Postgraduate Program in Nutrition Sciences, Fluminense Federal University (UFF), Niterói, RJ, Brazil.
Postgraduate Program in Cardiovascular Sciences, Faculty of Medicine, Fluminense Federal University, Niterói, Brazil.
Eur J Nutr. 2021 Oct;60(7):3567-3584. doi: 10.1007/s00394-021-02491-6. Epub 2021 Feb 3.
Trimethylamine N-oxide (TMAO) is a metabolite that has attracted attention due to its positive association with several chronic non-communicable diseases such as insulin resistance, atherosclerotic plaque formation, diabetes, cancer, heart failure, hypertension, chronic kidney disease, liver steatosis, cardiac fibrosis, endothelial injury, neural degeneration and Alzheimer's disease. TMAO production results from the fermentation by the gut microbiota of dietary nutrients such as choline and carnitine, which are transformed to trimethylamine (TMA) and converted into TMAO in the liver by flavin-containing monooxygenase 1 and 3 (FMO1 and FMO3). Considering that TMAO is involved in the development of many chronic diseases, strategies have been found to enhance a healthy gut microbiota. In this context, some studies have shown that nutrients and bioactive compounds from food can modulate the gut microbiota and possibly reduce TMAO production.
This review has as main objective to discuss the studies that demonstrated the effects of food on the reduction of this harmful metabolite.
All relevant articles until November 2020 were included. The articles were searched in Medline through PubMed.
Both the food is eaten acutely and chronically, by altering the nature of the gut microbiota, influencing colonic TMA production. Furthermore, hepatic production of TMAO by the flavin monooxygenases in the liver may also be influenced by phenolic compounds present in foods.
The evidence presented in this review shows that TMAO levels can be reduced by some bioactive compounds. However, it is crucial to notice that there is significant variation among the studies. Further clinical studies should be conducted to evaluate these dietary components' effectiveness, dose, and intervention time on TMAO levels and its precursors.
三甲胺 N-氧化物（TMAO）是一种代谢物，由于其与多种慢性非传染性疾病（如胰岛素抵抗、动脉粥样硬化斑块形成、糖尿病、癌症、心力衰竭、高血压、慢性肾脏病、肝脂肪变性、心脏纤维化、内皮损伤、神经退行性变和阿尔茨海默病）呈正相关而受到关注。TMAO 的产生是由于肠道微生物群对膳食营养素（如胆碱和肉碱）的发酵，这些营养素转化为三甲胺（TMA），并在肝脏中由黄素单加氧酶 1 和 3（FMO1 和 FMO3）转化为 TMAO。鉴于 TMAO 参与了许多慢性疾病的发展，人们已经发现了一些增强健康肠道微生物群的策略。在这种情况下，一些研究表明，食物中的营养物质和生物活性化合物可以调节肠道微生物群，并可能减少 TMAO 的产生。
本综述的主要目的是讨论证明食物对减少这种有害代谢物的影响的研究。
纳入了截至 2020 年 11 月的所有相关文章。通过 PubMed 在 Medline 上搜索这些文章。
无论是急性还是慢性食用食物，都会通过改变肠道微生物群的性质，影响结肠 TMA 的产生。此外，肝脏中黄素单加氧酶产生的 TMAO 也可能受到食物中存在的酚类化合物的影响。
本综述中提出的证据表明，一些生物活性化合物可以降低 TMAO 水平。然而，值得注意的是，研究之间存在显著差异。应该进行进一步的临床研究，以评估这些饮食成分对 TMAO 水平及其前体的有效性、剂量和干预时间。
