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TMAO has a high turnover rate, with more than 90% excreted in the urine after being metabolized by the kidney ( Figure 1 Studies have found that high levels of TMAO are closely related to the occurrence of atherosclerosis, HF, hypertension, and other CVDs ( Figure 2 )

The guideline identifies specific populations in which dietary supplementation may be necessary, such as women who are pregnant or lactating and adults older than 50

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These osmolytes are obtained from food and synthesized endogenously using dietary constituents like choline and carnitine