A common dilemma for researchers is how to follow the herd enough to get a paper published, while simultaneously presenting replicable evidence of tested hypotheses. But unlike study researchers, reviewers are free to:

• Express their beliefs as facts;
• Over/under emphasize study limitations; and
• Disregard and misrepresent evidence as they see fit.

Reviewers also aren’t obligated to make post-publication corrections for their errors and distortions.

Here’s one of a dozen 2023 papers I read this week on TMAO. I picked this review because they attempted to come clean at the end of several sections.

I rated it as Wasted resources rather than Detracted from science as there might be a slight sniff of facts underneath the stench. Facts do not include “is associated with” or “is correlated with.”

The meme (repeated many times):

“Overall diet, lifestyle choices, genetic predisposition, and other underlying health conditions may contribute to higher trimethylamine N-oxide (TMAO) levels and increased cardiovascular risk. This review explores the potential therapeutic ability of resveratrol (RSV) to protect against cardiovascular diseases (CVD) and affect TMAO levels.”

Sections starting with premises that contained contradictions included:

2.2. TMAO and cardiovascular disease

Higher TMAO levels raise the risk of adverse cardiovascular events.

Overall, eating fish with high TMAO levels has relatively few adverse effects on CVD.

2.2.1 Relationship between TMAO and atherogenesis

Collectively, these findings provide a possible link between gut bacteria, platelet activation, and the risk of thrombosis.

More research is required to show the function of TMAO in the formation of CVD.

3. Application potential of phytochemicals such as polyphenols, RSV and its modified derivatives in regulating CVD

TMAO is a unique and independent risk factor for developing AS, partly through suppression of hepatic bile acid production.

Eating plants in general affects TMAO levels.

3.1. TMAO-lowering phytochemicals

Since the discovery of TMAO as a pro-atherogenic metabolite is relatively recent, only relatively small numbers of polyphenol-rich extracts and single phenolic compounds have been investigated as TMA/TMAO lowering agents.

Cardioprotective function of phytochemicals may arise from a combination of different mechanisms.

And so on.

https://febs.onlinelibrary.wiley.com/doi/10.1002/2211-5463.13762 “Cardiovascular risk of dietary trimethylamine oxide precursors and the therapeutic potential of resveratrol and its derivatives”

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How many people would be healthy after they stopped eating fish, meat, and foods that had choline, carnitine, betaine, or ergothioneine? There are no clinical trials that omit all of these “TMAO precursors” from human diets because people would die.

Propagating the TMAO meme is dumb. It isn’t politically driven AFAIK, though, so doesn’t drop to the sub-basement evidence levels of politically correct memes.