Try This: Setting The Record Straight About Eggs

Hi ,

I don’t know if you’ve seen the headlines, but eggs are under fire—AGAIN.

First, it was cholesterol, and more recently, the avian flu and inflation, gorging prices to record highs. Now, eggs are at the forefront of yet another controversial claim. This time it’s because their choline content causes…blood clots?!

The alleged link is based on a 2017 Cleveland Clinic study that recently resurfaced. We’ll go into that study more next, but it essentially reported that dietary choline increased TMAO, a gut metabolite linked to an increased risk of heart disease, heart attack, and stroke. So, what’s the deal? We finally let eggs off the hook, and now the media is putting them back on the chopping block!?Not so fast! In today’s newsletter, we’re getting to the bottom of this controversy (and confusion) by answering the question, “Do eggs really cause blood clots?” Let’s find out!

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The Basis of the Claim That Eggs Cause Blood Clots

As I mentioned above, the foundation for the claim that eggs cause blood clots is largely based on this 2017 Cleveland Clinic study. The study, which was super small by the way (18 people), gave healthy middle-aged adults 450mg of supplemental choline daily for two months. 

After one and two months, TMAO levels increased by more than tenfold, and markers of blood clots and platelet aggregation also increased significantly. The researchers concluded that dietary choline was linked to high levels of TMAO and increased risk for blood clots. 

Did you catch that? The study prescribed supplemental choline, and the authors concluded that dietary choline was responsible for the TMAO-raising, blood clotting effects…Not the same thing! And the media took that and ran with it.

That’s what you call lousy reporting, false hype, or a totally erroneous interpretation of results. Whatever you want to call it, the researchers falsely contextualized the data to apply to dietary choline, not supplements. 

Clearing Up the Confusion: Findings from a 2021 Follow-Up Study

I don’t think this was purposeful, though, because in 2021 the Cleveland Clinic set the record straight with a follow-up study called Dietary Choline Supplements, but Not Eggs, Raise Fasting TMAO Levels in Participants with Normal Renal Function: A Randomized Controlled Trial. 

The study prescribed choline supplements or eggs to healthy adults and found that choline supplementation (not eggs!) was associated with increased TMAO levels and blood clotting. Participants in the egg intervention group ate four eggs per day for four weeks with no markers of blood clotting or increased TMAO. 

These findings further support that choline supplementation can increase TMAO and the risk of blood clots. Dietary choline may increase TMAO, too, but the report found no concerns for blood clots. That’s a very important distinction to make! 

There are plenty of studies that show dietary choline can increase TMAO. As a matter of fact, choline, carnitine, and protein (nutrients found in animal foods) have all been shown to increase TMAO levels. But our brains require choline. Our muscles, bones, and organs require protein, and our mitochondria thrive on dietary sources of carnitine for energy. 

This raises the question, is elevated TMAO after eating whole-food sources of choline, carnitine, and protein a concern? Let’s see what my dear friend Dr. Terry Wahls has to say about it!

A Little Perspective from Dr. Terry Wahls

In a new blog post, Dr. Terry Wahls sets out to clear up the confusion. In addition to addressing the outlandish controversies around eggs, she proposes that gut dysbiosis from our modern-day Westernized diet might be a bigger source of the blame.  

The Standard American Diet is rich in processed foods, refined carbs, low-quality fats, and sugar-sweetened beverages; is deficient in fiber; and lacks a diversity of plant foods, healthy fats, and nutrient-dense whole foods. 

We know the average American’s diet today looks a hell of a lot different from our ancestral diet. Based on a recent study, high TMAO is more accurately a reflection of gut dysbiosis from our high-fat, high-sugar diet than anything else. 

Dr. Wahls says, “Before we tell people to stop eating eggs and meat, we should tell them to stop eating added sugar, fast food, and ultra-processed foods. We should encourage a diet with a diversity of plants and animal products and plenty of fiber. There are already plenty of studies that document the health benefits of those recommendations.” And I have to agree!

Before we start scrutinizing meat and eggs, which have been a part of our diet for thousands of years, we need to cut down on ultra-processed foods, which have only been in our diets for the past 100-or-so years.

Final Thoughts

It’s super shocking and slightly absurd to me that the media would choose to bully eggs rather than focus on the real killer: ultra-processed foods and added sugar. These foods are clearly making us sick but continue to be left out of the mainstream media conversation. The question is, why?

Because sensationalism sells. Emotion-brewing headlines get clicks. And I genuinely believe that is how the media operates. They take a press release and run with it. 

The media rarely takes the time to do “boots on the ground” journalism, which means vetting their sources, dissecting studies, and leaning on a team that has the authority and intellect to make sense of the many nuances within a headline. Can you see why the public has lost trust?

This is a concept known as “churnalism,” and Dr. Vinay Prasad covers this topic at length in part one and part two of this Substack article. Media that runs on churnalism is super problematic for all areas, but especially so when it comes to nutrition and wellness.So many people rely on the mainstream media as their primary source of health information, and churning out headlines like “Eggs Cause Blood Clots” for clickbait is not doing anything but causing more confusion for the public. Here's to your health,Dhru Purohit