Animal products, including meat, cheese, and eggs contain carnitine and choline, metabolites that are converted by gut bacteria into TMA, which is then converted by the liver into TMAO. Plasma levels of TMAO are associated with an increased risk of disease and death, so should we limit intake of these animal products? Separately, fish contains relatively high levels of TMAO, and blood levels of TMAO spike after fish consumption, but there is a decreased all-cause mortality risk for fish consumers. To explain these disparate findings, other factors may be involved in the TMAO-health and disease story. In the video, I discuss the impact of kidney function on plasma levels of TMAO, disease and mortality risk.
Great discussion here on TMAO (which I had been studying for other reasons) and its links to both CVD and kidney function, as well as the gut microbiome.
I see that Quest Labs is now offering a TMAO blood test, which sounds like it could be a pretty interesting biomarker to try to manipulate through diet, probiotics…and also there is research showing it can be reduced with intake of polyphenols. Not sure if the test is available anywhere else, but I will be watching for that opportunity.