Mixed
Higher plasma levels of the gut microbiome-derived metabolite Trimethylamine-N-oxide (TMAO) are associated with a significantly higher risk of incident atherosclerotic cardiovascular disease (ASCVD) in a diverse, community-based population free of prior cardiovascular disease.
This study suggests that higher levels of TMAO, a byproduct of gut bacteria processing nutrients like red meat and eggs, are linked to a higher risk of heart disease. While it doesn't tell you to eliminate these foods, it highlights the importance of your gut health and kidney function. If you have risk factors for heart disease, discussing your diet and TMAO levels with your doctor might be worthwhile, especially if you have reduced kidney function.
After multivariate adjustment, TMAO associated with higher risk of ASCVD in a dose-dependent fashion, with hazard ratios across quintiles of 1.02, 1.17, 1.23, and 1.33 (95% CI 1.02, 1.74), respectively, compared to the lowest quintile (P-trend = 0.01).
Why this rating
Large, prospective, multi-ethnic cohort with serial measurements and rigorous adjustment for confounders, though observational design prevents definitive causality.
Source
Trimethylamine-N-oxide (TMAO) and risk of incident cardiovascular events in the multi ethnic study of Atherosclerosis
Matthew J. Budoff et al. · Scientific Reports · 2025
DOI 10.1038/s41598-025-05903-3
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