of 3rd study on CVD and eggs: "These findings suggest that consumption of up to 1 egg per day is UNLIKELY to have substantial overall impact on the risk of CHD or stroke among healthy men and women. The apparent increased risk of CHD (coronary heart disease) associated with higher egg consumption among diabetic participants warrants further research." Keep in mind negative outcomes occurred in those WHO ALREADY HAD DIABETES.
First study in the eggs-diabetes -USA part is astonishingly titled "Regular egg consumption does not increase the risk of stroke and cardiovascular diseases" and concludes: "Consumption of greater than 6 eggs per week (average of 1 egg or greater per day) does not increase the risk of stroke and ischemic stroke. The increased risk of coronary artery disease associated with higher egg consumption among diabetics warrants further investigations." and again discusses the idea that among those WHO ALREADY HAVE DIABETES, negative outcomes in heart health were observed (duh).
Final study in USA diabetes egg section says: Dietary cholesterol and egg consumption were associated with increased CVD risk among older, community-dwelling adults with type 2 diabetes. Further research on the biological mechanism(s) for the increased CVD risk with higher dietary cholesterol and frequent egg consumption among older adults with diabetes is warranted." These are old people in "community dwellings" who ALREADY HAVE DIABETES and are in poor health!!! You can't extrapolate info on eggs with all those confounding factors.
Greek study concludes: Amongst confirmed diabetic persons, increased physical activity is associated with significant reduction of mortality, whereas increased consumption of eggs and saturated fats is associated with significant increase of mortality. Monounsaturated lipids are preferable for diabetic persons." This study, like the others, looked at persons WHO ALREADY HAD DIABETES. No control group of healthy non-diabetic egg consumption.
This is just as far as I went so far for the sake of thread length. I will be posting another response in my choline thread addressing the issues with those studies.
Vitamin A shoved in the liver for onward detoxing via the bile. At 10.29 in this Elliot Overton there's a useful diagram to see that phosphatidylcholine goes into the bile. We also know that low serum retinol could be a low choline problem if health problems still exist. https://www.youtube.com/watch?v=PgssbwKm02k
Many of Garrett Smith's egg/choline twitter thread tweets and studies actually supported eggs for choline and some of the studies which he posted linked disease with eggs were actually very low egg consumption. Sometimes one or two a week. I'd suggest the studies were set up to fail eggs. In one study in Iran more than 4 eggs a week was not significantly associated with NAFLD. So thanks to Dr Smith. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5387362/
This study showed eggs were more bioavailable as a choline source compared to the supplement. Also no TMAO issue in HEALTHY participants with 3 eggs a day in the study period of 4 weeks. https://pubmed.ncbi.nlm.nih.gov/29764315/
The last study in Dr Smith's egg/choline twitter thread. He's trying to say higher serum cholinesterase increases risk of death. As many of us know it's often low serum cholinesterase that's the problem eg when nightshades inhibit cholinesterase. Unfortunately, Dr Smith has misread the study perhaps understandably as the conclusion doesnt define the association very precisely. Results: During follow-up, 568 subjects died. There was a positive correlation between serum Alb and ChE levels (r = 0.30). Kaplan-Meier analysis showed that all-cause mortality in the low group was significantly higher for both serum Alb and ChE levels (log-rank p < 0.01). So the low serum cholinesterase group was associated with higher all-cause mortality. He's got it wrong again. @jaj agrees with me.
GS Twitter Thread https://threadreaderapp.com/thread/1601623635474587648.html?fbclid=IwAR3Tf80mjr8EuuBaIbuUoI3QQltvuqti5IK-0YEf8TsFtJLkF_ohoB1LuvU
What is cholinesterase?
Cholinesterase hydrolyzes (BREAKS DOWN) acetylcholine & other choline esters
If there was too much acetylcholine, it makes sense that the body would ⬆️ cholinesterase, correct?
Higher cholinesterase = ? 👇
⬆️ cholinesterase, ⬆️ risk of death
ACh in bile = toxic bile leakage
⬆️ eggs = ⬆️ choline = ⬆️ ACh = ⬆️ cholinesterase = earlier DEATH
Hopefully the patterns are becoming evident
Dr S Egg Twitter Thread. I dont have the foggiest what he's trying to prove with acetylcholine in these isolated cell studies which he usually hates. It's phosphatidylcholine that helps bile flow. Acetylcholine may be in charge of bile secretion from the gallbladder. It seems of little relevance to put the wrong substance in the bile. There seems a total disconnect here. https://www.sciencedirect.com/topics/biochemistry-genetics-and-molecular-biology/gallbladder-emptying#:~:text=The%20gallbladder%20is%20also%20stimulated%20less%20strongly%20by,in%20other%20parts%20of%20the%20upper%20gastrointestinal%20tract.
Twitter thread. https://pubmed.ncbi.nlm.nih.gov/995213/
Twitter thread. https://pubmed.ncbi.nlm.nih.gov/9096580/
Thank God you made this new egg thread!