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Trimethylamine-N-oxide and its biological variations in vegetarians

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European Journal of Nutrition Aims and scope Submit manuscript

Abstract

Purpose

Restriction of animal foods and choline may affect plasma trimethylamine-N-oxide (TMAO). In vegetarians, we investigated the association between TMAO concentrations and the strictness of the diet or sex. We also studied the biological variations of TMAO in vegans.

Methods

Concentrations of plasma TMAO and choline metabolites were measured in 38 vegans and 67 lacto-ovo-vegetarians (group 1: mean age ± SD = 50 ± 15 years). Group 2 consisted of 66 vegans (29.2 ± 7.3 years) that was tested twice within 3 months of intervention with vitamin B12 or a placebo.

Results

In group 1, plasma TMAO did not differ according to the strictness of the diet (both means 3.7 µmol/L). In lacto-ovo-vegetarians, men had higher TMAO and betaine, but lower trimethylamine than women. In group 2, the intervention with vitamin B12 had no effect on plasma TMAO or choline metabolites. The mean within-subject change of TMAO within 3 months was −0.3 (95 % confidence intervals = −0.7–0.1 µmol/L). TMAO increased after 3 months (mean 1.7 to 2.8 µmol/L) in vegans with a lower baseline dimethylglycine (2.2 µmol/L), while it declined (from 2.7 to 1.9 µmol/L) in vegans with a higher dimethylglycine (3.1 µmol/L). The intra-class correlation coefficients were 0.819 for TMAO, 0.885 for betaine and 0.860 for dimethylglycine.

Conclusions

Plasma TMAO was not related to the strictness of the vegetarian diet. Metabolisms of TMAO and dimethylglycine are interrelated. Intra-individual variations of TMAO are low in vegans. Changes of fasting plasma TMAO >80 % upon retesting are likely to exceed the biological variations.

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Abbreviations

BHMT:

Betaine-homocysteine methyltransferase

BMI:

Body mass index

FMO3:

Flavin-containing monooxygenase 3

MMA:

Methylmalonic acid

tHcy:

Total homocysteine

TMAO:

Trimethylamine-N-oxide

UPLC-MS/MS:

Ultra-performance liquid chromatography-tandem mass spectrometry

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Acknowledgments

R. Obeid was supported by a Marie-Curie research fellowship at the University of Aarhus, Denmark. H. M. Awwad was supported by a scholarship from the University of Saarland. The intervention study was partly funded by Logocos Naturkosmetik AG (Salzhemmendorf, Germany). The funding source had no role in planning the study, data acquisition, data analyses or interpretation, writing or approval of the article.

Author contributions

R.O wrote the manuscript and participated in the conception and design of the studies, measurements of blood markers, and analyses and interpretation of data; H.M.A participated in measurements of the biomarkers, recruitment of subjects, acquisition of data, and gave input to the final draft of the manuscript; M.K participated in planning and conducting the interventional study and provided critical impact to the content; J.G participated in planning the studies and provided critical impact to the discussion. The corresponding author has access to the data and the main responsibility for the content and data analyses.

Conflict of interest

The authors have no conflict of interest regarding the content of this manuscript. All authors have read and approved the final article.

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Authors and Affiliations

  1. Department of Clinical Chemistry and Laboratory Medicine, Saarland University Hospital, Building 57, 66421, Homburg/Saar, Germany

    Rima Obeid, Hussain M. Awwad & Juergen Geisel

  2. Aarhus Institute of Advanced Studies, University of Aarhus, Høegh-Guldbergs Gade 6B, Building 1632, 8000, Aarhus C, Denmark

    Rima Obeid

  3. Institute of Alternative and Sustainable Nutrition, 35444, Biebertal/Giessen, Germany

    Markus Keller

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  1. Rima Obeid
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  2. Hussain M. Awwad
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Correspondence to Rima Obeid.

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Obeid, R., Awwad, H.M., Keller, M. et al. Trimethylamine-N-oxide and its biological variations in vegetarians. Eur J Nutr 56, 2599–2609 (2017). https://doi.org/10.1007/s00394-016-1295-9

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  • DOI: https://doi.org/10.1007/s00394-016-1295-9

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