Trial reportEuropean heart journal2019
Impact of chronic dietary red meat, white meat, or non-meat protein on trimethylamine N-oxide metabolism and renal excretion in healthy men and women.
Trial report in European heart journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 292 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Plant-Based Meat vs Animal "Red" Meat: a Randomized Cross-over Trial
Impact of Facilitated Vegan Diet on Cardiometabolic Endpoints and Trimethylamine N-oxide
Mediterranean Diet Uptake and Nutrition on Child Health, Inflammation, and Early-life Symbiosis (MUNCHIES): A Randomized Controlled Trial
Who cites it
292 citing papers in PubMed, 7 syntheses or guidelines pooled it, 461 citations in OpenAlex.
- A systematic review of TMAO, microRNAs, and the oral/gut microbiomes in atherosclerosis and myocardial infarction: mechanistic insights and translational opportunities.Journal of translational medicine · 2025Pooled it
- The Effect of Red Meat Consumption on Circulating, Urinary, and Fecal Trimethylamine-N-Oxide: A Systematic Review and Narrative Synthesis of Randomized Controlled Trials.Advances in nutrition (Bethesda, Md.) · 2025Pooled it
- Gut microbial metabolite trimethylamine N-oxide as a novel predictor for adverse cardiovascular events after PCI: a systematic review and dose-response meta-analysis.Nutrition journal · 2025Pooled it
- The Association Between Lifestyle Interventions and Trimethylamine N-Oxide: A Systematic-Narrative Hybrid Literature Review.Nutrients · 2025Pooled it
- The Gut-Heart Axis: Effects of Intestinal Microbiome Modulation on Cardiovascular Disease-Ready for Therapeutic Interventions?International journal of molecular sciences · 2024Pooled it
- Terrestrial Animal Source Foods and Health Outcomes for Those with Special Nutrient Needs in the Life Course.Nutrients · 2024Pooled it
- Red meat consumption and risk for dyslipidaemia and inflammation: A systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2022Pooled it
- Energy restriction and iron supplementation improve iron status in women with obesity regardless of red meat consumption: a randomized controlled trial.Scientific reports · 2026Trial
- Processed plant-based meat-supplemented diet versus red meat-based supplemented diet randomized cross-over trial Finding Optimal Oral Diet-1 (FOOD-1) trial.Scientific reports · 2026Trial
- Trial
- Effect of Varying Quantities of Lean Beef as Part of a Mediterranean-Style Dietary Pattern on Gut Microbiota and Plasma, Fecal, and Urinary Metabolites: A Randomized Crossover Controlled Feeding Trial.Journal of the American Heart Association · 2025Trial
- Effect of resistance training and chicken meat on muscle strength and mass and the gut microbiome of older women: A randomized controlled trial.Physiological reports · 2024Trial
- The effects of substituting red and processed meat for mycoprotein on biomarkers of cardiovascular risk in healthy volunteers: an analysis of secondary endpoints from Mycomeat.European journal of nutrition · 2023Trial
- Plasma Trimethylamine-Journal of the American Heart Association · 2023Trial
- Effects of a diet based on the Dietary Guidelines on vascular health and TMAO in women with cardiometabolic risk factors.Nutrition, metabolism, and cardiovascular diseases : NMCD · 2022Trial
- Gut Microbiome-Dependent Metabolic Pathways and Risk of Lethal Prostate Cancer: Prospective Analysis of a PLCO Cancer Screening Trial Cohort.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2022Trial
- Assessing the effects of alternative plant-based meatsJournal of nutritional science · 2022Trial
- Fecal Microbiome Composition Does Not Predict Diet-Induced TMAO Production in Healthy Adults.Journal of the American Heart Association · 2021Trial
- Review
- Cardiovascular-kidney-metabolic syndrome through the lens of gut‑derived uremic toxins.Gut microbes · 2026Review
232 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
12 authors at 4 institutions in 1 country.
Funding
Abstract
aimsCarnitine and choline are major nutrient precursors for gut microbiota-dependent generation of the atherogenic metabolite, trimethylamine N-oxide (TMAO). We performed randomized-controlled dietary intervention studies to explore the impact of chronic dietary patterns on TMAO levels, metabolism and renal excretion. METHODS AND
resultsVolunteers (N = 113) were enrolled in a randomized 2-arm (high- or low-saturated fat) crossover design study. Within each arm, three 4-week isocaloric diets (with washout period between each) were evaluated (all meals prepared in metabolic kitchen with 25% calories from protein) to examine the effects of red meat, white meat, or non-meat protein on TMAO metabolism. Trimethylamine N-oxide and other trimethylamine (TMA) related metabolites were quantified at the end of each diet period. A random subset (N = 13) of subjects also participated in heavy isotope tracer studies. Chronic red meat, but not white meat or non-meat ingestion, increased plasma and urine TMAO (each >two-fold; P < 0.0001). Red meat ingestion also significantly reduced fractional renal excretion of TMAO (P < 0.05), but conversely, increased fractional renal excretion of carnitine, and two alternative gut microbiota-generated metabolites of carnitine, γ-butyrobetaine, and crotonobetaine (P < 0.05). Oral isotope challenge revealed red meat or white meat (vs. non-meat) increased TMA and TMAO production from carnitine (P < 0.05 each) but not choline. Dietary-saturated fat failed to impact TMAO or its metabolites.
conclusionChronic dietary red meat increases systemic TMAO levels through: (i) enhanced dietary precursors; (ii) increased microbial TMA/TMAO production from carnitine, but not choline; and (iii) reduced renal TMAO excretion. Discontinuation of dietary red meat reduces plasma TMAO within 4 weeks.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.