Summary of interventions to reduce the levels of TMAO
| Intervention | Efficacy | Population |
|---|---|---|
| Plant-based diets (e.g., Mediterranean) | Reduces TMAO by promoting beneficial gut bacteria | General population, those with cardiovascular/metabolic issues |
| High-fiber diet | Reduces TMA-producing bacteria | General population, those with metabolic/gut health issues |
| Reduced red meat consumption | Lowers TMAO by reducing LC and choline | Those with cardiovascular/metabolic diseases |
| Seafood | Increases TMAO levels; should be avoided for TMAO reduction | General population, those looking to lower TMAO |
| Legumes, soy, quinoa, fermented foods | Decreases TMAO by promoting beneficial bacteria | General population, those with metabolic/cardiovascular concerns |
| Probiotics | Suppresses TMA-producing bacteria (e.g., Lactobacillus, Bifidobacterium) | Those with high TMAO or gut dysbiosis |
| Prebiotics | Promotes growth of TMA-independent bacteria | Those with gut health issues |
| Exercise (endurance/aerobic) | Increases microbial diversity, reduces TMA-producing bacteria | General population, those with cardiovascular/metabolic issues |
| Antibiotics (rifaximin & metronidazole) | Reduces TMAO by targeting TMA-producing bacteria | Short-term use for those with high TMAO levels |
| Omega-3 supplements | Can help reduce TMAO levels | Those aiming to lower TMAO or improve metabolic health |
| Choline/LC-lowering drugs | May reduce TMAO levels | Those with elevated TMAO due to diet or metabolism |
LC: L-carnitine; TMA: trimethylamine; TMAO: trimethylamine-N-oxide
HSW: Conceptualization, Writing—original draft, Writing—review & editing, Supervision, Validation. FR: Writing—original draft, Writing—review & editing. AWI: Writing—original draft, Writing—review & editing. JAK: Writing—original draft, Writing—review & editing. AAS: Writing—original draft.
The authors declare that they have no conflicts of interest.
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