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Fourth, the majority of the studies were conducted in high-income countries, which may limit the generalizability of findings to low- and middle-income countries

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Prebiotic and probiotic use may help reduce TMAO production: Administration of probiotic Lacticaseibacillus paracasei , but not Lacticaseibacillus casei, or Lactiplantibacillus plantarum , may reduce circulating TMA and TMAO levels Enterobacter aerogenes ZDY01 increased Bacteroidales ( Bacterodetes phylum) and decreased Prevotellaceae and Helicobacteraceae families Supplementing with Archeobacteria phylum, may reduce TMA and TMAO The prebiotic Arabinoxylan oligosaccharide plus vitamins B and D showed a small reduction in serum TMAO Prebiotics such as resveratrol increased the Bacterodetes phylum, while Firmicutes , aside from Lactobacillus and Bifidobacterium genus, decreased along with TMAO plasma levels Physical activity has a favorable effect on gut microbiota composition Some natural products, including 3,3-dimethyldimetyl-1-butanol (DMB) from vinegar, olive oil, and grapeseed oil, may inhibit the conversion of choline, betaine, and carnitine to TMA