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Eggs may provoke bacteria to increase heart risk: 7 tip to prevent

Teresa Tanoos's picture
Study shows eggs can increase heart attack risk

Researchers are now reporting that eggs, in addition to other foods reported in recent weeks, have been linked to bacteria that can increase the risk of heart attacks, according to a new study published April 25 in the New England Journal of Medicine.

It was only two weeks ago that researchers reported that carnitine, a compound found in red meat, can put people at a higher risk for heart disease because it provokes intestinal bacteria.

Now, they are reporting a similar finding with lecithin in egg yolks.

The link between bacteria and lecithin in egg yolks, as found in this newest study, reveals the extent to which researchers are learning more about bacteria in the body and its impact on health and disease. Similar to what researchers have learned by studying nutrition and its impact on heart disease, studying how the body’s bacteria can affect health only further adds to our understanding of its impact on disease.

“Heart disease perhaps involves microbes in our gut,” said the new study’s lead author, Dr. Stanley Hazen, chairman of the department of cellular and molecular medicine at the Cleveland Clinic Lerner Research Institute.

How this pertains to eggs begins with the digestive process of lecithin, which is abundant in egg yolks. During digestion, lecithin is broken down into its constituent parts, which includes the chemical choline. Intestinal bacteria then metabolize choline, releasing another chemical called trimethylamine N-oxide, or TMAO, which has been linked to an increased risk of heart attack and stroke when it’s present in high levels.

To illustrate the effect of eggs on TMAO, participants in the new study were instructed to eat two hard-boiled eggs. As a result, such participants had a higher level of TMAO in their blood. However, participants who took an antibiotic before ingesting the eggs to eradicate intestinal bacteria, did not have higher levels of TMAO in their blood after eating the eggs.

The researchers also studied 4,000 patients who had previously been examined at the Cleveland Clinic, and they found that the higher the amount of TMAO they had in their blood, the higher their risk was for a heart attack or stroke within the next three years.

Dr. Hazen said that carnitine in red meat and lecithin in egg yolks are chemically related, as they both release choline when digested, which can then activate intestinal bacteria.

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To reduce the risk of heart attack, Dr. Hazen recommends reducing the amount of lecithin and choline in your diet – and to avoid supplements or vitamins with added choline.

Cardiovascular disease leading to heart attack or stroke is by far the leading cause of death in both men and women with diabetes, according to Dr. Om P. Ganda, a board-certified specialist in Internal Medicine, Endocrinology and Metabolism, and an Associate Clinical Professor of Medicine at Harvard Medical School.

Dr. Ganda offers these seven tips for preventing heart disease:

1. Control your weight. One of the most important things you can do if you have diabetes is maintain a healthy weight. If you are overweight, talk to a registered dietitian about healthy ways to lose weight.

2. Get regular physical activity. There is a significant body of research that proves the myriad cardiovascular benefits of regular physical activity (that goes beyond weight loss). Start off slowly, and build a plan that works well for you and meets your needs.

3. Don’t smoke. If you already do, make plans to begin a smoking cessation program.

4. Maintain tight control over glucose. Tight control can prevent many complications from diabetes and also protects your heart. Shoot for an A1C reading of less than 7%.

5. Lower your LDL cholesterol (the "bad" type). Both the American Diabetes Association and the American Heart Association recommend an LDL cholesterol goal of less than 100 mg/dl. Dr. Ganda recommends eating fiber-rich foods, such as fruits, vegetables, and whole grains. Also, he recommends asking your healthcare provider about omega-3 fish oil supplements.

6. Control your blood pressure. All people with diabetes should aim for a blood pressure reading of less than 130/80, advises Dr. Ganda.

7. Consider incorporating aspirin into your daily routine. If you are older than thirty years of age, you may want to speak to your doctor about taking a baby aspirin daily. In addition, taking a multivitamin can be extremely helpful for those with diabetes, says Dr. Ganda.

SOURCE: New England Journal of Medicine (N Engl J Med 2013; 368:1575-1584 April 25, 2013 DOI: 10.1056/NEJMoa1109400); Seven Tips for Preventing Heart Disease by Dr. Om P. Ganda, Joslin Diabetes Center