Latvian Institute of Organic Synthesis, LV-1006 Riga, Latvia.
Faculty of Pharmacy, Riga Stradiņš University, LV-1007 Riga, Latvia.
Nutrients. 2022 Mar 5;14(5):1093. doi: 10.3390/nu14051093.
Elevated plasma levels of trimethylamine N-oxide (TMAO) have been proposed as a diet-derived biomarker of cardiometabolic disease risk. Caloric restriction is the most common dietary intervention used to improve cardiometabolic health; however, novel trends suggest a fasting-mimicking diet (FMD) as a more feasible alternative. FMD is a variation of intermittent fasting, based on caloric restriction and limitation of protein sources of animal origin, applied in daily cycles during a 5-day period. As TMAO is intensively produced by gut microbiota after the consumption of animal-derived products, we aim to investigate whether a 5-day FMD affects plasma TMAO levels and markers of metabolic health. To investigate whether an increase in vegetable intake possesses similar effects on TMAO levels and metabolic parameters, healthy volunteers ( = 24) were subjected to a 5-day FMD and 19 volunteers served as a reference group (VEG). This group of volunteers consumed an additional four servings of vegetables per day, but otherwise stayed on their usual diet. FMD resulted in a twofold decrease in plasma TMAO levels, which was not evident in the volunteers from the VEG group. Moreover, FMD led to a weight loss of 2.8 ± 0.2 kg and a subsequent reduction in BMI compared to baseline. The FMD group exhibited a significant elevation in plasma ketone bodies (14-fold compared to baseline) and a decrease in IGF-1 levels by 37 ± 8 ng/mL. Since fasting glucose and C-peptide levels decreased, all volunteers in the FMD group showed improved insulin sensitivity and a decreased HOMA-IR index. In contrast, in the VEG group, only a slight reduction in plasma levels of fasting glucose and triglycerides was noted. In conclusion, we show that FMD is a viable strategy to reduce plasma levels of TMAO by limiting caloric intake and animal-derived protein consumption. The reduction in the level of TMAO could be an additional benefit of FMD, leading to a reduced risk of cardiometabolic diseases.
血浆中三甲胺 N-氧化物（TMAO）水平升高被认为是代谢性心血管疾病风险的饮食衍生生物标志物。热量限制是改善代谢性心血管健康最常用的饮食干预措施；然而，新的趋势表明，禁食模拟饮食（FMD）是一种更可行的替代方案。FMD 是间歇性禁食的一种变体，基于热量限制和限制动物源性蛋白质来源，在 5 天的周期内每天循环应用。由于 TMAO 在食用动物源性产品后被肠道微生物大量产生，我们旨在研究 5 天 FMD 是否会影响血浆 TMAO 水平和代谢健康标志物。为了研究增加蔬菜摄入量是否对 TMAO 水平和代谢参数具有相似的影响，健康志愿者（n = 24）接受了 5 天 FMD，19 名志愿者作为对照组（VEG）。该组志愿者每天额外食用四份蔬菜，但仍保持其常规饮食。FMD 导致血浆 TMAO 水平降低了两倍，但 VEG 组志愿者中没有明显变化。此外，FMD 导致体重减轻 2.8 ± 0.2 kg，与基线相比 BMI 降低。FMD 组的血浆酮体水平显著升高（与基线相比增加了 14 倍），IGF-1 水平降低了 37 ± 8 ng/mL。由于空腹血糖和 C 肽水平降低，FMD 组所有志愿者的胰岛素敏感性均提高，HOMA-IR 指数降低。相比之下，VEG 组仅观察到空腹血糖和甘油三酯的血浆水平略有降低。总之，我们表明 FMD 通过限制热量摄入和动物源性蛋白质的消耗是降低 TMAO 血浆水平的可行策略。TMAO 水平的降低可能是 FMD 的额外益处，从而降低代谢性心血管疾病的风险。
