Your Gut Bacteria Linked to Heart Attack and Stroke.

Jojy Cheriyan MD;MPH-April 24,2013

When it comes to heart attack and stroke, the first culprits that come to our minds are high blood pressure, high cholesterol, smoking and alcohol. Today (April 24,2013) medical scientists discovered another culprit which is widespread in your body, in millions or in trillions, living as a useful entity but can also be harmful as a manufacturer of a chemical compound that can clog your blood vessels.

The scientists of Cleveland Clinic today reported their ground-breaking research study in the New England Journal of Medicine (April 25, 2013 issue-online before print) about the role of gut bacteria in the formation of atherosclerosis (plaque formation in blood vessels) leading to heart attack and stroke.

In this study scientists discovered that the intestinal bacteria can turn dietary lecithin into a chemical compound called trimethylamine-N-oxide (TMAO) which causes clogging of arteries, leading to heart attack and stroke.

Lecithin (also called Phosphatidyl choline) is a nutrient found in egg yolks, liver, beef and pork. The study found that people who had high levels of TMAO in their blood suffered heart attack, stroke and death at a rate 2 to 3 times more than those with low levels of TMAO. This 2-3 fold higher risk is independent of other risk factors which make screening of TMAO a predictor of heart attack, stroke and death.

Researchers also noted that antibiotic use was not a solution against these bacteria since they can become resistant and cause more production of TMAO. But they suggested that avoiding excessive consumption of the major sources of lecithin- eggs, liver, beef and pork- can keep the TMAO levels down.

A vegetarian or high fiber diet can reduce total intake of lecithin. It should also be noted that lecithin is a semi-essential nutrient and should not be completely eliminated from the diet, since this can result in a deficiency state.

This study is a breakthrough and TMAO could enter the arsenal of blood tests that can predict possibility of cardiovascular diseases and death, despite having no other risk factors. This discovery may lead to new approach to preventing cardiovascular diseases like altering the gut bacteria or newer drugs to eliminate blood level of TMAO.

Use of prebiotics and probiotics which increase the growth of gut bacteria has also become a controversy with the release of this new study, because more gut bacteria means more TMAO.

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