What Happens When Pregnant Women Eat More Animal Protein

Are high-protein diets during pregnancy healthful or harmful? That question was answered about 40 years ago in the infamous Harlem Trial of 1976: a “randomized controlled trial of nutritional supplementation pregnancy, in a poor black urban population in the United States.” The study, which I discuss in my video The Effect of Animal Protein on Stress Hormones, Testosterone, and Pregnancy, “was begun when protein was commonly assumed to be deficient in the diet of the poor.” Had researchers actually analyzed their diets before they started, they would have realized that this wasn’t true, but why let facts get in the way of assumptions? So, the researchers split poor black pregnant women into three groups, each receiving one of the following treatments: (1) an extra 40 grams of animal protein a day, which is essentially a couple cans of Ensure, (2) an extra 6 grams of animal protein, or (3) no extra protein. Then they sat back and watched what happened. The high-protein group suffered “an excess of very early premature births and associated neonatal [infant] deaths, and there was significant growth retardation” in the babies who survived. More protein meant more prematurity, more deaths, and more growth retardation, which you can see reflected in the chart at 1:00 in my video.

What’s more, animal protein intake during pregnancy has been associated with children becoming overweight later in life and getting high blood pressure. The “offspring of mothers who reported eating more meat and fish had higher systolic blood pressure” in adulthood. This was part of another failed dietary intervention trial in which mothers were advised to eat a pound of meat a day. The increased weight gain and high blood pressure may be due to the obesity-causing chemical pollutants in the meat supply, as I’ve discussed in my video Animal Protein, Pregnancy, and Childhood Obesity, or the animal protein-induced rise in the growth hormone IGF-1. Or, it could be due to a steroid stress hormone called cortisol.

As you can see in the chart at 2:01 in my video, a single meal high in animal protein can nearly double the level of the stress hormone in the blood within a half hour of consumption, much more than a meal closer to the recommended level of protein. When subjects are given a meal of crab, tuna fish, and cottage cheese, the stress hormone level shoots up. If they’re instead given some barley soup and a vegetable stir-fry on rice, the stress hormone level goes down after the meal, as you can see at 2:27 in my video. Imagine eating meat-fish-dairy meals day after day. Doing so “may chronically stimulate” our stress response axis “and increase the release of vasoactive hormones” that could increase our blood pressure. And, all that extra cortisol release has been linked to increased risk for elevated blood levels of insulin, triglycerides, and cholesterol.

When men on a high-protein diet, “such as meat, fish, poultry, egg white,” were switched to a high-carb diet of bread, vegetables, fruit, and sugary junk, their cortisol levels dropped about a quarter within 10 days. At the same time, their testosterone levels shot up by about the same amount, as you can see at 3:09 in my video. High-protein diets suppress testosterone. That is why, if men eating plant-based diets begin to eat meat every day, their testosterone levels go down and some estrogens actually go up, and that’s why bodybuilders can get such low testosterone levels. It’s not the steroids they’re taking. If you look at natural bodybuilders who don’t use steroids, there is a 75 percent drop in testosterone levels in the months leading up to a competition. Testosterone levels were cut by more than half, which is enough to drop a guy into an abnormally low range, as you can see at 3:47 in my video. It’s ironic that they’re eating protein to look manly on the outside, but it can make them less and less manly on the inside. And, from an obesity standpoint, in general, a drop in testosterone levels may increase the risk of gaining weight and body fat. What does cortisol have to do with weight?

There’s actually a disease caused by having too much cortisol, called Cushing’s syndrome, which can increase abdominal obesity. Even in normal women, though, chronic stress and chronic high cortisol levels can contribute to obesity. What’s more, if they’re pregnant, high-meat and low-carb diets may increase cortisol levels in the moms, which can lead to inappropriate fetal exposure to cortisol, which, in turn, can affect the developing fetus, resetting her or his whole stress response thermostat and leading to higher cortisol levels in later adult life. This can have serious, life-long health consequences. Every maternal daily portion of meat and fish was associated with 5 percent higher cortisol levels in their children as much as 30 years later, though green vegetable consumption was found to be protective. Higher meat consumption, such as three servings a day compared to one or two, was associated with significantly higher cortisol levels, but eating greens every day appeared to blunt some of that excess stress response, as you can see at 5:12 in my video.

As well, the adult children of mothers who ate a lot of meat during pregnancy don’t only have higher stress hormone levels, they also appear to react more negatively to whatever life throws at them. Researchers put them through the Trier Test, which involves public speaking in front of a panel of judges, following by a live math exercise. You can see in my video at 5:36 a chart comparing the stress hormone responses in those whose moms ate less than two servings of meat per day, about two servings a day, or about two to three servings a day. Note that before the test started, the cortisol levels of the two groups eating less meat started out about the same, but their exaggerated cortisol response was laid bare when exposed to a stressful situation. The real-world effects of this are that after that sort of test, when people are given their own private snack buffet with fruits and veggies versus fatty, sugary, comfort foods like chocolate cake, guess who may eat less of the fruits and veggies? Those who have high chronic stress levels. “Cortisol has been implicated as a factor in motivating food intake” even when we aren’t really hungry.

