What’s Happening: TMAO

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TMAO, short for Trimethylamine N-Oxide, is the big news in the Paleo world this week, after a study in the journal Nature Medicine claimed red meat eaters have a higher risk of heart disease due to increased levels of TMAO in the blood. This comes hot on the heels of the new book Paleofantasy, which claims to “debunk” the myth of an evolutionary diet – it seems like the faster the Paleo movement grows, the harder the mainstream media tries to fight back.

Paleo under fire is nothing new, and the Paleo world has been responding with its own heavy artillery to every new “debunking” article.

Responses to the TMAO study:

  • Chris Masterjohn wrote the most thorough critique. He condemns the study for focusing only on red meat when other foods also increase TMAO just as much, and seafood even more so. He criticizes the study for having such a small sample size, various confounding factors like the use of antibiotics on the study subjects and the fact that none of them ate steak alone (they were given steak along with a carnitine supplement). He also picks apart the mouse studies linking carnitine to TMAO to heart disease in the first place.
  • Chris Kresser’s response focuses on the epidemiological biases in the study and the lack of conclusive data about what TMAO actually is and does.
  • Dave Asprey (at the Bulletproof Executive) criticizes the use of CAFO meat and the cooking method as a confounding factor, the focus on red meat instead of the gut biome as the important factor, and the assumptions about cholesterol that the researchers used to draw their conclusions.
  • Paul Jaminet points out that the study showed a link between red meat and heart disease that was dependent on gut flora, not on the meat itself, and offers practical suggestions for how we can actually behave to reduce the risk of heart disease.
  • Mark Sisson provides an excellent “short version” of all the criticisms about rodent studies, gut flora, and the complicated relationship between TMAO and overall health.

Lamb Cutlets

The most exciting part of the entire affair might be the downplayed admission in the fourth paragraph of the New York Times article: “In fact, these scientists suspected that saturated fat and cholesterol made only a minor contribution to the increased amount of heart disease seen in red-meat eaters.” Of all the things you never thought you’d read in a mainstream critique of red meat, this has to be #1.

If you’re ready to celebrate the exoneration of cholesterol with some red meat of your very own, try a batch of our new bison bulalo recipe. And pork might be “the other white meat,” but it’s definitely tasty, especially when it’s as convenient as this canned pork.

Have you come across any other in-depth discussions of the TMAO study? Let us know on Facebook or Google+!

P.S. Have a look at our Paleo Recipe Book. It's a cookbook we've created to help you eat the best Paleo food. It contains over 370 recipes and covers everything you need.

+ Your Guide to Paleo, our handy Paleo Guide, is now also available. It'll help you avoid common pitfalls and reach your health and weight loss goals faster.

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