Tuesday, October 8, 2013

Does Seafood Produces More TMAO than Any Other Food, Including Beef?


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 Previous Research Shows Seafood Produces More TMAO than 

Any Other Food, Including Beef

    The 1999 study did show however, one food group that stood out as a major
source of TMAO, and that was seafood. Virtually all fish and invertebrates,
with few exceptions (including trout and cockles) produced statistically
significant more TMAO than the “light breakfast” control alone. And,
according to Masterjohn’s own statistical test, all invertebrates except
clams and cockles, and all fish except tuna, trout, plaice, and roe produced
significantly more TMAO than beef. He writes:

        “The single 'representative female omnivore' from the [2013] Nature
Medicine paper excreted similar amounts of TMAO in her urine as the six
subjects from the 1999 study after consuming red meat, suggesting that, had
they measured the response to seafood, the authors of the Nature Medicine
paper would also have found much greater excretion of TMAO after consumption
of seafood than after consumption of red meat.

        The difference between seafoods and red meat in the 1999 paper is
like the difference between night and day. To take the most extreme example,
halibut generated over 107 times as much TMAO as red meat. It seems obvious
from this study that if any foods should be singled out for the production of
TMAO, it should be seafoods. Yet the Nature Medicine paper makes no mention
of fish and the New York Times article only mentions fish to point out that
it has less carnitine than red meat (and thus, by inference, will generate
less TMAO, though that is clearly not the case, presumably because seafood
tends to be contaminated with trimethylamine or TMAO itself...)

        If we are to single out red meat as a source of TMAO, we should be
able to identify other foods with which it should be replaced that generate
less TMAO. Yet this 1999 study, which had a small sample size but tested an
expansive number of foods, found that there basically are no other foods that
generate meaningfully less TMAO than red meat.”

Axing Beef to Prevent Heart Disease Looks Like Another Red Herring...

    Chris Kresser L.Ac has also weighed in on this issue, comparing the
hypothesis that red meat causes heart disease via TMAO to the patently false
notion that dietary cholesterol and saturated fat cause heart disease by
raising serum cholesterol. Kresser lists three reasons for not taking the
featured study at face value:

        Inconsistent epidemiological evidence
        “Healthy user” bias, and
        Inconclusive and insufficient evidence on the role of TMAO in heart

        “...even if Paleo meat eaters have higher TMAO levels than vegans and
vegetarians, we still don’t have evidence proving a causal relationship
between TMAO and cardiovascular disease,” he writes. “Once again, the
supposed link between cholesterol and saturated fat and heart disease should
serve as a reminder not to jump to hasty conclusions that unnecessarily
deprive people of nutrient-dense, healthy foods. It is virtually impossible
to control for all of the possible confounding factors.”

Should You Avoid L-Carnitine and Choline-Rich Foods and Supplements?

    Masterjohn offers an in-depth critique of the featured study’s data in
his recent Weston A. Price article,10 so for more information I recommend
reading it in its entirety. For example, he points out that the study does
not include any data for eating steak alone (the steak was consumed with a
carnitine supplement); the data also does not indicate if TMAO differences
are due to a single outlier or a fundamental gender difference, or if the
antibiotic treatment is a confounding factor as none of the vegans were given
antibiotics. According to Masterjohn:

        “There is no data in this paper showing that TMAO increases in

response to steak alone in anyone.”

    At this time, more investigation is still needed to support the
assumption that red meat and other animal foods, along with supplements
containing L-carnitine, lecithin or choline should be avoided. What’s more,
these substances occur naturally in a wide range of foods, making it nearly
impossible, and likely inadvisable, to avoid them entirely.

    In terms of L-carnitine, an omnivorous diet provides 20 to 200 mg/day,
compared to a strict vegetarian diet, which would add about 1 mg/day.11 But
even non-dairy infant formulas are sometimes fortified with L-carnitine, and
the substance is also found in seafood, chicken breast, avocado and cheese
(although in far lower amounts than are found in red meats, especially beef).

It’s also important to realize that both L-carnitine and choline are
essential nutrients your body needs. Choline, for instance, is linked to
beneficial epigenetic changes in fetuses that likely last into adulthood,
while L-carnitine has been shown to improve insulin sensitivity in type 2

    Masterjohn also points out that while there were significant differences
in the intestinal bacterial strains between omnivores and vegans, which might
account for why TMAO levels were 45 percent higher in the meat eaters,
intestinal flora may not be the sole answer. He writes:

        “While it is possible that intestinal flora accounts for the
difference, it is disappointing that the authors did not consider other
possibilities, such as differences in the activity of the enzyme that
converts trimethylamine to TMAO. For example, vitamin B2 is the main cofactor
for the enzyme, and vegans are three times as likely to be deficient in
vitamin B2 as vegetarians and omnivores.

        ...While antibiotics wipe out TMAO levels in humans and mice, showing
that intestinal bacteria are necessary for its formation, the authors provide
no clear evidence that the specific differences in intestinal bacteria
between vegetarians and vegans on the one hand and meat-eaters on the other
cause the observed difference in TMAO levels. It is unclear whether the 45
percent higher TMAO levels in meat-eaters represents something that we should
regard as 'unhealthy.' As I pointed out above, for all we know it could be
due to riboflavin (vitamin B2) deficiency among the vegans.”

The Link Between Whole Grains and Gut Bacteria that Drive TMAO Production

    Jeff Leach with the Human Food Project has also weighed in on the
featured study. His article is well worth reading in its entirety as well. He
expounds on many of the same issues as Masterjohn and Kresser, but also
focuses much of his discussion on the role of gut bacteria in the conversion
of carnitine to TMAO. He writes,

        “If we assume for the moment that TMAO can accelerate
atherosclerosis, then the observation that enriched levels of Prevotella are
associated with higher levels in of TMAO become more interesting – especially
as enrichment of this group of bacteria seems to occur in vegans and
vegetarians as well as omnivores. So what causes enrichment of Prevotella?

        In a paper published in 2010, Italian researchers found that rural
African kids in Burkina Faso had super high levels of Prevotella, while a
similar aged group of kids in suburban Italy had none.The striking dietary
difference between the kids in Burkina Faso and the Italian kids was whole
grain consumption... whole grains made up >50% of the daily calories in this
[African] village... In contrast, the Italian kids got ~25% of their daily
calories from highly processed bread, biscuits, pasta, and rice... All in
all, a much more diverse diet, though apparently devoid of whole grains but
high in processed foods. As mentioned, the Italian kids had no traceable
amounts of Prevotella in their stool samples...

        In the Burkina Faso paper, the researchers attributed the high levels
of Prevotella to grain-based carbohydrates... it doesn’t appear that dietary
fiber in general is driving enrichment of Prevotella... So, it appears
somehow specific to the starch in grains or the dietary fiber in grains.”


God Bless Everyone & God Bless The United States of America.

Larry Nelson
42 S. Sherwood Dr.
Belton, Tx. 76513

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