Plasma TMAO and Choline Levels in Individuals With Metabolic Syndrome - Comparison Between Eggs and Choline Supplement.

Epidemiological data suggests that egg intake does not increase the risk for cardiovascular
disease (CVD). In fact eggs are a good source of phosphatidyl choline (PC) and choline has a
number of metabolic roles including lipid metabolism, membrane structure, liver health and a
neurotransmitter. Recent reports that choline may be metabolized by the intestinal microbiota
into TMAO, a compound that may increase the risk for heart disease. It is not clear how much
egg contribute to TMAO formation in individuals with metabolic syndrome.

Therefore the objective of this study is to determine the impact of daily intake of 3 eggs
versus a choline supplement on plasma TMAO and other biomarkers for CVD risk and also to
assess if there are changes in microbiota with these interventions that might lead to the
increases of TMAO in plasma.

Inclusion Criteria:

- All genders

- 35-70 years

- Metabolic syndrome (based on 3 out of 5 characteristics: waist circumference > 88 cm
for women and > 102 cm for men, plasma triglycerides > 150 mg/dL, fasting glucose >
100 mg/dL, blood pressure > 135/85 and HDL < 40 mg/dL for men and < 50 mg/dL for
women),

- willing to consume 3 eggs per day for 4 weeks

- willing to consume choline supplement (400 mg/day for 4 weeks)

Exclusion Criteria:

- Self-reported diaberes, cardiovascular disease, history of stroke, liver disease or
cancer

- Taking glucose lowering medications

- Taking antibiotics in the previous 1 month

- Triglycerides > 500 mg/dL,

- Cholesterol > 240 mg/dL,

- blood pressure > 145/100 mm of Hg

- Allergic to eggs or to choline