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A Novel Risk Factor for Heart Failure

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Prof UC Samal, Patna    04 January 2018

  1. Our gut flora/microbiome is a key regulator of TMAO production, though as commensals enormously beneficial in providing nutrition and other essential nutrients and offer immunity.
  2. Carnivorous diet is principal source of TMAO, particularly, Egg yolk and red meat and some sea food like cod, salmon, tuna, shark, scallop, etc. and even in ‘wheat germ’.
  3. Mediterranean diet being rich in complex carbs and fibers (vegetables, fruits, nuts and also olive oil) very low in TMAO yield are already recommended in global guidelines (UNESCO:2013:Baku). Vegetarian diet, more so vegan diets are safer proposition against TMAO, but the food in moderation always.
  4. DMB (Dimethyl-1-butanol), a choline analog, is a small molecule being used in trial models which inhibits TMA production (TMA-FMO3-TMAO), and safe for human use is the future hope for the risk intervention. TMAO is a novel risk factor, modifiable and measurable, but needs further validation by larger multicentric RCTs.

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