There is a huge opportunity for further research in the gut-heart axis. Gut microbiome strategies have emerged for the prevention of cardiovascular disease due to TMAO being dependent on metabolism by the intestinal microbiota. Here we show how natural products rich in polyphenols lower plasma trimethylamine n-oxide (TMAO) known for its proatherogenic effects by modulating the intestinal microbiota. In this study, Fruitflow®, a water soluble tomato concentrate, rich in secondary metabolites, including nucleosides, phenolic conjugates and polyphenols was to be investigated to see how this substrate could be utilized by the host microorganism. A randomized double blind, placebo controlled crossover study comprising of 37 overweight participants was undertaken.
Fruitflow® significantly decreased fasting blood and urine TMAO when compared to baseline as well as plasma LPS, a marker of intestinal permeability and low-grade inflammation. Moreover, when compared to the placebo group, this was also significantly different for urine TMAO. A clear distinction was observed also between plasma samples when applying untargeted metabolomics, with TMAO being the top-ranking feature driving the differences found across the Fruitflow® product group compared to the control group. Significant changes in microbial beta diversity were also highlighted. In addition, the microbiome composition changed significantly in the Fruitflow® product group. Lower levels of Bacteroides, Ruminococccus and Hungatella were found, which are known for the involvement in TMA/TMAO metabolism. The findings of this study are in line with the studies showing a reduction in plasma TMAO suggesting reproducible effects with polyphenol rich extracts. As a conclusion of this trial we could assert that polyphenol-rich extracts can modulate the gut microbiota conferring a host health benefit.
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