How and why does gut health influence heart health?
The connection between gut health and heart health is an emerging area of research, and while the exact mechanisms are still being investigated, several factors suggest an intricate relationship between the two:
Inflammation: A healthy gut microbiome helps maintain a balanced immune response and reduces inflammation throughout the body. Chronic inflammation is a key driver of cardiovascular disease, contributing to the development of conditions such as atherosclerosis (hardening of the arteries) and hypertension (high blood pressure).
Metabolism: The gut microbiome plays a crucial role in metabolizing nutrients and regulating energy balance. Disruption of the gut microbiome, such as through an unhealthy diet or antibiotic use, can lead to metabolic dysfunction, including obesity, insulin resistance, and dyslipidemia all of which are risk factors for cardiovascular disease. Certain beneficial bacteria in the gut produce short-chain fatty acids (SCFAs) through the fermentation of dietary fiber. SCFAs have been shown to have anti-inflammatory properties and may help regulate blood pressure and cholesterol levels, thereby protecting against cardiovascular disease.
Microbial Metabolites: Gut bacteria produce various metabolites, including trimethylamine N-oxide (TMAO), which has been linked to an increased risk of cardiovascular events. TMAO is formed from the breakdown of certain dietary compounds, such as choline and carnitine, and has been associated with the development of atherosclerosis and thrombosis.
Hormonal Regulation: The gut microbiome influences the production and metabolism of hormones involved in cardiovascular health, such as serotonin and bile acids. Alterations in these hormonal pathways can affect blood pressure, heart rate, and vascular function.
Immune System Modulation: The gut microbiome plays a crucial role in training and regulating the immune system. Dysbiosis, or an imbalance in gut bacteria, can lead to immune dysfunction and chronic inflammation, which are detrimental to heart health. You are what you eat, goes a common saying. Additionally, fresh studies continue to imply that this theory might be true each year. Scientists have recently directed their attention toward a possible connection between heart and gut health. Physicians already advise patients to consume heart-healthy foods, and experts in the field concur that the gut microbiome including its composition and the toxic byproduct it produces during the metabolism of some foods plays a major role in the relationship between gut health and heart health.
Every expert we spoke with agreed that heart health can be significantly impacted by the gut microbiota. The human digestive tract, particularly the large intestine (colon), is home to a complex community of trillions of microorganisms known as the gut microbiome. These microorganisms include bacteria, viruses, fungi, and protozoa. Depending on what we feed them, these microorganisms can be either healthy or unhealthy. Any number of our body’s systems could malfunction if they are unhealthy. The microbiome depends on humans for health, just as we do for its own. It is becoming more and more clear that maintaining the health of our microbiome is crucial for all of our organs, including the heart and arteries. We now know that inflammation, particularly in the heart, may be the primary cause of a great deal of health issues these days. One important factor in reducing inflammation is the microbiome.
There’s more and more research coming out that there is a connection between the composition of someone’s gut flora and the microbiome. There’s a connection between the type, distribution, and relative composition of gut bacteria that someone has and an association with their risk factors for heart disease that includes high blood pressure, high cholesterol, [and] obesity
Another way in which the gut microbiome can potentially have harmful effects on the heart is through the production of trimethylamine-N-oxide (TMAO). When gut microbes feed on choline found in red meat, poultry, eggs, [and] certain fish they make trimethylamine(TMA), which is absorbed into the body and goes to the liver where it is changed into TMAO, Dr. John P. Higgins, a sports cardiologist at McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth) explained. TMAO is bad because it is associated with cholesterol and artery-narrowing plaque in important arteries in the body, especially the coronary arteries which supply blood to the heart. So people with high levels of TMAO are at increased risk of heart attacks or stroke.
Studies have associated TMAO with aspects of inflammation and blood vessel dysfunction, Dr. Chen added. It also promotes foam cells in the blood vessels. All of these different things end up promoting different types of heart disease, such as atherosclerosis, and they can also lead to different aspects of cardiovascular risk factors such as high blood pressure. A study published in October 2019 linked TMAO to disease severity and mortality rate in people with peripheral artery disease. Research published in March 2023 reported an increase of TMAO in blood plasma was an independent predictor for major adverse cardiac and cerebrovascular events in people who experienced acute myocardial infarction (heart attack).
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