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Gut Flora: Still a “Way Out There” Idea

the heart and gut flora

“It is still a ‘way out there’ idea,” says Dr. Stanley Hazen, but the idea that the makeup of your gut flora has a profound direct effect on your risk for heart attack won the Cleveland Clinic a spot on the American Heart Association’s list of 2013’s Top 10 Advances in Heart Disease and Stroke Science.

Gut flora can  make a big difference in your health

And Hazen’s research is just one example of the investigations into gut flora being conducted by scientists and medical researchers around the globe. The implications are mind-boggling. They hold promise for breakthroughs in just about every one of the major diseases that plague us: heart disease, cancer, obesity, depression, diabetes, GERD, leaky gut syndrome … and more.

The Cleveland Clinic study was published in the April 2013 edition of the peer-reviewed journal, Nature Medicine. The focus was on a compound found primarily in red meat: carnitine.

Carnitine, TMAO, and Heart Attack

Earlier studies showed that carnitine increases levels of trimethylamine N-oxide (TMAO) and TMAO serves to encourage a buildup of plaque in arteries … and that can lead to stroke or heart attack. Earlier research by the team indicated that levels of TMAO are an effective predictor of heart attack risk(1) – more so than monitoring cholesterol numbers.

What does this have to do with gut flora?

The Cleveland study was designed to look at why the consumption of red meat can contribute to heart disease – even in those who take statin drugs and seemingly have their cholesterol levels under control. From previous studies, they suspected the fatty component of red meat, and the resultant cholesterol-building tendencies, were not the real problem – that TMAO was instrumental in the health risk.

A series of projects were designed to assess the diets of vegetarians and meat-eaters to see whether the gut flora components differed. After consuming a serving of steak, blood was drawn from each. As expected, TMAO levels spiked for habitual meat-eaters – but not for the vegetarians or vegans.

Escherichia coli
Escherichia coli (public domain) – gut flora

There are several important practical take-aways from the work:

  1. A vegetarian or vegan diet provides a gut flora community that does not lead to buildups of TMAO. If meat-eaters are given a high dose of antibiotics to kill off the gut flora, they do not then exhibit the spike in TMAO after eating  red meat or otherwise ingesting carnitine. Scientists found that the makeup of the gut flora is solely responsible for the buildup in TMAO.
  2. Carnitine can also be found in many energy drinks. Given the apparent relationship between carnitine and heart attack risk, the scientists advise against them – and those beverages are especially popular with younger people. (Look for carnitine or L-carnitine in the list or ingredients.)
  3. This doesn’t mean a person should not eat red meat at all – but that it may be wise to limit the amount and frequency. The habitual consumption of red meat leads to an overabundance of the type of gut flora that produce TMAO.

How quickly, though, can the types and numbers of gut flora change? According to a Harvard University study, published in the Nature journal, radical changes in what you eat can have a huge impact on the gut flora – even in one day.

“You are what you eat,” says the old maxim. Science is proving that daily. The trillions of microorganisms that inhabit your digestive tract can make a huge difference in your health – and your diet can make a huge difference in their composition. Your gut is central to your health.

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10 thoughts on “Gut Flora: Still a “Way Out There” Idea

    My wife is Peruvian… I love plants… so the Amazon was a probable destination and we have been lucky enough to visit that huge river two or three times…. One time I was asked to bring back one of the large Amazon lilies… (twelve foot lilly pads) and found a good specimen and grabbed the plant at the base underwater and they have long three inch spines that went into my hand and inoculated me with Typhoid which created Typhoid Fever… Her uncle a medical doctor gave me some stomach flora… primarily… that was what made me better after three weeks… So yeah… stomach flora… very very good … in fact all probiotics… are good… for us…

    Thanks for the words of wisdom Don 🙂

    I think we’ve done incredibly well with changing our diet to be as healthy as possible. Though, after finding out that having a 3rd party pick your produce isn’t always desirable, I started to supplement more with green smoothies and vegan protein powder.

    Sometimes small steps make a huge difference diet wise, that’s for sure.

    As for health being the most important thing to invest in, I agree. Sometimes the price of that investment just isn’t feasible.

      Remember the old bumper-sticker, “What if schools had all the funding they need and the Air Force had to hold a bake sale to buy a bomber”? Wouldn’t it be great if it was easy and inexpensive to get nutritious foods and you had to go to a specialty store to buy junk? I am encouraged by studies showing how quickly our internal systems can turn around. I’m kicking off a “whole juice fast” soon (using a Vitamix instead of a juicer) and wondering which foods to use and which to avoid. The thing is, optimal diet may be very much individual.

      Doc Haley, do you have any suggestions on how to get started on a turn-around … on a budget

    I rarely eat red meat. Chicken, maybe pork, but not much red meat. I mean, I love burgers, but we just don’t eat them very often.

    I’d much prefer eating vegetarian entirely! Working on that (and the hubby, who is very much a meat and potatoes kinda guy). While we try to eat only organic, it tends to be far more expensive. Food IS expensive these days. That could be a big reason why we don’t eat much red meat, it tends to be the most expensive I think too.

    We totally cut out sweet drinks in our house. No pop, no sweetened juice, no energy drinks. It’s tea, coffee or water only. I drink 2L of water easily per day. Once you start consistently doing that, it’s easy. You then crave the water. Funny how that works.

    Gut flora wise, hard to say where I’m at. With various medications and being limited to what I can eat as-is, it’d be a tough call. I’d have to see a specialist of some kind I’m sure. Just not really high on the priority list at moment. Especially when extra treatments/specialists always means more money to spend.

      I hear you, Shannon. Food is expensive enough, just buying whatever is on sale. When one begins to pick and choose — and shop for “health foods,” it can be a scary ordeal.

      Two things I’ve decided: 1) That there is no more important investment than health … if I have to spend more money on proper nutrition and less somewhere else, then so be it. 2) Eating healthier generally means eating simpler. Sometimes, simple isn’t the most attractive option … you won’t find any Super Bowl commercials glorifying a salad and spring water … but it’s the best (and usually the least expensive).

      It’s tough making dietary changes; that’s for sure … but it will be a lot easier if you and your husband can reach common ground and support one another’s efforts.

      Wishing you great success …. Don

    You got me a bit worried now Don. I use L-carnitine quite often. For some reason I convinced myself I will be able to run faster and exercise longer if I drink a bottle of carnitine before I go (yes, of course I know how stupid that sounds…). I will definitely give it a second thought now (although health still comes last with me…)

      That is good, Ivana. I hope it encourages you to watch the issue. As with most things, there are proponents on both sides. Doc may wade in with more insight for use. The thing that really concerns me about this is that so many young and healthy folks use energy drinks daily. One thing, though, don’t you mean health comes “first” with you?

        Thank you Don, and thank you for correcting me. Yes, of course I meant health comes ‘first’ with me 🙂 (it’s a work in progress…).


          You made me stop and think, Ivana. I would love to say health comes first with me — and it does (in my mind). In practice, pleasure more often comes first. Last night, for instance, I pigged out on fettuccine alfredo and coffee. Seldom a wise move … but I love the stuff.

            I had to Google that out Don (fettuccine alfredo), looks delicious! Not sure how it goes with coffee thought :).

            My problem is not so much with food and cravings (although I could really cut down on chocolate), but more on the amount of time I spend in front of my computer screen, and in the lack of sleep. I convinced myself that if I take a 30 min run after 12 hours of sitting – I’ll be ok. But my back says otherwise.

            I guess I still believe I’ll be young forever (although years are piling up on me quickly).

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