Tag Archives: Diet

Carnitine Levels | The Paleo Diet

Hi Loren,

Here I go again with the question of the week. I love my job!

What do you think about carnitine found in high levels in red meat ( and in other products- other meats,  sports drinks, etc) and its potential association with the formation of coronary plaque?

I appreciate your response to my questions.  Feel free to answer when you have time.  No rush.

Thanks for your time and expertise.

— Pam

Dr. Cordain’s Response:

Hi Pam,

Good to hear from you. General practitioners such as yourself are responsible to your patients for giving them proper dietary advice, particularly whether or not they should avoid red meat to protect against heart disease.  The most recent commotion about red meat, carnitine and formation of coronary plaque (atherosclerosis) comes from the paper1 listed below from Stanley Hazen’s group at the Cleveland Clinic.

My colleague, Chris Masterjohn, has done a superb job of critiquing this paper and it’s scientific shortcomings in “Does Carnitine From Red Meat Contribute to Heart Disease Through Intestinal Bacterial Metabolism to TMAO?

I am in complete agreement with Chris’s conclusion that, “The bottom line here is that the popular interpretation of this study as an indictment of red meat makes no sense.” I have a few additional comments that corroborate Chris’s conclusion.

Although intriguing, Hazen’s model doesn’t fit well with the bigger picture of atherosclerosis etiology, particularly the two large meta analyses by Key’s group2, 3 showing cardiovascular disease (CVD) mortality in vegans and vegetarians to be no better than the general population.  Vegans/vegetarian data from India actually show high mortality from CVD and an earlier disease progression/mortality.4

Another point worth considering are the well studied polymorphisms disrupting FMO3 activity in trimethylaminuria patients causing inefficient conversion of TMA to TMAO.  Hence in these patients tissue concentrations of TMAO are severely reduced.  Given this metabolic scenario, one would expect that any of the polymorphisms disrupting the FMO3 gene would be highly protective for CVD (if the Hazen hypothesis is correct).  No CVD epidemiologic evidence supports this evidence.  In fact, a recent study5 shows that heterozygote genotypes (158Glu/Lys and 308Glu/Gly) increase the risk of stroke six times in hypertensives.


Loren Cordain, Ph.D., Professor Emeritus


1. Koeth RA, Wang Z, Levison BS, Buffa JA, Org E, Sheehy BT, Britt EB, Fu X, Wu Y, Li L, Smith JD, Didonato JA, Chen J, Li H, Wu GD, Lewis JD, Warrier M, Brown JM, Krauss RM, Tang WH, Bushman FD, Lusis AJ, Hazen SL. Intestinal microbiota metabolism of l-carnitine, a nutrient in red meat, promotes atherosclerosis. Nat Med. 2013 May;19(5):576-85

2. Key TJ, Fraser GE, Thorogood M, Appleby PN, Beral V, Reeves G, Burr ML, Chang-Claude J, Frentzel-Beyme R, Kuzma JW, Mann J, McPherson K. Mortality in vegetarians and nonvegetarians: detailed findings from a collaborative analysis of 5 prospective studies. Am J Clin Nutr. 1999 Sep;70(3 Suppl):516S-524S.

3. Key TJ, Appleby PN, Spencer EA, Travis RC, Roddam AW, Allen NE. Mortality in British vegetarians: results from the European Prospective Investigation into Cancer and Nutrition (EPIC-Oxford).  Am J Clin Nutr. 2009 May;89(5):1613S-1619S

4. Kumar J, Garg G, Sundaramoorthy E, Prasad PV, Karthikeyan G, Ramakrishnan L, Ghosh S, Sengupta S. Vitamin B12 deficiency is associated with coronary artery disease in an Indian population. Clin Chem Lab Med. 2009;47(3):334-8.

