Advanced Prostate Cancer
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Choline / Eggs

New study below [1].

What we already know:

i) PCa cells have an increased uptake of choline - hence the interest in radio-labeled choline PET imaging. Fluorodeoxyglucose (fludeoxyglucose) can't be used, since prostatic (including PCa) cells prefer fatty acids to glucose. (Sugar does not affect proliferation.)

ii) A couple of large epidemiological studies by Erin Richman associated egg intake with PCa.

iii) Many men with PCa avoid eggs.

From the new (non-PCa) study:

"Choline is an essential nutrient with critical roles in several biological processes including neuronal development, cell signaling, nerve impulse transmission, and lipid transport and metabolism. The National Cancer Institute method was used to assess usual intakes of choline from foods according to data for participants enrolled in the National Health and Nutrition Examination Survey 2009–2014 datasets... Suboptimal intakes of choline are present across many gender and life-stage subpopulations.... Only 8.03 ... of adults ... meet the AI for choline. ... Adults 19+ years who consume eggs were more likely to meet their gender and life-stage AI as compared to non-consumers ... Consumers of eggs had almost double the usual intake of choline as compared to non-consumers (525 ... mg/d and 294 ...). Protein food (meat, poultry and seafood) consumption also increased usual choline intakes compared to non-consumers (345 ... mg/day and 235 ...) to a lesser degree, but did not result in substantial increases in the percent of individuals meeting the AI. No subpopulation exceeded the UL for choline. This research illustrates that it is extremely difficult to achieve the AI for choline without consuming eggs or taking a dietary supplement."

Here's someyhing I wrote a year ago:

"The {adequate intake} for adult men is 550 mg/day." [2]

A large egg has 147 mg.

8 oz cod has 190 mg.

1 lb broccoli = 182 mg

8 oz chicken has 150 mg

(Eat any 3 of those 4 & you would still come up short.)

"Most common signs of choline deficiencies are fatty liver and hemorrhagic kidney necrosis."

The egg lady (Erin Richman) has tried to pin the blame on choline, but I'm not convinced.

If I ate an egg every day, I would still have a problem hitting 550mg. I have a great source of freerange eggs & would have no worry about eating a daily egg for the duration.

What puzzles me is how our hunter-gatherer ancestors managed to meet 550mg adequacy.

For anyone who buys into Erin's theory, a vegan diet without a choline supplement will create deficiency. But watch out for the "fatty liver and hemorrhagic kidney necrosis".

In Erin's data associating choline intake with lethal PCa, it's the men in the lowest quintile who have the protection. Risk factors for 2nd, 3rd, 4th & 5th quintiles:

1.58 1.30 1.51 1.68, compared to the 1st (1.00). [5]

{One way of looking at that: there is one-third less risk of lethal PCa if one is in the lowest level of intake.}

The earliest PCa paper on PubMed for [(11)C]choline positron emission tomography (PET) is de Jong et al, 2003. In 2005, the same Dutch team looked into choline uptake & proliferation [3]:

{Note that Ki-67 "is a cellular marker for proliferation. It is strictly associated with cell proliferation." [4]}

"In vivo uptake of [(11)C]choline does not correlate with cell proliferation in human prostate cancer as depicted by Ki-67. Our results suggest that a process other than proliferation is responsible for the uptake of [(11)C]choline in prostate cancer."

-Patrick

[1] mdpi.com/2072-6643/9/8/839

[2] en.wikipedia.org/wiki/Choline

[3] ncbi.nlm.nih.gov/pubmed/157...

[4] en.wikipedia.org/wiki/Ki-67...

[5] ncbi.nlm.nih.gov/pmc/articl...

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Thanks Patrick. I guess I know quite a lot, but I don't know much of anything for sure. Until this science is clearer, I'll continue to avoid eggs and get my choline from broccoli and other plant-based sources.

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It is the egg yolks that are suspect. I eat egg beaters twice a week. no yolks.

There is a very small amount of choline in the egg whites.

Rich

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Dr. Michael Greer in his 2015 book How Not To Die refers to Harvard researchers' paper Choline Intake and Risk of Lethal Prostate Cancer. They blame the conversion of Choline to the toxin trimethylamine. I miss my eggs! Thanks for your data.

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Do you still eat chicken ??

Dr. Michael Greger says " Patients may face twice the prostate cancer progression risk from eating less than a single egg per day and up to quadruple the risk from eating less than a single serving of chicken or turkey daily." page 252 in his book "How Not To Die".

Apart from anything else, it is my opinion that Dr Greger's title "How Not To Die" is exceedingly presumptuous. As if its even possible :-) Not dying, that is.

Cheers and all the very best.

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Patrick

So what is your personal strategy with eggs?

What opinion do you have about just eating egg whites?

Take a look at this discussion (it includes a compilation of the egg lady's research):

healthunlocked.com/advanced...

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I buy eggs from a local farm where the chickens are free to roam. It's up to them to find most of what they need and not overdo the grain. The eggs are superb.

I would happily eat one a day, or two small eggs, but I eat other things too.

Men with PCa can sometimes obsess about the choline content, but most of us have diets that are barely sufficient at best.

It is a crime to eat only the egg white & to discard the yolk, and an egg white omelet is a culinary abomination.

-Patrick

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