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In May 2013, we reported the discovery of a proatherogenic molecule, trimethylamine-N-oxide (TMAO; JW Gen Med May 14 2013). People with the highest blood levels of TMAO, compared with those with the lowest levels, had 2.5-fold higher risk for cardiovascular disease. TMAO is produced when certain gut bacteria metabolize lecithin.
In a new study, researchers found that gut bacteria also produce TMAO when metabolizing l-carnitine, a compound that is abundant in red meat. Meat-eaters produced more TMAO after meals containing a measured amount of l-carnitine than vegans did; meat-eaters also harbored more of the types of bacteria that metabolize l-carnitine into TMAO. Studies in mice confirmed that diets rich in l-carnitine increased the number o…