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| Item Type: | Preprint |
|---|---|
| Title: | Plant-forward diets lower circulating TMAO in adults: a systematic review and meta-analysis |
| Creators Name: | Zupo, Roberta, Castellana, Fabio, Catino, Feliciana, Lampignano, Luisa, Zheng, Yalin, Lip, Gregory, Mastrangelo, Annalaura, Ikram, Mohammad Arfan, Rodriguez-Mateos, Ana, Menni, Cristina, Cuthbertson, D.J., Pischon, Tobias, Nimptsch, Katharina, Raymond, Frederic, Muhamadali, Howbeer, Petukhov, Ivan Andrushevich, Isanejad, Masoud and Sardone, Rodolfo |
| Abstract: | Diet modulates circulating trimethylamine N-oxide (TMAO), a gut microbiota-derived metabolite linked to cardiovascular risk; whether plant-forward versus animal-based dietary patterns consistently influence TMAO concentrations in adults remains unclear. A PRISMA-2020-compliant systematic review and meta-analysis (PROSPERO: CRD420261326106) was conducted through February 2026 across multiple databases; eligible studies assessed dietary patterns, food groups, or diet-related interventions in relation to circulating TMAO in adults. Random-effects meta-analyses were performed where data were combinable. Thirty-four studies were included; 11 contributed to quantitative synthesis. Eight RCTs showed significantly lower TMAO with plant-forward versus animal-based exposures (pooled MD −1.08 µM, 95% CI −1.52 to −0.65; I² [a measure of between-study heterogeneity] = 0%), consistent across dietary-pattern (−0.85 µM) and food-group subgroups (−1.24 µM). Three cross-sectional studies linking higher meat intake to higher TMAO showed substantial heterogeneity (I² = 75%). Plant-forward diets are associated with lower circulating TMAO in adults, with the strongest evidence from RCTs. |
| Keywords: | Trimethylamine N-oxide, TMAO, Dietary Patterns, Plant-Based Diet, Animal-Based Diet, Gut Microbiota, Cardiovascular Risk, Meta-Analysis, Systematic Review, Food Groups |
| Source: | Research Square |
| Publisher: | Research Square |
| Article Number: | rs.3.rs-9382739/v1 |
| Date: | 14 April 2026 |
| Official Publication: | https://doi.org/10.21203/rs.3.rs-9382739/v1 |
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