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Whole Grains and Long-Chain n–3 Fatty Acids Rich Diets Increase TMAO Levels in Blood

According to the findings of a study, a dietary pattern high in long-chain n–3 fatty acids (LCn3) from marine foods or whole-grain cereals (WGCs) might significantly raise plasma trimethylamine N-oxide (TMAO) concentrations.

Whole Grains and Long-Chain n–3 Fatty Acids Rich Diets Increase TMAO Levels in Blood
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"These changes mirrored the direct associations between TMAO concentrations and intakes of fish and WGCs," the researchers wrote. "This suggests that TMAO reflects intakes of these healthy foods and, thus, it is not a universally valid biomarker of cardiometabolic risk independent of the background diet."

An auxiliary investigation within two randomized controlled trials was conducted to examine the medium-term impact of diets naturally rich in polyphenols and/or LCn3 or WGCs on cardiometabolic risk variables (Ether paths Project and Health Grain Project).

Changes in TMAO (8-week minus baseline) were statistically significant in the Ether paths research (n=78) for meals high in LCn3 (1.1511.58 μmol/L; p=0.007), but not for diets rich in polyphenols (–0.149.66 μmol/L; p=0.905) or their combination (p=0.655; 2-factor ANOVA).

The WGC group (0.943.58 μmol/L) significantly varied from the Refined Cereal group (–1.293.09 μmol/L; p=0.037) in the Health Grain Study (n=48).

TMAO concentrations were linked to LCn3, eicosapentaenoic acid (20:5n–3), and protein intake, but not saturated fatty acids, fiber, monounsaturated fatty acids, or polyphenol intake, according to the combined data of participants in the two investigations.

TMAO was also linked to fish, vegetables, and whole-grain goods, but not to meat, processed meat, or dairy products.

“TMAO has received a lot of attention as a marker for a variety of chronic diseases,” the authors said. "Data on the relationship between diet and TMAO are contradictory, and just a few human intervention studies have looked into causality."


Source: Am J Clin Nutr 2021;114:1342-1350

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