Page 10 - Summer2011

Caustic Commentary

Sally Fallon Morell takes on the Diet Dictocrats

CHOLINE ACCUSED acid, which is used as an important signaling molecule. El-
Choline is an essential nutrient found in cholesterol-rich foods evated blood levels of choline, then, and perhaps its metabolite
like liver and egg yolks. Among many other roles, it supports betaine, could simply reflect an inflammatory or pro-clotting
neurological development and mental health, and protects environment—they are an indicator, not a cause. Elevated
against fatty liver disease. So it will be no surprise to our TMAO could reflect dietary trimethylamine or TMAO from
readers that establishment nutritionists have choline in the seafood, but it could also reflect impaired excretion into the
crosshairs. For example, a recent paper published in Nature urine, or enhanced conversion of trimethylamine to TMAO
suggests that dietary choline may contribute to heart disease in the liver. So you can continue to enjoy egg yolks and liver,
(Nature 2011;472(7341):57-63). The authors argue that dietary as we have no evidence that eating choline-rich animal foods
choline, found mostly in a form called phosphatidylcholine, increases TMAO at all. For further information, see Chris
enters the intestine where our gut bacteria convert it to free Masterjohn's blog, "Does Dietary Choline Contribute to Heart
choline and then to trimethylamine, a gas that smells like Disease?" at www.westonaprice.org.
rotting fish. Then our livers detoxify the trimethylamine to
an odorless product called trimethylamine oxide (TMAO), PLACING BLAME
and TMAO, the authors argue, fills our arteries with plaque. Health officials are warning about rising rates of degenerative
In support of this hypothesis, the authors showed that blood disease in developing countries. No longer diseases of rich
levels of choline, its metabolic byproduct betaine, and TMAO nations, cancer and heart disease are increasing throughout
all correlated with the incidence and severity of cardiovascular the world. For example, more than half of all people newly
disease in humans (although this was not prospective data diagnosed with cancer in 2008 lived in developing coun-
showing that the occurrence of these compounds in the blood tries such as Nigeria, Egypt and Brazil, compared to just 15
early in life predicted the development of heart disease later percent in 1970. The projected increase in cancer deaths for
in life). They also showed that feeding mice phosphatidyl- 2002-2020 is over 60 percent for South Central Asia, North
choline did in fact produce TMAO, but only in the presence Africa, West Asia, Latin America, the Caribbean and South-
of gut bacteria. Further, feeding mice five-fold or ten-fold east Asia, compared with 20 percent for Europe. To explain
higher concentrations of choline chloride than they would these epidemics, health officials cite the fact that people
ordinarily receive, or simply feeding them TMAO itself, are living longer and dying less frequently from infectious
increased atherosclerotic lesion size, and atherosclerotic le- disease (Scientific American, December 2010). There is no
sion size correlated with blood levels of TMAO. There’s just mention of fundamental dietary changes (such as replacing
one major problem with this hypothesis. Studies in humans animal fats with vegetable oils) and heavy use of pesticides
have shown that neither phosphatidylcholine nor choline-rich and other chemicals as developing nations embrace industrial
foods produce detectable increases in trimethylamine. For agriculture and modern food processing technology.
example, in a 1999 study, researchers fed forty-six different
foods to humans and looked at the subsequent excretion of THE STRONG CHIN IMPERATIVE
trimethylamine and TMAO. Choline-rich foods like liver and Psychologists at the University of Toronto and Tufts Univer-
eggs did not produce any increase in urinary trimethylamine sity have shown that law firms are more profitable when led
or TMAO over control levels. But how should we interpret the by managing partners with “powerful-looking” faces. Their
correlation between heart disease risk and plasma concentra- studies also showed that an individual’s career success can
tions of choline, betaine and TMAO in humans? Blood levels be predicted thirty to forty years earlier simply by looking
of choline are currently considered an emerging marker for at his or her face. Researchers asked participants to judge
destabilization of coronary plaques or ischemia in acute coro- photos of seventy-three managing partners from the top one
nary syndrome, as reviewed here. During the process of blood hundred American law firms in 2007. They used a scale of one
clotting, inflammatory enzymes release choline from mem- to seven to measure qualities like dominance, facial maturity,
brane phospholipids in order to also generate phosphatidic likability and trustworthiness. Half the judges rated current
10 Wise Traditions SUMMER 2011

79998_WAP_Text.indd 10 6/15/11 10:08 AM