ArticleNature medicine2013
Intestinal microbiota metabolism of L-carnitine, a nutrient in red meat, promotes atherosclerosis.
Article in Nature medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 6 registered trials, which are not on this map. Cited by 2,363 papers, 4 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.
Gut Flora Metabolite Reduction After Dietary Intervention (GRADY)
Impact of Diet and Gut Microbiota on Trimethylamine-N-oxide Production and Fate in Humans
A Dietary Intervention With Functional Foods Reduce Metabolic Endotoxemia and Attenuates Biochemical Abnormalities in Subjects With Type 2 Diabetes by Modifying the Gut Microbiota.
Plant-Based Meat vs Animal "Red" Meat: a Randomized Cross-over Trial
Impact of Facilitated Vegan Diet on Cardiometabolic Endpoints and Trimethylamine N-oxide
Effects of a Whole Food Based Nutritional Formulation on Trimethylamine N-oxide and Cardiometabolic Endpoints in Healthy Adults.
Who cites it
2,363 citing papers in PubMed, 4 syntheses or guidelines pooled it, 4,291 citations in OpenAlex.
- Pooled it
- Heart-Gut Axis in Cardiometabolic Disease: Microbiome-Mediated Pathways Linking Metabolic Syndrome to Cardiovascular Risk.Medicina (Kaunas, Lithuania) · 2026Pooled it
- Global Microbiome: Core and Unique Signatures Across Diverse Populations.International journal of molecular sciences · 2026Pooled it
- Plasma trimethylamine N-oxide and arteriosclerotic cardiovascular disease: a systematic review and meta-analysis of case-control studies.Frontiers in cardiovascular medicine · 2026Pooled it
- Trimethylamine N-oxide (TMAO) as a prognostic marker among patients at nutritional risk. A secondary analysis of the randomized clinical trial EFFORT.European journal of clinical nutrition · 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
- Effect of a polyphenol-rich pomegranate extract on plasma trimethylamine N-oxide levels following an oral carnitine challenge: a randomized controlled crossover trial in healthy adults.Frontiers in nutrition · 2026Trial
- Trial
- Low Bioavailability and High TMAO Production: Novel Insights Into Acetylcarnitine and Carnitine Metabolism.Molecular nutrition & food research · 2025Trial
- Trial
- Cardiovascular-kidney-metabolic syndrome through the lens of gut‑derived uremic toxins.Gut microbes · 2026Review
- Microbial metabolite-driven mechanisms linking the gut microbiome to atherosclerosis: multi-omic and translational perspectives.Gut microbes · 2026Review
- Glucagon-like peptide-1: a critical link between gut microbiota dysbiosis and degenerative musculoskeletal diseases.Gut microbes · 2026Review
- Gut microbiota metabolic reprogramming drives the development of metabolic diseases in the host.Gut microbes · 2026Review
- Gut microbiota and diet in colorectal cancer: Converging determinants of carcinogenesis.Gut microbes · 2026Review
- Article
- Review
- Gut-heart-kidney communication in cardiovascular disease: from a single-metabolite hypothesis to a context-dependent metabolite network.American journal of physiology. Heart and circulatory physiology · 2026Review
- Vascular smooth muscle cell FTO deletion aggravates atherosclerotic plaque instability by promoting VSMC migration through the NScience China. Life sciences · 2026Article
- [Correlation between trimethylamine-N-oxide and cardiovascular metabolic markers].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2026Article
2,303 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
23 authors at 5 institutions in 1 country.
Funding
Abstract
Intestinal microbiota metabolism of choline and phosphatidylcholine produces trimethylamine (TMA), which is further metabolized to a proatherogenic species, trimethylamine-N-oxide (TMAO). We demonstrate here that metabolism by intestinal microbiota of dietary L-carnitine, a trimethylamine abundant in red meat, also produces TMAO and accelerates atherosclerosis in mice. Omnivorous human subjects produced more TMAO than did vegans or vegetarians following ingestion of L-carnitine through a microbiota-dependent mechanism. The presence of specific bacterial taxa in human feces was associated with both plasma TMAO concentration and dietary status. Plasma L-carnitine levels in subjects undergoing cardiac evaluation (n = 2,595) predicted increased risks for both prevalent cardiovascular disease (CVD) and incident major adverse cardiac events (myocardial infarction, stroke or death), but only among subjects with concurrently high TMAO levels. Chronic dietary L-carnitine supplementation in mice altered cecal microbial composition, markedly enhanced synthesis of TMA and TMAO, and increased atherosclerosis, but this did not occur if intestinal microbiota was concurrently suppressed. In mice with an intact intestinal microbiota, dietary supplementation with TMAO or either carnitine or choline reduced in vivo reverse cholesterol transport. Intestinal microbiota may thus contribute to the well-established link between high levels of red meat consumption and CVD risk.
Indexed as
Identifiers
What OpenQuestion 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 OpenQuestion graph.