Gut Bacteria Linked to Cardiovascular, Kidney Diseases
For years, cholesterol was thought to be the primary cause of cardiovascular disease. However, new research has found direct links between gut bacteria and heart failure and chronic kidney disease.
The process involves two nutrients, choline (a component of lecithin, which is found in meat and eggs) and L-carnitine (found primarily in red meat), which, when digested, form a waste product called trimethylamine (TMA). This is then converted into TMAO (trimethylamine N-oxide) in the liver. TMAO then enters the bloodstream and inhibits cholesterol removal from artery walls. Higher TMAO levels are linked to an elevated three-year risk of heart attack, stroke, and death. The study was published online in the journal Cell March 10, 2016.
What You Should Know
A new blood test enables physicians to know a patient’s TMAO levels. The levels are determined by gut bacteria, and not necessarily related to animal product consumption; vegetarians and vegans are known also to have high TMAO levels. However, if TMAO levels are high, patients can avoid or limit consumption of animal products. In addition, they should maintain better weight control, treat lipids and blood pressure, exercise, and stop smoking.
The TMAO Journey. Once TMAO makes it to the bloodstream, it is involved in changes in whole-body cholesterol metabolism, platelet function and clot formation, vascular inflammation, and unstable plaque formation in artery walls.
Study author Stanley Hazen, MD, PhD, Chair of Cellular and Molecular Medicine and Section Head of Preventive Cardiology and Rehabilitation, Cleveland Clinic, says TMAO inhibits cholesterol removal from the artery wall, causing a buildup of cholesterol. TMAO also causes platelets to be more active and form clots, making a person more vulnerable to cardiovascular events, such as heart attack, stroke, and death.
Confirms Previous Studies. The current study builds on previous findings five years ago by the same research team, which discovered the link between TMAO, gut microbes, and heart disease.
“It’s reasonable to think of the intestinal microbiome as our largest endocrine organ,” says Dr. Hazen. “Our gut bacteria serve as the filter of our largest environmental exposure—the food we eat. Once we work out the chemical language of this organ,” he says, “we can develop drugs to manipulate it and reduce the risk of cardiovascular disease, heart failure, kidney disease and possibly a host of other conditions.” The study results also suggest possible nutritional interventions to help prevent cardiovascular events, he adds.
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