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The Influence of Animal- or Plant-Based Diets on Blood and Urine Trimethylamine-N-Oxide (TMAO) Levels in Humans

  • Cardiovascular Disease (JHY Wu, Section Editor)
  • Published:
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Abstract

Purpose of Review

The aim of the review was to evaluate which diets are associated with higher TMAO levels.

Recent Findings

Several studies have shown that plasma and urinary levels of trimethylamine N-oxide (TMAO) are a reliable indicator of cardiovascular disease risk. Diet certainly has a strong influence on TMAO levels, but there is still uncertainty about which diet is the most effective in reducing this risk factor.

Summary

PubMed, Web of Science and Scopus were searched for studies that were published up until July 1, 2021 using specific keywords. In total, 447 studies were evaluated, of which papers on individual foods or supplements, or conducted in children, in vitro or in animal model studies were excluded. Twenty-five studies were included in this review. Three studies showed that caloric restriction and (visceral) weight loss improve TMAO levels. Six out of eight studies revealed beneficial effects of plant-based diets on plasma or urinary TMAO concentrations. Most of the studies demonstrated that a diet high in protein, particularly of animal origin, such as diets rich in fish or red meat, have negative effects on TMAO levels. Most studies that have evaluated the relationship between diet and plasma or urinary concentrations of TMAO seem to indicate that plant-based diets (Mediterranean, vegetarian and vegan) are effective in improving TMAO levels, while animal-based diets appear to have the opposite effect. Further long-term studies are needed to assess whether vegetarian or vegan diets are more effective than the Mediterranean diet in reducing TMAO levels.

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Abbreviations

TMAO:

Trimethylamine N-oxide

TMA:

Trimethylamine

MD:

Mediterranean diet

VD:

Vegetarian diet

RCT:

Randomised controlled trial

CVD:

Cardiovascular disease

LCn3:

Long chain omega-3 polyunsaturated fatty acids

WD:

Western-style diet

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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  1. Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, via di Val Cannuta, 247, 00166, Rome, Italy

    Mauro Lombardo, Giovanni Aulisa & Daniele Marcon

  2. Independent Researcher, Via Venezuela, 66, Messina, 98121, Italy

    Gianluca Rizzo

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Lombardo, M., Aulisa, G., Marcon, D. et al. The Influence of Animal- or Plant-Based Diets on Blood and Urine Trimethylamine-N-Oxide (TMAO) Levels in Humans. Curr Nutr Rep 11, 56–68 (2022). https://doi.org/10.1007/s13668-021-00387-9

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