Food as Medicine: Gut-Microbiome and Cardiometabolic Implications
We have all heard the advice to avoid red meat for heart health, yet most do not know this mechanism takes root in the gut microbiome. The gut microbiome is a significant link between nutrition and heart health, as host-microbiome interactions influence the synthesis and release of several metabolites, including trimethylamine-N-oxide (TMAO), bile acids (BA), and short-chain fatty acids (SCFA).
An alteration in diversity and composition of the gut microbiome and its associated metabolites are implicated in cardiovascular and
metabolic health outcomes. Microbial dysbiosis has been implicated in the progression and pathogenesis of cardiovascular disease, including atherosclerosis, hypertension, and heart failure. Irritable bowel syndrome may precede myocardial infarctions. Notably, fecal microbial transplants influence not only obesity, but blood pressure and clotting risk.
As we recognize coronary heart disease is a lifestyle disease with a nutritional component, a comprehensive stool assessment is appropriate to identify chronic dietary patterns, as a mechanism to utilize food as medicine. Additionally, moving beyond simply evaluating cholesterol, LDL and HDL, and including oxidized LDL,
small dense LDL, and non-HDL cholesterol is warranted. Consideration of metabolic markers such as glycomark and fasting insulin provide a holistic approach to cardiometabolic health.