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Brazil nut supplementation does not affect trimethylamine-n-oxide plasma levels in patients with coronary artery
Karen Salve Coutinho-Wolino1,2, Beatriz Oliveira da Cruz2, Ludmila F M De F Cardozo2
1Postgraduate Program in Nutrition Sciences, Fluminense Federal University, Niterói, Brazil.
Insights
Brazil nut supplementation did not alter trimethylamine N-oxide (TMAO) levels in coronary artery disease (CAD) patients. While glutathione peroxidase (GPx) activity showed a non-significant increase, this study suggests further research with varied dosages may be needed.
Area of Science:
- Nutritional Biochemistry
- Cardiovascular Disease Research
- Oxidative Stress Mechanisms
Background:
- Trimethylamine N-oxide (TMAO) is linked to oxidative stress and increased cardiovascular disease (CAD) risk.
- Antioxidant enzymes, such as glutathione peroxidase (GPx), play a role in mitigating oxidative stress.
- Brazil nuts are recognized for their antioxidant properties, primarily due to selenium content, which supports GPx activity.
Purpose of the Study:
- To investigate the impact of daily Brazil nut supplementation on plasma TMAO levels in patients with CAD.
- To assess the effect of Brazil nut intake on the activity of glutathione peroxidase (GPx) in this patient cohort.
- To explore the potential of Brazil nuts as a nutritional strategy to reduce TMAO-related oxidative stress in cardiovascular health.
Main Methods:
- A randomized controlled trial involving patients diagnosed with coronary artery disease (CAD).
- Participants were assigned to either a Brazil nut group (one nut daily for 3 months) or a control group.
- Measurements included plasma TMAO levels, TMAO precursors, and GPx activity before and after the 3-month intervention period.
Main Results:
- No significant changes were observed in TMAO levels or their precursors in either the Brazil nut or control group after 3 months.
- A 41% increase in GPx activity was noted in the Brazil nut group, although this finding was not statistically significant.
- TMAO levels demonstrated a negative association with total dietary fiber intake (r = -0.385, p = 0.02).
Conclusions:
- Three months of daily Brazil nut supplementation did not significantly alter TMAO levels or GPx activity in patients with CAD.
- The observed trend of increased GPx activity suggests a potential, albeit not statistically significant, antioxidant effect.
- Further studies with adjusted dosages and durations are warranted to fully elucidate the role of Brazil nuts in modulating TMAO and oxidative stress in cardiovascular disease.
Abstract:
The purposes of this study were to assess the effect of Brazil nut supplementation on trimethylamine N-oxide (TMAO) levels and glutathione peroxidase (GPx) activity in patients with coronary artery disease (CAD). Patients with CAD were randomly assigned to two groups, Brazil nut group (23 patients, 48% male, 62.7 ± 6.8 years, 29.4 ± 5.8 kg/m2 ), which received one Brazil nut per day for 3 months, and the control group (14 patients, 43% male, 63.7 ± 8.7 years, 28.4 ± 4.2 kg/m2 ) who did not receive any supplementation. After 3 months, TMAO levels and their precursors did not change in either group. Although not significant, GPx activity increased by 41% in the Brazil nut group. TMAO levels were negatively associated with total fiber intake (r = -0.385 and p = .02). A 3-month Brazil nut supplementation did not change TMAO levels and GPx activity in CAD patients. PRACTICAL APPLICATIONS: Trimethylamine N-oxide (TMAO) has been associated with oxidative stress and cardiovascular disease risk. Thus, the increase in antioxidants enzymes production could be a promising strategy to reduce TMAO-mediated oxidative stress. In this context, nutritional strategies are well-known as activators of cellular antioxidant responses. As Brazil nuts have a known role in reducing oxidative stress by increasing glutathione peroxidase (GPx) activity (a selenium-dependent antioxidant enzyme), this study hypothesized that Brazil nuts could be a strategy that, via antioxidant capacity, would reduce TMAO plasma levels. Although no changes in TMAO levels and GPx activity can be observed in this study, it is believed that other results can be obtained depending on the dosage used. Thus, this study can open new paths and direct other studies with different doses and treatment times to evaluate the effects of Brazil Nuts on TMAO levels.
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