TMAO–How your gut affects your heart?

In honor of Heart awareness month, this February, our blog is dedicated to help reduce the incidence of heart disease in the US and the world by raising awareness on the ill effects of TMAO(trimethylamine oxide) on our arteries, particularly coronary arteries(heart disease).


Traditional modifiable risk factors for heart disease, according to the World Health Organization include high blood pressure, cigarette smoking, diet high in saturated fats and low in fruits/vegetables,  physical inactivity and obesity.


Recent groundbreaking research has shown that high levels of circulating TMAO are associated with increased incidence of  major cardiac events(major heart attack, death) independent of the above traditional risk factors. So, what is TMAO?


TMAO is a compound made in the liver from its precursor TMA(trimethylamine), which in turn is formed in our gut by our microbiota(100 trillion bacteria that reside in our gut), when exposed to a diet rich in carnitine and choline.


Carnitine in our diet primarily comes from red meat, whereas fish, chicken, eggs and dairy are high in choline. Gut bacteria of individuals who eat a plant based diet is different from individuals who eat an omnivore diet(diet high in animal products).


Individuals consuming an omnivore diet have bacteria that convert the choline and carnitine in animal products into TMA, which is then converted to TMAO by our liver. TMAO is thought to increase the risk of major cardiac events by increasing build up of plaque in our arteries.  Moreover, increased levels of TMAO increase the risk for clot formation leading to increased risk for heart attack, stroke and death.


Interestingly, individuals who eat a plant based diet, but are fed steak(high in carnitine), their blood levels of TMAO don’t rise, because the favorable bacteria in their gut, do not make TMA, the precursor to TMAO. But if these individual switch from a plant based diet to an omnivore diet, their gut bacteria changes within a couple of weeks and their blood levels of TMAO do rise after eating a meal high in carnitine or choline.


To feed the good bacteria in our gut, we need to eat a diet that is plant based and high in fiber. So this February and throughout the coming year, show your gut bacteria some love💚 (plant foods) and they, in turn, will 💖love you back and protect you from heart disease and so much more!


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