• Brian Dooreck, MD

Connecting My Gut and My Heart



What is the gastrointestinal (GI) tract or system?


The gastrointestinal (GI) tract does many things. It transports food, converts food into energy and nutrients, helps eliminate waste, and allows us to live. It is now known, that the GI tract or GI system involves many components of immunity, emotional stress, chronic illness, and even cancer.


What is the microbiome?


The bacteria and microorganisms that make up the stomach and small intestines are called the microbiome. It is the "gut bacteria" in simpler terms. We can refer to it also as "gut health."



How is my gut and heart connected?


Emerging details of this complex connection are becoming clearer in terms of the connection between gut and heart health. Why has red meat long been associated with higher heart disease risk? Read on.


The gut microbiome, in addition to the above, makes vitamins and provides protection against disease-causing microorganisms. Recent studies from the Cleveland Clinic demonstrated that the gut microbiome directly affects the function of blood platelets.


What are platelets?


Platelets are cells that circulate in the blood and clot to keep us from bleeding. Platelets also have a direct influence on one's risk for heart attack and stroke.


What is the connection?


The gut bacteria break down certain nutrients. The broken down nutrients create compounds that are further converted in the liver to end products. Let me explain.


Nutrients such as (1) choline (found in red meat, egg yolks, and dairy products) and (2) L-carnitine (found in red meat, some energy drinks and supplements) are broken down by gut bacteria to trimethylamine (TMA). Then TMA in the liver is converted into the compound, trimethylene N-oxide (TMAO).


What is TMAO?


High levels of TMAO lead to a higher risk for clot-related events. These life threatening clot-related events, for example, are heart attacks and strokes, a leading cause of morbidity and mortality.


High levels of TMAO lead to a higher risk for heart attacks and strokes

Furthermore, they showed a higher rates of premature death in patients with stable coronary artery disease and a four-fold greater overall risk of dying from any cause over the following five years.


What is the meaning or TMAO?


By altering your gut microbiome in a positive way, it can help to reduce damage to blood vessels leading to a stronger cardiovascular system. This also opens research for potential new heart disease therapies.


What foods can cause high TMAO level?


  • Red meat

  • Egg yolks

  • Dairy products

  • Energy drinks and supplements


Is there testing for TMAO now?


In 2015, the Cleveland HeartLab introduced the first TMAO lab-developed test to help clinicians identify TMAO blood levels in patients. In 2017, Quest Diagnostics acquired Cleveland HeartLab.


How can I lower my TMAO levels?


Minimize the consumption of:

  • Full-fat dairy products (whole milk, egg yolk, cream cheese, and butter)

  • Processed and unprocessed red meat (beef, pork, lamb, and veal)

  • Nutritional supplements and energy drinks containing choline, phosphatidylcholine (lecithin), and/or L-carnitine



Vegetarians and vegans, who avoid meat products, for instance, produce little TMAO




What can I eat to for lower TMAO levels?


In general, eat a diverse diet rich in plant foods and whole-grain fiber. There are compounds being studied that minimize TMAO production from their gut microbiome. Some of there compounds are found naturally in Mediterranean diet foods (such as red wine and extra virgin olive oil).


Personally


I eat a high fiber, mostly plant-based diet, no red meat, drink 4 liters of water a day, exercise, and am focused on "nutrition simplified." No pills. No supplements. No purchased meals.


🥬 Join me when I post “Lunch 🥗 with @dr.dooreck” on LinkedIn.


Eat Smart. Eat Healthy. 🥬 🌾 🥦

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