Effect of egg ingestion on trimethylamine-N-oxide production in humans

A randomized, controlled, dose-response study

Carolyn A. Miller, Karen D. Corbin, Kerry Ann Da Costa, Shucha Zhang, Xueqing Zhao, Joseph A. Galanko, Tondra Blevins, Brian J. Bennett, Annalouise O'Connor, Steven H. Zeisel

Research output: Contribution to journalArticle

100 Citations (Scopus)

Abstract

Background: It is important to understand whether eating eggs, which are a major source of dietary choline, results in increased exposure to trimethylamine-N-oxide (TMAO), which is purported to be a risk factor for developing heart disease. Objective: We determined whether humans eating eggs generate TMAO and, if so, whether there is an associated increase in a marker for inflammation [ie, high-sensitivity C-reactive protein (hsCRP)] or increased oxidation of low-density lipoprotein (LDL). Design: In a longitudinal, double-blind, randomized dietary intervention, 6 volunteers were fed breakfast doses of 0, 1, 2, 4, or 6 egg yolks. Diets were otherwise controlled on the day before and day of each egg dose with a standardized low-choline menu. Plasma TMAO at timed intervals (immediately before and 1, 2, 4, 8, and 24 h after each dose), 24-h urine TMAO, predose and 24-h postdose serum hsCRP, and plasma oxidized LDL were measured. Volunteers received all 5 doses with each dose separated by >2-wk washout periods. Results: The consumption of eggs was associated with increased plasma and urine TMAO concentrations (P <0.01), with ∼14% of the total choline in eggs having been converted to TMAO. There was considerable variation between individuals in the TMAO response. There was no difference in hsCRP or oxidized LDL concentrations after egg doses. Conclusions: The consumption of ≥2 eggs results in an increased formation of TMAO. Choline is an essential nutrient that is required for normal human liver and muscle functions and important for normal fetal development. 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. This trial was registered at clinicaltrials.gov as NCT01906554.

Original languageEnglish (US)
Pages (from-to)778-786
Number of pages9
JournalAmerican Journal of Clinical Nutrition
Volume100
Issue number3
DOIs
StatePublished - Sep 1 2014
Externally publishedYes

Fingerprint

Ovum
Eating
Choline
Eggs
C-Reactive Protein
Volunteers
trimethyloxamine
Urine
Egg Yolk
Breakfast
Microbiota
Fetal Development
LDL Lipoproteins
Heart Diseases
Atherosclerosis
Diet
Inflammation
Food
Muscles
Liver

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Medicine(all)

Cite this

Miller, C. A., Corbin, K. D., Da Costa, K. A., Zhang, S., Zhao, X., Galanko, J. A., ... Zeisel, S. H. (2014). Effect of egg ingestion on trimethylamine-N-oxide production in humans: A randomized, controlled, dose-response study. American Journal of Clinical Nutrition, 100(3), 778-786. https://doi.org/10.3945/ajcn.114.087692

Effect of egg ingestion on trimethylamine-N-oxide production in humans : A randomized, controlled, dose-response study. / Miller, Carolyn A.; Corbin, Karen D.; Da Costa, Kerry Ann; Zhang, Shucha; Zhao, Xueqing; Galanko, Joseph A.; Blevins, Tondra; Bennett, Brian J.; O'Connor, Annalouise; Zeisel, Steven H.

In: American Journal of Clinical Nutrition, Vol. 100, No. 3, 01.09.2014, p. 778-786.

Research output: Contribution to journalArticle

Miller, CA, Corbin, KD, Da Costa, KA, Zhang, S, Zhao, X, Galanko, JA, Blevins, T, Bennett, BJ, O'Connor, A & Zeisel, SH 2014, 'Effect of egg ingestion on trimethylamine-N-oxide production in humans: A randomized, controlled, dose-response study', American Journal of Clinical Nutrition, vol. 100, no. 3, pp. 778-786. https://doi.org/10.3945/ajcn.114.087692
Miller, Carolyn A. ; Corbin, Karen D. ; Da Costa, Kerry Ann ; Zhang, Shucha ; Zhao, Xueqing ; Galanko, Joseph A. ; Blevins, Tondra ; Bennett, Brian J. ; O'Connor, Annalouise ; Zeisel, Steven H. / Effect of egg ingestion on trimethylamine-N-oxide production in humans : A randomized, controlled, dose-response study. In: American Journal of Clinical Nutrition. 2014 ; Vol. 100, No. 3. pp. 778-786.
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abstract = "Background: It is important to understand whether eating eggs, which are a major source of dietary choline, results in increased exposure to trimethylamine-N-oxide (TMAO), which is purported to be a risk factor for developing heart disease. Objective: We determined whether humans eating eggs generate TMAO and, if so, whether there is an associated increase in a marker for inflammation [ie, high-sensitivity C-reactive protein (hsCRP)] or increased oxidation of low-density lipoprotein (LDL). Design: In a longitudinal, double-blind, randomized dietary intervention, 6 volunteers were fed breakfast doses of 0, 1, 2, 4, or 6 egg yolks. Diets were otherwise controlled on the day before and day of each egg dose with a standardized low-choline menu. Plasma TMAO at timed intervals (immediately before and 1, 2, 4, 8, and 24 h after each dose), 24-h urine TMAO, predose and 24-h postdose serum hsCRP, and plasma oxidized LDL were measured. Volunteers received all 5 doses with each dose separated by >2-wk washout periods. Results: The consumption of eggs was associated with increased plasma and urine TMAO concentrations (P <0.01), with ∼14{\%} of the total choline in eggs having been converted to TMAO. There was considerable variation between individuals in the TMAO response. There was no difference in hsCRP or oxidized LDL concentrations after egg doses. Conclusions: The consumption of ≥2 eggs results in an increased formation of TMAO. Choline is an essential nutrient that is required for normal human liver and muscle functions and important for normal fetal development. 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. This trial was registered at clinicaltrials.gov as NCT01906554.",
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