Key takeaways:

1. Trimethylamine N-oxide (TMAO) is a compound linked to an increased risk of metabolic diseases, particularly heart and kidney diseases.
2. High levels of TMAO are associated with a 50% higher risk of cardiovascular diseases, a threefold increase in stroke risk, and a 39% higher risk of hypertension.
3. TMAO contributes to atherosclerotic plaque formation, cardiac fibrosis, blood clotting risks, and endothelial damage, leading to increased blood pressure.
4. Elevated TMAO levels are also associated with an increased risk of type 2 diabetes due to worsened insulin resistance and impaired pancreatic beta cell function.
5. TMAO is harmful to kidney health, contributing to kidney inflammation, fibrosis, and accelerated development of pre-existing kidney diseases.
6. Individuals with high TMAO levels have an almost 3.5 times higher risk of premature death.
7. TMAO is produced in the body from choline and L-carnitine, found in foods like eggs, meat, milk, and cheese, by gut bacteria.
8. Moderation in the consumption of eggs (2-3 per day), red meat, fish, and seafood can help manage TMAO levels.
9. Certain fish and seafood naturally contain high levels of TMAO, so their consumption should be limited to 3-4 times a week.
10. Strategies to reduce TMAO levels include supplementing with vitamin D and B vitamins, consuming garlic and its active ingredient allicin, and incorporating foods rich in polyphenols and glucosinolates.
11. Limiting salt intake, particularly from highly processed foods, can prevent the inhibition of TMAO excretion through urine.
12. Routine measurement of TMAO concentration is not common, and finding a laboratory that offers this test can be challenging.

# Introduction to Trimethylamine N-Oxide (TMAO)

• TMAO is a chemical compound linked to metabolic diseases.
• It is formed in the body from dietary components by gut bacteria.
• High levels of TMAO are associated with significant health risks.

# Impact of TMAO on Health

• TMAO poses a significant risk to the cardiovascular system, increasing the likelihood of heart diseases, stroke, and hypertension.
• It accelerates atherosclerotic plaque formation and promotes cardiac fibrosis.
• TMAO disrupts blood clotting mechanisms and damages the endothelium, potentially leading to increased blood pressure.
• Elevated TMAO levels are linked to a higher risk of type 2 diabetes due to increased inflammation, oxidative stress, and impaired insulin resistance and pancreatic beta cell function.
• TMAO is detrimental to kidney health, contributing to kidney disease and exacerbating existing kidney conditions.

# The Connection Between Diet and TMAO Levels

• TMAO is produced from choline and L-carnitine, which are found in nutritious foods like eggs, meat, and dairy products.
• Gut bacteria, particularly Firmicutes and Proteobacteria, convert these nutrients into TMAO.
• High consumption of TMAO-rich foods, including certain fish and seafood, can lead to increased TMAO levels in the body.

# Managing TMAO Levels Through Diet

• Consume eggs in moderation (2-3 per day).
• Limit the intake of fish and seafood known to contain high levels of TMAO to 3-4 times a week.
• Include omega-3-rich fish in the diet for their heart-protective benefits.

# Additional Strategies to Reduce TMAO

• Supplement with vitamin D and B vitamins to lower TMAO levels.
• Incorporate garlic and its active component allicin, which have antimicrobial properties that may inhibit TMAO production.
• Eat foods rich in polyphenols (e.g., berries, green tea, dark chocolate) and glucosinolates (e.g., cruciferous vegetables) to support a healthy gut microflora and reduce TMAO formation.
• Reduce salt intake, especially from processed foods, to avoid inhibiting TMAO excretion.

# Monitoring TMAO Levels

• Routine TMAO testing is not standard, and finding a laboratory that offers this service can be difficult.
• Blood tests are considered more authoritative than urine tests for measuring TMAO concentration.

# Conclusion and Further Learning

• TMAO is a silent risk factor for various metabolic diseases and premature death.
• Awareness and management of TMAO levels through diet and supplementation can mitigate associated health risks.
• For more information on TMAO and other health-related topics, consider subscribing to Dr. Bartek's Morning Health Journal.

For those interested in learning more about health risks and preventive strategies, Dr. Bartek's health newsletter offers valuable insights and actionable advice. Subscribers can sign up at www.drbartek.pl/dziennik for daily health tips and information.

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