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Drs. Oz and Roizen: Dodge this major heart risk

Steak. Hamburgers. Egg yolks. Liver. Groundbreaking research shows that these foods are as dangerous for your arteries as smoking, but surprisingly, the fat and cholesterol they contain aren’t the only reasons.

A heart-threatening substance called TMAO – trimethylamine n-oxide – is an even bigger menace, plugging arteries with ever-more plaque, and maybe helping cancers thrive, too.

Fortunately, we now know how to prevent TMAO-related health risks. Brand-new studies from the Cleveland Clinic – where Dr. Mike is chief wellness officer – have uncovered a Superman compound that thwarts TMAO. And you can start using it today, deliciously, to lower your risk for heart attack, stroke, even kidney problems and wrinkles.

This protector is called DMB, but it’s far from dumb. Found in some extra-virgin olive oils and red wines, DMB (3,3-dimethyl-1-butanol) stops bacteria in your digestive system from turning choline, l-carnitine and lecithin from food into TMA, a precursor that the liver then converts into TMAO.

With less TMAO in the bloodstream, the study showed that atherosclerosis – the buildup of fatty, gunky plaque in artery walls – slowed down and even went into reverse. Wow! Meanwhile, back in the digestive system, there was a decrease in TMA-producing gut bugs. It doesn’t take many of these unfriendly bugs to cause problems in your arteries, so the fewer the better. Double benefits!

WHY TMAO Matters

TMAO burst into the headlines two years ago when the Cleveland Clinic’s Dr. Steven Hazen, looked at it in the lab and in humans. Hazen’s team measured TMAO in 4,007 people; those with the highest levels were two and a half times more likely to have a heart attack or stroke over the next three years than those with the lowest. It turns out that TMAO traps cholesterol inside gunky, foamy cells that burrow into artery walls. Normally, some of this cholesterol is sucked out and whisked away by friendly HDL cholesterol. But dastardly TMAO shuts down that cleanup operation, inviting more and more cholesterol to pile in. The shocker: Risk was high regardless of whether levels of “bad” LDL cholesterol were high or low.

Where did this TMAO come from? In related studies, people who ate two hard-boiled eggs or an 8-ounce sirloin steak saw blood levels of TMAO soar. The researchers also have discovered links between high TMAO and declining kidney health. TMAO might raise cancer risk and promote skin wrinkles, too.


Thanks to this amazing research from the Cleveland Clinic, we know more than ever about how to knock back TMAO. Here’s what you can do right now to avoid its dangers, and what we think you’ll be able to do in the near future, too.

1. Eat less of these You don’t have to become a vegan (but it helps) to reduce TMAO levels. Eating up to 4 ounces of red meat, 8 ounces of lean pork or two egg yolks per week is safe. Fish is a better entree, but limit servings of tilapia, cod and Chilean sea bass; these contain more TMAO than other seafood.

2. Go for “fruity” extra-virgin olive oil There’s DMB in some fruity-tasting extra-virgin olive oils. You need two to four tablespoons a day; at 120 calories per tablespoon, you need to be aware of how that could add up to extra calories. Be sure to use olive oil in place of other fats and make other calorie adjustments as needed. Store olive oil away from light in a tightly capped, brown bottle to preserve DMB. Grapeseed oil, balsamic vinegar and red wine also may be good sources.

3. Ask about the new TMAO blood test Available to doctors since December, this brand-new blood test could give you and your health care team new insights into your future heart health.

4. Watch for a DMB pill This would affect just your gut bacteria. Someday, cutting TMAO could be that simple. Stay tuned!

Dr. Mehmet Oz is host of “The Dr. Oz Show,” and Buffalo native Dr. Mike Roizen is chief wellness officer and chairman of the Wellness Institute at the Cleveland Clinic.