These Common Food Raise TMAO Levels & Your Risk of Disease
Systematic reviews & meta-analysis of prospective studies have found elevated serum TMAO concentrations to be linked to:
A 62% increased risk of all-cause mortality
A 23% higher risk of cardiovascular events
What is TMAO?
Trimethylamine N-oxide (TMAO) is an organic molecule that has gained significant interest due to its links with cardiovascular diseases & metabolic disorders.
TMAO is formed in the body as a result of the metabolism of certain dietary compounds by gut bacteria.
Some foods also naturally contain high levels of TMAO itself.
Here’s a more detailed overview of TMAO and its connection to disease:
Formation of TMAO: TMAO is produced in a multi-step process. It begins with the consumption of foods rich in choline, lecithin, and carnitine, which are abundant in meat, fish, eggs, and full fatdairy products. These compounds are broken down by gut bacteria into trimethylamine (TMA), which is then absorbed into the bloodstream.
Conversion in the Liver: Once TMA is absorbed into the bloodstream, it is transported to the liver, where it is converted into TMAO by an enzyme called flavin-containing monooxygenase 3 (FMO3). TMAO is then released into the circulation and can be measured in the blood.
A. Cardiovascular Diseases: Elevated levels of TMAO have been linked to an increased risk of cardiovascular diseases, including atherosclerosis & heart disease. TMAO promotes the accumulation of cholesterol in artery walls & can contribute to the development of plaques.
B. Metabolic Disorders: Metabolic disorder & Type 2 diabetes is characterized by high blood sugar levels due to insulin resistance & impaired insulin secretion. Higher serum TMAO has been associated an increase in fasting glucose among middle-aged & older adults. TMAO’s impact on this metabolic disorder is multifaceted:
Insulin Resistance: Elevated TMAO levels have been linked to insulin resistance. This resistance hinders the uptake of glucose into cells, leading to elevated blood sugar levels.
Inflammation: TMAO has been shown to activate pro-inflammatory pathways in various cell types. Inflammation worsens progression of type 2 diabetes. TMAO’s pro-inflammatory effects may exacerbate inflammation in diabetes, further compromising insulin sensitivity.
Synergistic Effects: There may be synergistic effects between TMAO-induced inflammation and the existing inflammatory state seen in type 2 diabetes. This dual inflammatory burden could intensify insulin resistance & beta cell dysfunction.
Oxidative Stress: TMAO has been associated with the activation of an enzyme called NADPH oxidase, which is a source of reactive oxygen species (ROS) production in cells. This activation can contribute to the accumulation of ROS & oxidative stress.
Kidney Function: Patients with chronic kidney disease (CKD) often exhibit elevated levels of TAMO in blood. Elevated TMAO levels, along with its dietary precursor choline, have been identified as potential predictors of heightened risk for the onset of CKD in healthy individuals. Experiments conducted with mice that were fed diets containing TMAO or choline have provided indications that TMAO may play a contributory role in the development of kidney dysfunction & renal fibrosis. TMAO levels are also sometimes used as a biomarker for assessing kidney disease.
Endothelial Dysfunction: TMAO has been associated with endothelial dysfunction, a condition in which the lining of blood vessels loses its ability to regulate vascular tone and inflammation. Endothelial dysfunction is a precursor to atherosclerosis.
Research has shown that dietary modifications, such as reducing the intake of foods rich in choline, lecithin, and carnitine, can lower TMAO levels.
It’s important to note that while TMAO is a metabolite of choline, lecithin, and carnitine, certain foods such as deep water fish cod, haddock naturally contain trimethylamine N-oxide (TMAO) in their tissues.
Stay tuned for upcoming episodes in the 'Nutritional Excellence' series where we will continue to dig into:
Various compounds that metabolise into TMAO
What foods contain these compounds
Foods that contain TMAO in itself
Possible dietary interventions/replacements can be made
In recent episode of the ongoing Supplement series, I released my Age-Better Longevity stack. If you have missed it, you can read about it here:
This information is not medical advice. This content and other content on this website is for informational and educational purposes only and is not intended to be a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
References
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