5. Türkanoğlu Özçelik A, Can Demirdöğen B, Demirkaya S, Adalı O. Flavin containing monooxygenase 3 genetic polymorphisms Glu158Lys and Glu308Gly and their relation to ischemic stroke. Gene. 2013 Mar 17. pii: S0378-1119(13)00244-8. doi: 10.1016/j.gene.2013.03.010. [Epub ahead of print]

The Healthiest Diet | The Paleo Diet

The fact is that virtually our entire physiologies operate exquisitely when they are functioning in the native human ecological niche in which they evolved –employing both the diet and exercise level of a hunter-gatherer. By contrasting the diets, lifestyles and health of hunter-gatherers to contemporary, westernized societies, we can gain invaluable insight into complex diet/disease related questions. The good news is that you can lose weight, gain more health, and eat food that is delicious – all on The Paleo Diet.

Following is just a sample of testimonials of people who have lost weight AND gained considerable health benefits from following The Paleo Diet:

“After being over weight most of my life at the age of 50, now I have finally found a good Doctor that told me about this diet. Since Dec 27th 2004 until May 9th 2005 I am down about 50 lbs I feel a lot better and I have told others about it as well.” …

“…I’ve been at it since January 1 of this year and I couldn’t be happier about it. I’m 46, generally healthy but was overweight; my family were all fat people and I was going that way myself despite being active. Being vegetarian for some years had only made me fatter: I was not a big dessert eater either, just cooking a lot of pasta and rice by habit. So now I’m three sizes smaller, have had to throw away clothes for being too big, some minor nagging skin problems have cleared up – my hair and skin make me look younger than my age now – some incipient aches and pains have vanished, and I have more energy and endurance than I’ve had since my twenties. I’m a graphic designer and was always fighting the forearm and wrist pains that computer people get. Not any more. And I hadn’t expected most of these improvements: they’re all a bonus. Another striking point was how easy the transition was. Friends have asked whether I don’t have to fight off cravings: I don’t. Of course I’m teased sometimes (“isn’t it time you went out and caught something for dinner?”) and occasionally nagged by vegetarians, but it’s worth it. I can’t imagine eating any other way now…”
–Kate M.

“THANK YOU SO MUCH! This diet is improving my health tremendously. PLEASE tell Dr. Cordain that everything he wrote in his book is true. I am losing weight effortlessly FOR THE FIRST TIME IN MY LIFE …”

“I’ve been on the Paleo Diet since May, and I’m down 30 lbs (most of it lost in the first 2 months) and have never been leaner in my life. I can’t stop talking about (it) when I’m with my friends and family when they ask how good I look. I’ve been evangelizing my Wall Street buddies every time we enjoy a steak house dinner. My acid reflux, IBS, allergies, attitude, and complexion have never been better, and I never go into food coma any more …”
–Rudy T.

“Thank you more than words can ever say for doing this research and for making it public. Over the past 25 years, I have gained 100 lbs & have asked every single doctor that I had been to for help. No one had advice that worked if they bothered to give any at all. I have been doing the paleo diet for 16 days now & have lost already 15 lbs, 1.5″ on my waist & 1.5″ on my hips…”

Diet, Losing Weight, and Your Health | The Paleo Diet

Many researchers now consider diet to be the most important facet in maintaining a person’s health … and unless you’ve been camping out in the Gobi desert for the past decade, you probably know that Americans are the fattest group of people on the planet. Despite the myriad of new diets offered each calendar year, we’re getting even fatter. As a result, we are also considerably less healthy as a society.

The Paleo Diet (also sometimes referred to as the Hunter-Gatherer Diet, the Paleolithic Diet, the Caveman Diet) has introduced thousands of people to the concept that the healthiest diet is one based on the way our Paleolithic ancestors ate. If you are overweight, on this diet you will lose weight … and it will be long term, permanent weight loss. Dr. Jennie Brand-Miller (Professor of Human Nutrition, University of Sydney), when reviewing the book, The Paleo Diet, called it “the most nutritious diet on the planet.”

So, what the Paleo Diet is proposing is nothing less than the world’s healthiest diet … not only will you lose weight from this diet (read success stories»), but you will have many health benefits that you may not initially think are related to weight loss. All of our information is backed by peer-reviewed scientific research from Loren Cordain and other Ph.D researchers and medical doctors.

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