Tomato extract may modulate gut microbiota and reduce TMAO levels

By Stephen Daniells

- Last updated on GMT

© Ignatiev / Getty Images
© Ignatiev / Getty Images

Related tags Gut microbiota cardiovascular health TMAO Heart health Fruitflow tomato extract Polyphenols

DSM’s Fruitflow tomato extract may beneficially change the gut microbiota and reduce levels of TMAO (trimethylamine-n-oxide), a gut metabolite linked to cardiovascular disease.

Four weeks of supplementation with Fruitflow, a water-soluble tomato concentrate, were associated with decreases fasting blood and urine TMAO levels, compared to a placebo, according to data published in The Journal of Nutrition.

TMAO is created when TMA (trimethylamine) is absorbed in the intestine and transported to the liver. TMA is a microbial metabolite produced by gut microbiota from dietary phosphatidylcholine and L-carnitine, commonly found in animal products like meat, cheese, and eggs.

TMAO is an emerging biomarker known for its proatherogenic effects and lipopolysaccharides (LPS), a marker of intestinal permeability and low-grade inflammation. This has led to the hypothesis that a changed gut microbiota and increased intestinal permeability may be the causes of chronic inflammation, which worsens cardiac function.

“The results of this study are incredibly encouraging and support earlier findings that polyphenol-rich extracts can lower TMAO concentrations through a targeted and beneficial modulation of the gut microbiota,” ​said Dr Robert Steinert, Principal Scientist at DSM and corresponding author on the study.

“We’re looking forward to working with our customers to develop new dietary supplement solutions targeting the gut-heart axis. Looking ahead, this study paves the way for future research into the gut-brain axis, especially age-related cognitive decline. This is an exciting time for gut-health research.”

The study was performed by scientists at DSM and Atlantia Clinical Trials, and funded by DSM Nutritional Products.


In May 2009, Fruitflow became the first natural cardio-protective functional ingredient to receive approval of an Article 13.5 claim from the European Commission.

Its health claim states that 150 milligrams (mg) of the ingredient “helps maintain normal platelet aggregation, which contributes to healthy blood flow.”

The effect is observed within 1.5 hours and lasts for 12 to 18 hours. When taken regularly on a once per day basis, the effect is continuous, making it ideal for use in functional foods or dietary supplements.

The new study indicates that the ingredient’s cardiovascular benefits may be multi-faceted, by impacting the gut microbiota to reduce TMAO levels.

Study details 

Dr Steinert and his co-workers recruited 22 overweight and obese adults to participate in their double-blind, placebo-controlled, cross-over study. Participants were randomly assigned to receive two 150 mg doses of Fruitflow per day or placebo for four weeks. This was followed by a six-week “wash-out” before crossing over to the other intervention.

The data showed that Fruitflow supplementation was associated with significant decreases in fasting blood and urine TMAO levels, compared to baseline levels. No such reductions were recorded during the placebo intervention. Compared to placebo, the TMAO reductions were only statistically significant for urine levels.

The microbiome composition and microbial beta diversity changed significantly with consumption of Fruitflow, with lower levels of Bacteroides, Ruminococccus,​ and Hungatella​ reported, which are known for their involvement in TMA and TMAO metabolism.

“Our results support earlier findings that polyphenol-rich extracts can lower TMAO concentrations and that this may be related to a targeted modulation of the gut microbiota along the definition of the prebiotic concept,” ​concluded the researchers.

Source: The Journal of Nutrition
Published online ahead of print, doi: 10.1016/j.tjnut.2022.11.009
“A water-soluble tomato extract rich in secondary plant metabolites lowers trimethylamine-n-oxide and modulates gut microbiota: a randomized, double-blind, placebo-controlled cross-over study in overweight and obese adults”
Authors: A. Rehman et al.                                                                                                                               

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