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These foods are typically our sources of carnitine. A 2018 crossover study with 113 participants found that chronic consumptiondefined as daily intake with around 258 mg/d of carnitine of red meat increased levels of TMAO produced from carnitine and decreased TMAO excretion, but these levels decreased within four weeks of stopping eating red meat.29 Given the uncertainty on this topic, relative to the overall body of evidence we have for CVD prevention, I tend to encourage folks not to focus on it too much, Klatt says, adding that other than current recommendations to focus on cardioprotective foods and limit red meat, making carnitine less of a concern, there are currently no evidence-based practice guidelines encouraging the planning of diets based around TMAO lowering.30 Focusing on the issue too much runs the risk of folks paying for expensive lab testing with limited known clinical utility. Carrie Dennett, MPH, RDN, CD, is the nutrition columnist for The Seattle Times , owner of Nutrition By Carrie, and author of Healthy for Your Life: A Non-Diet Approach to Optimal Well-Being

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