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Effect of egg ingestion on trimethylamine-N-oxide production in humans: a randomized, controlled, dose-response study , , ,
Open accessAbstract
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.
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In the citing paper
“Studies have also shown dose-dependent TMA/TMAO formation with egg ingestion.2,18”
From Impact of chronic dietary red meat, white meat, or non-meat protein on trimethylamine N-oxide metabolism and renal excretion in healthy men and women (2019) · cites this paper as [18]
In the citing paper
“About 15% of the PtdCho in eggs was converted to TMA, and peak plasma TMA concentrations were achieved between 6 and 8 h after ingestion of the eggs (79).”
From Trimethylamine N -Oxide, the Microbiome, and Heart and Kidney Disease (2017) · cites this paper as [79]
In the citing paper
“However, consumption of ≥2 eggs, which contain mostly PtdCho, results in increased formation of TMAO (79,110).”
From Trimethylamine N -Oxide, the Microbiome, and Heart and Kidney Disease (2017) · cites this paper as [79]
In the citing paper
“After people consume a meal containing eggs, TMAO concentrations in plasma peak at 6 to 8 h and return to baseline by 24 h after the meal (79).”
From Trimethylamine N -Oxide, the Microbiome, and Heart and Kidney Disease (2017) · cites this paper as [79]
In the citing paper
“suggest that other factors (e.g., host genotype) besides the abundance of TMA-producing bacteria may account for differences in TMAO accumulation (25).”
From Intestinal Microbiota Composition Modulates Choline Bioavailability from Diet and Accumulation of the Proatherogenic Metabolite Trimethylamine- N -Oxide (2015) · cites this paper as [25]
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The Gut Microbiota and Inflammation: An Overview
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“Eggs are a major source of dietary choline and consumption results in increased exposure to trimethylamine-N -oxide, a metabolite linked to atherosclerosis (Miller et al. 2014; Senthong et al. 2016).”
The contributory role of gut microbiota in cardiovascular disease
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Metadata
- Authors
- Miller, C. A., Corbin, K. D., da Costa, K.-A., Zhang, S., Zhao, X., Galanko, J. A., Blevins, T., Bennett, B. J., O’Connor, A., & Zeisel, S. H.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2014-09
- Volume
- 100
- Issue
- 3
- Pages
- 778-786
- ISSN
- 0002-9165 (ISSN-L)
- PMC
- PMC4135488
- OpenAlex
- W2073054952
- Cited by
- 240
- References
- 32
- Citations by year
- 2026: 10 · 2025: 12 · 2024: 11 · 2023: 14 · 2022: 16 · 2021: 27 · 2020: 30 · 2019: 25 · 2018: 29 · 2017: 23 · 2016: 24 · 2015: 16 · 2014: 3
- FWCI
- 21.89
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (DK56350, P30DK034987, P30DK056350)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Keywords
- trimethylamine N-oxide, dietary choline, dietary cholesterol, gut microbiota, C-reactive protein, inflammation, oxidized LDL, atherosclerosis risk, dose-response relationship
- MeSH terms
- Adult, C-Reactive Protein, Choline, Double-Blind Method, Egg Yolk, Eggs, Female, Heart Diseases, Humans, Lipoproteins, LDL, Longitudinal Studies, Male, Methylamines, Middle Aged, North Carolina, Pilot Projects, Risk Factors, Biomarkers, Up-Regulation, Cross-Over Studies
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