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An observational study comparing healthy adults found circulating levels of TMAO negatively correlated with MedDiet score after adjusting for BMI, physical activity, and total energy intake (123)

Observational studies A large number of cross-sectional and prospective cohort studies have associated elevated blood homocysteine concentrations with measures of poor cognitive scores and increased risk of dementia, including Alzheimer's disease (reviewed in 67, 69)

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Diarrhea and constipation both occur, sometimes alternating, as gut motility adjusts to the medication