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Randomized Controlled Trial
. 2022 Aug;46(8):e14201.
doi: 10.1111/jfbc.14201. Epub 2022 Apr 25.

Brazil nut supplementation does not affect trimethylamine-n-oxide plasma levels in patients with coronary artery disease

Karen Salve Coutinho-Wolino  1   2 , Beatriz Oliveira da Cruz  2 , Ludmila F M De F Cardozo  2 , Igor Alexandre Fernandes  3 , Claudio Tinoco Mesquita  2 , Peter Stenvinkel  4 , Peter Bergman  5   6 , Denise Mafra  1   2   7 , Milena Barcza Stockler-Pinto  1   2
Affiliations
Randomized Controlled Trial

Brazil nut supplementation does not affect trimethylamine-n-oxide plasma levels in patients with coronary artery disease

Karen Salve Coutinho-Wolino et al. J Food Biochem. 2022 Aug.

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.

Keywords: Brazil nut; coronary artery disease; selenium; trimethylamine N-oxide.

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References

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