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Instead, it is more appropriate to envision metabolic plasticity regarding uptake of alternative metabolic substrates and promotion of metabolic rewiring as a built-in feature that has evolved to allow cancer cells to constantly adapt to changing intracellular- and extracellular metabolic conditions 2

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6 Multiple microbes in both the small and large intestines can convert dietary L-carnitine into GBB, but relatively few can transform GBB into TMA.13 The GBB-to-TMA conversion is much higher in omnivores than in vegans and vegetarians, likely because of differences in the gut microbiota, although this aspect of the L-carnitine-to-TMAO pathway is not fully understood

10.1016/j.bmcl.2016.05.061 22 ChenK.ZhengX.FengM.LiD.ZhangH