Researchers are exploring a possible link between gut microbes that live in the digestive system and the development of atherosclerotic plaque. Researchers from the Cleveland Clinic first took blood samples from two groups of people, those who had recently had a heart attack or stroke and those who hadn't. Blood from those with cardiovascular disease carried higher levels of choline, betaine, and trimethylamine N-oxide (TMAO). All three are breakdown products of lecithin, a dietary fat. In step two, the researchers determined that the body converts dietary lecithin and choline into TMAO. They also determined that feeding mice lecithin or choline promotes the development of atherosclerotic plaque. To identify the source of TMAO production, the researchers gave mice a course of antibiotics, which wipes out many gut bacteria. When these mice were fed a diet rich in lecithin, they didn't make TMAO, and there was no increase in atherosclerosis.
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