It’s no surprise then that a woman’s animal protein intake during pregnancy may lead to larger weight gain for her children later in life—and maybe even for her grandchildren. “Remarkably, recent evidence suggests that the long-term consequences of adverse conditions during early development may not be limited to one generation, but may lead to poor health in the generations to follow, even if these individuals develop in normal conditions themselves.” Indeed, the diet of a pregnant mother may affect the development and disease risk of her children and even her grandchildren. Ultimately, these findings may shed light on our rapidly expanding epidemics of diabetes, obesity, and heart disease.


Whoa, there was a lot to unpack! Rather than break it up, since so much of it was tied together, as you could see, I compiled everything into this one, heftier piece. You may want to read this a second time and watch the video to absorb it all.

For more on how a woman’s diet during pregnancy can affect her children, see Maternal Diet May Affect Stress Responses in Children and Animal Protein, Pregnancy, and Childhood Obesity.

Protein is such a misunderstood nutrient. For more information, check out:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

Do Poultry Viruses Cause Human Cancers?

The incidence of cancers has been rising for the last half century, and the question is why? Up to 20 percent of all cancers are caused by infectious agents, chiefly viruses. We’ve known this was possible for a century, when a cancer-causing virus was discovered in chickens. The idea was considered such heresy that Dr. Peyton Rous, the man who made this landmark discovery, wouldn’t get his Nobel Prize until 55 years later.

If there are cancer-causing chicken viruses, might they have any effect on people who handle or eat poultry? Concern has been raised about the potential infectivity of cancer-causing farm animal viruses for decades. The first question was whether there was any evidence of human exposure, and, indeed, people do have antibodies to these cancer-causing chicken viruses in their bloodstream. This indicates that the virus is no stranger to our immune systems. Is there any evidence, though, that the virus itself can get into our blood? There wasn’t any such evidence…until 2001.

As I explain in my video The Role of Poultry Viruses in Human Cancers, there is a cancer-causing herpesvirus in poultry, but does it pose a public health hazard? Researchers used DNA fingerprinting techniques to test the blood of 202 people and found that 20 percent, or one in five individuals, had viral DNA in their bloodstream. Testing positive for avian herpesvirus doesn’t mean these diseases can necessarily infect human cells, however. But, as it turns out, they can indeed.

But do they cause human disease? How can that be figured out? Since we can’t just inject people, researchers looked at poultry workers, which is the way we figured out how other farm animal diseases, such as brucellosis and anthrax, jumped to humans. In fact, studying workers is also how we discovered the carcinogenic nature of things like asbestos and benzene. If the poultry workers, who are exposed day in and day out, don’t have higher cancer rates, then presumably the viruses are harmless. Unfortunately, they do have higher rates. In fact, those with high exposure to cancer-causing poultry viruses have “increased risk of dying from several cancers.”

As such, “the relative ease” with which some of the viruses can infect human cells, as well as infect and cause tumors in primates in laboratories, “may be of public health significance, particularly because of the…increased risk of cancer in meat workers” and the evidence that we may become infected with these viruses. However, even if poultry workers are at risk, it doesn’t mean people who merely eat chicken or eggs are. For example, workers who kill chickens were found to be six times more likely to die from brain cancer compared to workers who do not kill poultry, but the slaughterers have live birds flapping in their faces. The “intensity of exposure to these viruses in the general population cannot be expected to be as high as those experienced by poultry workers…[but] the general population is nevertheless widely exposed” to the viruses simply because we eat so many chickens and eggs.

This is supported by data showing that it’s not only the factory farm workers who are at higher risk for brain tumors, but also butchers and meat cutters who have no exposure to live birds, particularly those who don’t wear gloves and frequently have cuts on their hands. These workers are at higher risk for other cancers, as well.

Those who handle meat for a living also have higher rates of non-cancer mortality, such as increased death from heart disease and other health concerns outlined at 3:32 in my video. Some of the poultry viruses not only cause cancer in chickens, but also atherosclerosis. Indeed, that cancer-causing poultry herpesvirus also triggers the buildup of cholesterol crystals in chickens. But, what about in people? “Because chickens infected with Marek disease virus, a herpesvirus, develop atherosclerotic lesions after infection, [researchers] looked for the presence of herpesvirus or parts thereof in human artery wall tissue…” Evidence of the virus was found, though any role they play in human heart disease remains speculative.

“Considerable attention has been paid to substances present in animal food before and after cooking as risk factors for human diseases such as heart disease, diabetes, and various cancers…[and] exposures have included heme [iron], fat or cholesterol, dioxins,” and the cooked meat carcinogens. We didn’t think, however, about the animal viruses, which “are important not only for supermarket workers and other workers in the meat and poultry industries, but also because the general population is exposed.” Indeed, the study that found chicken virus DNA circulating in people’s bloodstreams also found about the same rates in office workers as they did in chicken slaughterhouse workers, which you can see at 4:42 in my video.


