Dr. Mercola’s latest input on this ongoing debate:

“The latest study is not the first to link gut bacteria to heart disease. In 2011, the same researchers, Hazen and colleagues, used data from nearly 2,000 people and showed that when the bacteria in your gut break down lecithin, a type of fat found in meat, eggs, dairy and other animal foods along with baked goods and dietary supplements, and its metabolite choline, it also leads to the creation of TMAO and, subsequently, increases your risk of heart disease.⁵

In response to this and the current study, many have wondered whether red meat and other animal foods, along with supplements containing L-carnitine, lecithin or choline should be avoided. Chris Masterjohn PhD, who is currently researching fat-soluble supplements at the University of Illinois, rebutted the 2011 findings stating:⁶

“…previous studies have shown that supplements with salts of free choline do in fact generate TMAO, but uncontaminated phosphatidylcholine, the main form of choline found in food, does not. Moreover, choline-rich foods like liver and eggs did not produce more TMAO than a control breakfast, but seafood, which is generally contaminated with some trimethylamine or TMAO, did.”

Masterjohn also disagrees with the group’s latest findings, in which the researchers claim that carnitine in red meat contributes to heart disease via the same pathway, i.e. the creation of TMAO. According to Masterjohn, incomplete reporting of data in the paper combined with “wild runaway inferences” by the press has generated a grossly misleading picture of red meat’s impact on heart disease, while simultaneously ignoring the food group that actually generates the most TMAO.

He points out that red meat is only one of many foods that increases TMAO when eaten, and cites data from a 1999 study that evaluated TMAO excretion following consumption of 46 different foods, which shows that red meat generated no more TMAO than fruits and vegetables. In fact, some veggies, such as peas, cauliflower and carrots generated more TMAO than beef did!”

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