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TMAO – Smoking gun or passive observer?

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Once again, a new study recommends a correlation between a metabolite trimethylamine N-oxide( TMAO) and heart disease risk. But does TMAO cause heart disease or is it a marker of other conditions that often go along with heart disease?

Another study, published in Journal of the American College of Cardiology( JACC ), suggests community organizations between TMAO and risk of heart disease. As we have handled before, TMAO is produced by our intestine bacteria and varies based on our food. Eating more veggies can decrease TMAO, and feeing more meat can increase TMAO. But is TMAO causative of heart disease?

Some interpret the body of exhibit as confirming that TMAO is causative.

But, as with most epidemiology research, this study does not support that claim.

In the JACC study, scientists set baseline TMAO stages in 760 healthy women around the 1989, and again ten years later. The writers ascertained how many females had heart attacks and then tried to correlate heart attack risk with blood levels of TMAO. Those with the highest baseline level of TMAO and the greatest increase in TMAO had a risk of heart disease of between 1.33 and 1.79.

However, women with the highest TMAO levels who had a heart attack, compared to those who did not have heart attack, were also much more likely to have hypertension( 32% vs 19% ), diabetes( 7.9% vs 1.3% ), and to be a current smoker( 4.5% vs 1.8% ).[ Note that this data is only available in the supplementary counters and is not included in the article .] So, once again, it is unclear if the TMAO level had anything to do with the increased risk of feeling events, or if it was simply a marker that coincided with unhealthy lifestyles or “unhealthy user bias.”

TMAO proponents frequently noted that heights rise as topics eat more red meat. Therefore, countless will conclude the results of the study pictures we need to avoid meat to reduce our nature danger. But “thats really not” what studies and research establishes; it’s a gross misunderstanding of outcomes.

Why did some with raised TMAO have heart attacks and others did not? It appears to be related to other known determining factor( like hypertension, diabetes, and smoking status ), rather than to the absolute elevation of TMAO status.

Does this mean that we can ignore TMAO? Not necessarily. If someone has hypertension, diabetes, or is a current smoker, then TMAO may be a marker of high risk. But in the absence of those comorbid circumstances, it is not clear that the impact is significant enough to alter an already healthy lifestyle, even( specially ?) if it includes dining meat.

For more information, please ensure our evidence-based guide to red meat, and our coverage of the GRADE assessments of how science does not support restrict red meat or even processed meat.

Thanks for learning, Bret Scher, MD FACC

Earlier

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Journal firestorm: JAMA documents orchestrated resentment

Warnings about processed meat neglect the test of discipline

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