Food / Diets / Nutrients & Trimethylamine-N-Oxide (TMAO)

The levels of Trimethylamine-N-Oxide (TMAO) in the body are influenced by the intake of certain nutrients, which are metabolized by the gut microbiota and then further processed by the liver.

Nutrients Affecting Trimethylamine-N-Oxide (TMAO) Levels

Studies have shown a correlation between the consumption of various types of fish (saltwater fish, dark meat fish, and shellfish) and increased urine or plasma TMAO values
Lombardo et al. 2021 Nutrients 13(5): 1426

Higher intake of animal protein, such as meat and eggs, has been associated with increased Trimethylamine-N-Oxide (TMAO) levels. Specifically, egg yolk consumption contributes significantly to plasma Trimethylamine-N-Oxide (TMAO) levels due to the phosphatidylcholine it contains, which is metabolized by the gut microbiota
Lombardo et al. 2021 Nutrients 13(5): 1426

Trimethylamine-N-Oxide (TMAO) is mainly formed from the metabolism of phosphatidylcholine/choline, carnitine, betaine, dimethylglycine, and ergothioneine by the gut microbiota
Gatarek & Kaluzna-Czaplinska 2021 EXCLI J. 20: 301-319

A diet high in red meat, which is rich in L-carnitine and choline, has been shown to increase plasma Trimethylamine-N-Oxide (TMAO) levels
Papandreou et al. 2020 Nutrients 12(5): 1330

A few key observations confirm the mechanistic context: Omnivore humans challenged with l-carnitine had higher Trimethylamine-N-Oxide (TMAO) levels than vegans or vegetarians
Zmora et al. 2019 Nat Rev Gastroenterology & Hepatology 16: 35

L-carnitine from, e.g., red meat in Bacteroides' presence decreases Trimethylamine-N-Oxide (TMAO) and the risk for cardiovascular disease
Zmora et al. 2019 Nat Rev Gastroenterology & Hepatology 16: 35

Emulsifiers such as lecithin increase Trimethylamine-N-Oxide (TMAO) and the risk for cardiovascular disease. The contribution of gut microbiota is not known yet
Zmora et al. 2019 Nat Rev Gastroenterology & Hepatology 16: 35

Polyphenols such as resveratrol reduce the abundance of Prevotella and decrease TMAO and the risk for cardiovascular disease
Zmora et al. 2019 Nat Rev Gastroenterology & Hepatology 16: 35

Choline, abundant in full-fat dairy products like whole milk, egg yolks, and cream cheese, is a precursor to Trimethylamine-N-Oxide (TMAO)

Some supplements and energy drinks contain L-carnitine and choline, which can also contribute to Trimethylamine-N-Oxide (TMAO) production

Dietary Patterns and Trimethylamine-N-Oxide (TMAO)

A plant-based diet has been explored for its effects on TMAO levels, with evidence suggesting that vegetarians and vegans, who avoid meat products, produce little Trimethylamine-N-Oxide (TMAO)

Foods common in the Mediterranean diet, such as Red wine and extra virgin Olive oil, may contain compounds like DMB that can reduce Trimethylamine-N-Oxide (TMAO) production

see also:
Choline & Gut microbiota
Mediterranean diet & Trimethylamine-N-Oxide (TMAO)
Trimethylamine-N-Oxide (TMAO) & Vegan Diet