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Metabolites were annotated using the MassHunter software (Agilent) according to the National Institute of Standards and Technology (NIST, Gaithersburg, USA) library and external standards listed above

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Examination of individual plots of plasma d 3 -TMAO production from oral d 3 -l-carnitine challenges among vegans/vegetarians ( n = 7) demonstrated that the mean increase observed was driven by only a subset ( n = 3) of subjects, with over half ( n = 4) of the vegans/vegetarians demonstrating essentially no metabolic capacity to convert oral d 3 -l-carnitine into d 3 -TMAO even after months of l-carnitine supplementation (Supplemental Figure 3)