Effects of lifestyle intervention on plasma trimethylamine N-oxide in obese adults

Melissa L. Erickson, Steven K. Malin, Zeneng Wang, J. Mark Brown, Stanley L. Hazen, John P. Kirwan

Research output: Contribution to journalArticlepeer-review

39 Scopus citations

Abstract

Accumulating evidence linking trimethylamine N-oxide (TMAO) to cardiovascular disease (CVD) risk has prompted interest in developing therapeutic strategies to reduce its production. We compared two lifestyle intervention approaches: hypocaloric versus eucaloric diet, combined with exercise, on TMAO levels in relation to CVD risk factors. Sixteen obese adults (66.1 ± 4.4 years, BMI (body mass index): 35.9 ± 5.3 kg/m 2 , fasting glucose: 106 ± 16 mg/dL, 2-h PPG (postprandial glucose): 168 ± 37 mg/dL) were randomly assigned to 12 weeks of exercise (5 days/week, 80–85% HR max (maximal heart rate)) plus either a hypocaloric (HYPO) (−500 kcal) or a eucaloric (EU) diet. Outcomes included plasma TMAO, glucose metabolism (oral glucose tolerance test (OGTT) and euglycemic-hyperinsulinemic clamps for glucose disposal rates (GDR)), exercise capacity (VO 2max , maximal oxygen consumption), abdominal adiposity (computed tomography scans), cholesterol, and triglycerides. Results showed that body composition (body weight, subcutaneous adiposity), insulin sensitivity, VO 2max , and cholesterol all improved (p < 0.05). HYPO decreased the percentage change in TMAO compared to an increase after EU (HYPO: −31 ± 0.4% vs. EU: 32 ± 0.6%, p = 0.04). Absolute TMAO levels were not impacted (HYPO: p = 0.09 or EU: p = 0.53 group). The change in TMAO after intervention was inversely correlated with baseline visceral adipose tissue (r = −0.63, p = 0.009) and GDR (r = 0.58, p = 0.002). A hypocaloric diet and exercise approach appears to be effective in reducing TMAO. Larger trials are needed to support this observation.

Original languageEnglish (US)
Article number179
JournalNutrients
Volume11
Issue number1
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Food Science
  • Nutrition and Dietetics

Keywords

  • Caloric restriction
  • Cardiovascular disease risk factors
  • Exercise
  • Gut microbiome
  • Lifestyle intervention
  • Obesity
  • Trimethylamine N-oxide

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