Effects of Lifestyle Intervention on Plasma Trimethylamine N-Oxide in Obese Adults

• Published in: Nutrients Vol. 11; no. 1; p. 179
• Main Authors: Erickson, Melissa L, Malin, Steven K, Wang, Zeneng, Brown, J Mark, Hazen, Stanley L, Kirwan, John P
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 16.01.2019; MDPI
• Subjects: Adiposity; Adults; Aged; Antibiotics; Atherosclerosis; Blood Glucose - metabolism; Body Composition; Body Mass Index; Caloric Restriction; Cardiovascular disease; cardiovascular disease risk factors; Cardiovascular diseases; Diabetes; Diet; Diet, Reducing; Dietary restrictions; Digestive system; Exercise; Family medical history; Female; Fitness equipment; Fitness training programs; Funding; Gastrointestinal surgery; Glucose Clamp Technique; Glucose Tolerance Test; gut microbiome; Health risks; Heart rate; Humans; Insulin Resistance; Intervention; Intestinal microflora; Life Style; lifestyle intervention; Lifestyles; Male; Medical treatment; Metabolic disorders; Metabolism; Metabolites; Methylamines - blood; Microbiomes; Microbiota; Middle Aged; Mortality; Obesity; Obesity - blood; Obesity - therapy; Oxygen Consumption; Physical training; Risk Factors; Trimethylamine; trimethylamine N-oxide; Weight control; United States > US; caloric restriction; cardiovascular disease risk factors; gut microbiome; exercise; trimethylamine N-oxide; lifestyle intervention; obesity
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu11010179

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/m², 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 (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 , maximal oxygen consumption), abdominal adiposity (computed tomography scans), cholesterol, and triglycerides. Results showed that body composition (body weight, subcutaneous adiposity), insulin sensitivity, VO , and cholesterol all improved ( < 0.05). HYPO decreased the percentage change in TMAO compared to an increase after EU (HYPO: -31 ± 0.4% vs. EU: 32 ± 0.6%, = 0.04). Absolute TMAO levels were not impacted (HYPO: = 0.09 or EU: = 0.53 group). The change in TMAO after intervention was inversely correlated with baseline visceral adipose tissue (r = -0.63, = 0.009) and GDR (r = 0.58, = 0.002). A hypocaloric diet and exercise approach appears to be effective in reducing TMAO. Larger trials are needed to support this observation.