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Evidence-Based Supplement Research
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Cocoa and Reduced TMAO Level

Doses used in studies
  • mg/day: 500 (median 500, IQR 500–500) — 1 study
Time to effect
Median: 12.2 months · IQR 12.2 months–12.2 months · Range 12.2 months–12.2 months — Reported in 1 of 1 study
1 of 1 paper

  • A pilot and feasibility analysis of serum TMAO and choline in a randomized sample from the COSMOS trial.

    • 2025
    • RCT · n = 40
    • Food & function 16(22)
      • Irene Sánchez Gavilán
      • Sidong Li
      • Michael G Sweet
      • Juanita G Ratliff
      • Pamela M Rist
      • Eunjung Kim
      • JoAnn E Manson
      • Howard D Sesso
      • Andrew P Neilson
    2 Insights on
    • High evidence
    • Rigorous Journal
    • Elderly

    those assigned to take a CE supplement, as compared to placebo, had similar TMAO and choline levels at baseline but showed trends toward lower levels of TMAO (-0.60 [95% CI, (-3.76, 2.55)]) at 1 year. However, the between-group differences in the 1 year changes in TMAO (CE minus placebo) were not statistically significant (-1.16 [95% CI, (-5.81, 3.50)]; P = 0.62).

    Effect
    Neutral
    Effect size
    Small
    Significant
    No
    Dose
    500 mg/day flavanols
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