Other viruses may actually play a role in the obesity epidemic. See, for example, Infectobesity: Adenovirus 36 and Childhood Obesity

For other potential microbiological hazards in poultry, check out:

And, for potential chemical hazards in poultry, see:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

How the Egg Industry Tried to Bury the TMAO Risk

“Metabolomics is a term used to describe the measurement of multiple small-molecule metabolites in biological specimens, including bodily fluids,” with the goal of “[i]dentifying the molecular signatures.” For example, if we compared the metabolic profile of those with severe heart disease to those with clean arteries, we might be able to come up with a cheap, simple, and noninvasive way to screen people. If heart patients happened to have something in their blood that healthy people didn’t, we could test for that. What’s more, perhaps it would even help us understand the mechanisms of disease. “To refer to metabolomics as a new field is injustice to ancient doctors who used ants to diagnose the patients of diabetes” (because the ants could detect the sugar in the diabetics’ urine).

The first modern foray discovered hundreds of substances in a single breath, thanks to the development of computer technology that made it possible to handle large amounts of information—and that was in 1971, when a computer took up nearly an entire room. “[N]ew metabolomics technologies [have] allowed researchers to measure hundreds or even thousands of metabolites at a time,” which is good since more than 25,000 compounds may be entering our body through our diet alone.

Researchers can use computers to turn metabolic data into maps that allow them to try to piece together connections. You can see sample data and a map at 1:28 in my video Egg Industry Response to Choline and TMAO. Metabolomics is where the story of TMAO started. “Everyone knows that a ‘bad diet’ can lead to heart disease. But which dietary components are the most harmful?” Researchers at the Cleveland Clinic “screened blood from patients who had experienced a heart attack or stroke and compared the results with those from blood of people who had not.”

Using an array of different technology, the researchers identified a compound called TMAO, which stands for trimethylamine N-oxide. The more TMAO people had in their blood, the greater the odds they had heart disease and the worse their heart disease was.

Where does TMAO come from? At 2:19 in my video, you can see a graphic showing that our liver turns TMA into TMAO—but where does TMA come from? Certain bacteria in our gut turn the choline in our diet into TMA. Where is the highest concentration of choline found? Eggs, milk, and meats, including poultry and fish. So, when we eat these foods, our gut bacteria may make TMA, which is absorbed into our system and oxidized by our liver into TMAO, which may then increase our risk of heart attack, stroke, and death.

However, simply because people with heart disease tend to have higher TMAO levels at a snapshot in time doesn’t mean having high TMAO levels necessarily leads to bad outcomes. We’d really want to follow people over time, which is what researchers did next. Four thousand people were followed for three years, and, as you can see in the graph at 3:10 in my video, those with the highest TMAO levels went on to have significantly more heart attacks, strokes, or death.

Let’s back up for a moment. If high TMAO levels come from eating lots of meat, dairy, and eggs, then maybe the only reason people with high TMAO levels have lots of heart attacks is that they’re eating lots of meat, dairy, and eggs. Perhaps having high TMAO levels is just a marker of a diet high in “red meat, eggs, milk, and chicken”—a diet that’s killing people by raising cholesterol levels, for example, and has nothing to do with TMAO at all. Conversely, the reason a low TMAO level seems so protective may just be that it’s indicative of a more plant-based diet.

One reason we think TMAO is directly responsible is that TMAO levels predict the risk of heart attacks, strokes, or death “independently of traditional cardiovascular risk factors.” Put another way, regardless of whether or not you had high cholesterol or low cholesterol, or high blood pressure or low blood pressure, having high TMAO levels appeared to be bad news. This has since been replicated in other studies. Participants were found to have up to nine times the odds of heart disease at high TMAO blood levels even after “controll[ing] for meat, fish, and cholesterol (surrogate for egg) intake.”

What about the rest of the sequence, though? How can we be certain that our gut bacteria can take the choline we eat and turn it into trimethylamine in the first place? It’s easy. Just administer a simple dietary choline challenge by giving participants some eggs.

Within about an hour of eating two hard-boiled eggs, there is a bump of TMAO in the blood, as you can see at 4:51 in my video. What if the subjects are then given antibiotics to wipe out their gut flora? After the antibiotics, nothing happens after they eat more eggs. In fact, their TMAO levels are down at zero. This shows that our gut bacteria play a critical role. But, if we wait a month and give their guts some time to recover from the antibiotics, TMAO levels creep back up.

These findings did not thrill the egg industry. Imagine working for the American Egg Board and being tasked with designing a study to show there is no effect of eating nearly an egg a day. How could a study be rigged to show no difference? If we look at the effect of an egg meal (see 5:32 in my video), we see it gives a bump in TMAO levels. However, our kidneys are so good at getting rid of TMAO, by hours four, six, and eight, we’re back to baseline. So, the way to rig the study is just make sure the subjects hadn’t eaten those eggs in the last 12 hours. Then, you can show “no effect,” get your study published in the Journal of the Academy of Nutrition and Dietetics, and collect your paycheck.


Unfortunately, this appears to be part for the course for the egg industry. For more on their suspect activities, see:

For more on the TMAO story, see:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations: