A lesser-known benefit of a plant based diet

You may not have heard about Trimethylamine oxide (TMAO), but this metabolite is created by the bacterial flora in the gut in response to certain food components.  This is the process.

TMAO originates from a precursor, trimethylamine (TMA) that is a metabolite of mainly choline and carnitine from ingested foods and may be involved in insulin resistance (Oellgaard J, et.al., 2017).  Why is TMAO important?

TMAO may not only increase the risk for insulin resistance, but also TMAO appears to be of particular importance

as a risk factor and potentially a causative agent of various pathologies, mostly cardiovascular disease and other associated conditions (Al-Rubaye H, et.al., 2018).

Dietary l-carnitine is converted into the atherosclerosis- and thrombosis-promoting metabolite TMAO via gut microbiota-dependent transformations.
TMAO transformation is induced by omnivorous dietary patterns and chronic l-carnitine exposure (Koeth RA, et.al., 2019 ).

A big difference in the TMAO levels can seen when comparing people eating animal-based protein to vegans (who eat plant-based protein). Eating a plant-based diet results in a different gut bacterial flora and will not produce much TMAO.

References

Trimethylamine N-oxide (TMAO) as a New Potential Therapeutic Target for Insulin Resistance and Cancer.
Oellgaard J, Winther SA, Hansen TS, Rossing P, von Scholten BJ.
Curr Pharm Des. 2017;23(25):3699-3712. doi: 10.2174/1381612823666170622095324. Review.
PMID:28641532

The Role of Microbiota in Cardiovascular Risk: Focus on Trimethylamine Oxide.
Al-Rubaye H, Perfetti G, Kaski JC.
Curr Probl Cardiol. 2018 Jul 7. pii: S0146-2806(18)30079-3. doi: 10.1016/j.cpcardiol.2018.06.005. [Epub ahead of print] Review.
PMID:30482503

l-Carnitine in omnivorous diets induces an atherogenic gut microbial pathway in humans.
Koeth RA, Lam-Galvez BR, Kirsop J, Wang Z, Levison BS, Gu X, Copeland MF, Bartlett D, Cody DB, Dai HJ, Culley MK, Li XS, Fu X, Wu Y, Li L, DiDonato JA, Tang WHW, Garcia-Garcia JC, Hazen SL. J Clin Invest. 2019 Jan 2;129(1):373-387. doi: 10.1172/JCI94601. Epub 2018 Dec 10.  PMID:30530985

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