Trimethylamine N-Oxide (TMAO), Diet and Cardiovascular Disease

Purpose of ReviewThe association between plasma Trimethylamine N-Oxide (TMAO), diet and risk for cardiovascular disease (CVD) is still not fully understood. While epidemiologic research shows a causal relationship between plasma TMAO concentrations and CVD risk, the role of dietary precursors in determining plasma concentrations of TMAO and biomarkers for CVD is inconclusive.Recent FindingsStudies in diverse populations show that plasma TMAO concentrations are positively associated with inflammation, endothelial dysfunction, type-2 diabetes, central adiposity and hypertension. Most recent studies utilizing challenges of dietary choline have not shown increases in plasma chronic TMAO concentrations while studies with carnitine have shown increases in plasma TMAO but in some cases, no alterations in plasma lipids or biomarkers of oxidative stress were observed.SummaryTMAO is an important plasma metabolite that through several mechanisms can increase the risk of CVD. The correlations between dietary choline and carnitine on chronic plasma TMAO levels and risk for CVD requires further investigation.

Automated summary

The link between plasma TMAO levels and CVD risk is established in epidemiological research, but the role of dietary precursors in determining TMAO levels is still inconclusive. Recent studies show positive associations between plasma TMAO concentrations and various CVD risk factors, but the impact of dietary choline and carnitine on chronic plasma TMAO levels and CVD risk requires further investigation.