Mountaineer Undergraduate Research Review

Document Type



The leading causes of death in the United States include many chronic diseases with modifiable risk factors including ischemic heart diseases. Gut microbiota-dependent trimethylamine N-oxide (TMAO) synthesis has been implicated in cardiovascular disease risk in recent years. New evidence may also implicate TMAO involvement in other chronic diseases including diabetes mellitus and chronic kidney disease. The role of diet in TMAO synthesis has also been of considerable interest, as certain dietary precursors are known to modulate circulating TMAO. The gut microbiome is indeed susceptible to diet-induced change which may modulate the risk for chronic disease. Plant-based diets are considered by many to be beneficial for gut health and may play a protective role by reducing TMAO synthesis. This review discusses the purported role of TMAO and the mechanisms by which TMAO may contribute to atherosclerosis and chronic disease risk. The role of diet in chronic disease is also discussed with emphasis on utilizing clinical nutrition to reduce the burden of disease.



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