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Will Eggs Increase Your Chance of a Heart Attack?

Is it appropriate to worry that eating eggs will raise TMAO and increase the chance of a heart attack? It depends on the rest of the diet.

When it comes to breakfast, emotions run high. For decades now, people have heard that enjoying eggs at breakfast will increase the chance of a heart attack. This is largely because eggs are the most common dietary source of cholesterol, and the assumption has been made that consuming cholesterol will raise the level of cholesterol in the blood stream. But that assumption was never based on science, and the most recent research shows no connection between egg consumption and the risk of heart attacks (American Journal of Clinical Nutrition, online Feb. 10, 2016). You can read what we wrote about that study here and here.

But there are other questions about whether eating eggs for breakfast is a risky health habit. Perhaps you have worried about the question troubling this reader.

Enjoying a Low-Carb Breakfast:

Q. I eat a low-carb diet. For me, that means eggs for breakfast nearly every day. Recently I’ve read that egg yolks raise the blood level of TMAO, which can be a marker for a greater chance of a heart attack or stroke.

Dr Oz recommends no more than two yolks per week. Most of your guests say eggs are just fine. Who’s right?

TMAO and the Chance of a Heart Attack:

A. The story on TMAO (trimethylamine N-oxide) is a bit more complicated than “don’t eat eggs.” Although high circulating levels of TMAO have been associated with serious cardiovascular complications, eating fish leads to higher levels of TMAO than eating egg yolks (Nutrition, Nov.-Dec., 2015).  No one would suggest that you should cut back on fish consumption, as diets that substitute fish for meat (as the Mediterranean diet does) are associated with a lower risk of heart disease. (In fact, if you would like some variety in your breakfast menu, fish makes a great low-carb alternative to eggs once in a while.)

It turns out that gut microbes are crucial for producing TMAO, and they change depending upon your diet (Cell, Dec. 17, 2015). Provided that you include plenty of high-fiber plant foods in your low-carb diet, you will be feeding bowel bacteria that are less prone to producing dangerous amounts of TMAO. As far as we can tell, you should not need to worry about eating eggs for breakfast several times a week. Just make sure that you are enjoying plenty of almonds, broccoli, kale, spinach and other low-carb, high-fiber foods.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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