Here we go again.

The “what to eat and why” plot thickens. So do our artery walls if we’re not careful.

According to the CDC (Centers for Disease Control), heart disease is the leading cause of death in the US for both men and women. Back in my exercise physiology days, I had a fascination with heart disease. I wrote my thesis paper on the effects of exercise on coronary collateralization, worked in cardiac rehab, helped develop an outpatient exercise program, watched up-close-and-personal heart procedures, and was convinced I’d make an awesomely fantastic cardiac surgeon (some of the docs back then were alpha males and not the best listeners). If not for that sternal saw thing, I might have given it more thought.

What I did learn from that experience, though, is that heart disease is a complex condition and doesn’t always follow a direct line to diagnosis or treatment. Researchers are now questioning some of the basic assumptions about causes, lab biomarkers (blood chemistry), nutrition protocols, drug therapies, and invasive surgeries. Some in the medical community are even rethinking our obsession with low cholesterol and statin drugs. I’ll resist picking up that rope, but suffice to say, there’s no easy answer. Throw in genetics and lifestyle choices and there’s a lot to consider.

And now, like there’s not enough to think about regarding heart health and that all-too-common side effect known as sudden death, researchers have discovered those pesky gut bacteria are also playing a role. It appears there’s a type of meat- and egg-loving microbe that produces a substance, which in turn, increases the risk for heart disease. It’s a convoluted pathway, but these microbes convert carnitine (in meat) and choline (in eggs) into a chemical the liver quickly converts to TMAO (trimethylamine N-oxide). TMAO ends up in circulation and is associated with an increased risk for atherosclerosis. That’s not good.

For a variety of reasons, I’ve never been much of a meat fan. I’ve always felt we’re better off sticking to a diverse, plant-based diet. If I eat red meat at all, it’s on very rare occasions and in condiment-sized portions. Plants high in beneficial fiber encourage the proliferation of good gut bacteria. Those are the microbes I want on my disease-fighting team, not the carnitine-fueled, gas-belching, TMAO-producing critters. There’s also growing evidence that carnitine and choline supplements promote higher TMAO levels. Beware.

The conclusion from the scientific and medical community might be (is) to develop antibiotics to eliminate these microbes. If we wipe out the bacteria that play a part in TMAO production, we solve the problem, right?

Hmmm? I wonder what the unintended consequences of that will be? How about we support the magic of our own innate healing power and skip the drugs?

Bottom line (in my humble opinion)? Eat more plants and rethink the use of supplements and energy drinks.

If you’re on a meat-laden Paleo diet, you might want to read the research.

For more information about plants, fiber, and gut bacteria, check my last post.
Plants, peels, fiber, and gut bugs

If you’re still with me, thank you. I’ll post some recipes that promote good bacteria later this week. No science talk, I promise. Just good food.

We’re all in this together. Peace, love, and plant power.
Melissa

References:

Husten, L “Researchers Find New Path Linking Heart Disease to Carnitine.” Forbes, online. http://www.forbes.com/sites/larryhusten/2013/04/07/researchers-find-new-pathway-linking-heart-disease-to-carnitine/ (accessed April 7, 2025)

Kolata, G “Culprit in Heart Disease Goes Beyond Meat’s Fat.” The New York Times, online. http://www.nytimes.com/pages/health/index.html (accessed April 7, 2025)

Wang Z, et al. “Gut flora metabolism of phosphatidylcholine promotes cardiovascular disease.” Nature 472, 57-63 (April 2011).

Willyard, C “Pathology: At the heart of the problem.” Nature 493, S10-S11 (January 2013).