Jafari Fatemeh, Damani Janhavi J, Petersen Kristina S
Department of Nutritional Sciences, Pennsylvania State University, University Park, PA, United States.
Department of Nutritional Sciences, Pennsylvania State University, University Park, PA, United States.
Adv Nutr. 2025 Jul;16(7):100453. doi: 10.1016/j.advnut.2025.100453. Epub 2025 May 24.
Cardiovascular concerns exist about the effect of red meat on circulating concentrations of trimethylamine N-oxide (TMAO), an emerging cardiovascular disease risk factor. The aim was to conduct a systematic review of randomized controlled trials (RCTs) to evaluate the effect of higher red meat intake, compared with lower intake, on circulating, urinary, and fecal TMAO concentrations in generally healthy adults and/or adults with stable chronic diseases. A systematic literature search was conducted using PubMed, the Cochrane Collaboration Library, and Web of Science. RCTs examining the effect of a ≥7-d dietary intervention featuring red meat on urinary, fecal, and/or circulating (plasma or serum) concentrations of TMAO in adults (≥18 y) were included. Eligible trials had a comparator group/condition that was exposed to a dietary intervention for ≥ 7 d lower in red meat and featuring white meat, fish, eggs, dairy, or plant-based protein sources. In total, 375 publications were identified. Fifteen publications reporting the results of 13 RCTs (n = 553; median duration 28 d), including 15 diet comparisons, were eligible. In 6 comparisons, higher circulating or urinary TMAO concentrations were observed after higher red meat intake (∼71-420 g/d) compared with comparator conditions lower in red meat. In 7 comparisons, no differences in serum/plasma TMAO concentrations were observed with higher red meat-containing diets (∼60-156 g/d) compared with diets lower in red meat. Two comparisons showed that consuming higher red meat diets lowered TMAO concentrations after 28 d compared with lower red meat diets containing seafood. In short-term studies (median duration of 28 d), higher red meat intake had inconsistent effects on circulating and urinary TMAO concentrations. Further high-quality research on red meat-related TMAO modulation, including effect magnitude and clinical relevance, is needed. This study was registered at Prospective Register of Systematic Reviews (PROSPERO) as CRD42023396799.
红肉对氧化三甲胺（TMAO）循环浓度的影响引发了心血管方面的担忧，TMAO是一种新出现的心血管疾病风险因素。本研究旨在对随机对照试验（RCT）进行系统评价，以评估与较低红肉摄入量相比，较高红肉摄入量对一般健康成年人和/或患有稳定慢性病的成年人的循环、尿液和粪便中TMAO浓度的影响。使用PubMed、Cochrane协作图书馆和科学网进行了系统的文献检索。纳入了研究≥7天以红肉为特色的饮食干预对成年人（≥18岁）尿液、粪便和/或循环（血浆或血清）中TMAO浓度影响的RCT。符合条件的试验有一个对照/条件组，该组接受≥7天的饮食干预，红肉含量较低，以白肉、鱼、蛋、乳制品或植物性蛋白质来源为特色。总共识别出375篇出版物。15篇报告13项RCT（n = 553；中位持续时间28天）结果的出版物符合条件，包括15种饮食比较。在6项比较中，与红肉含量较低的对照条件相比，较高的红肉摄入量（约71 - 420克/天）后观察到循环或尿液中TMAO浓度较高。在7项比较中，与红肉含量较低的饮食相比，红肉含量较高的饮食（约60 - 156克/天）在血清/血浆TMAO浓度上未观察到差异。两项比较表明，与含有海鲜的较低红肉饮食相比，食用较高红肉饮食28天后TMAO浓度降低。在短期研究（中位持续时间28天）中，较高的红肉摄入量对循环和尿液中TMAO浓度的影响不一致。需要对红肉相关的TMAO调节进行进一步的高质量研究，包括效应大小和临床相关性。本研究已在系统评价前瞻性注册库（PROSPERO）注册，注册号为CRD42023396799。
