Lately, there has been a lot of research looking at the link between the brain and the gut. We wanted to know: Is there a similar link between the heart and the gut? Doctors agree there most certainly is, and mostly it is mediated by the health and balance of the gut microbiome.
In this Special Feature, we explore the strong link between the gut and heart
health.
A popular adage has it that “you are what you
eat.” And every year new research continues to suggest that this idea may, in
fact, be correct.
Recently,
scientists have been focusing on a potential
link between the health of the gut and that of the heart.
Doctors
already recommend eating heart-healthy foods, and medical professionals
agree that much of the correlation between heart and gut health has to do with
the gut microbiome,
including its composition, and a toxic byproduct it creates when metabolizing
certain foods.
Medical News Today spoke with five experts to get to the bottom of how much gut health truly impacts cardiovascular health.
What is the gut microbiome?
All the experts
we spoke to agreed that the gut microbiome can have a profound impact on heart
health.
“The
gut microbiome is a complex community of trillions of microorganisms, including
bacteria, viruses, fungi, and protozoa, that reside in the human digestive
tract, primarily in the large intestine (colon),” Dr.
Nathaniel E. Lebowitz, a cardiologist with Hackensack University
Medical Center in New Jersey explained to MNT.
“These
microorganisms can be healthy or unhealthy depending on what we feed them. If
they are unhealthy, all of our body’s systems can go haywire. Just like we
depend on the microbiome for our health, it depends on us for its health,” he
detailed.
“Keeping
the microbiome healthy is increasingly found to be critically important for all
of our organs — including the heart and arteries,” Dr. Lebowitz continued. “We
know that
In
turn, Dr.
Cheng-Han Chen, a board-certified interventional cardiologist and
medical director of the Structural Heart Program at MemorialCare Saddleback
Medical Center in Laguna Hills, CA, told MNT that:
“There’s
more and more research coming out that there is a connection between the
composition of someone’s gut flora or 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
Past
research has linked an unbalanced gut microbiome to an increased risk for
several cardiovascular diseases, including
What is TMAO?
Another way in
which the gut microbiome can potentially have harmful effects on the heart is
through the production of
“When
gut microbes feed on choline — found in
“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,” he noted.
“Studies
have associated TMAO with aspects of inflammation and blood vessel
dysfunction,” Dr. Chen added. “It also promotes
A
study published in October 2019 linked TMAO to disease severity and mortality
rate in people with
Research
published in March 2023 reported an increase of TMAO in blood plasma was an
independent predictor for
And
a study published in March 2022 correlated elevated TMAO levels with
Why is a well-balanced gut microbiome important?
As the gut
microbiome influences not only heart health, but the well-being of the entire
body, experts agree that it must be well-balanced for optimal function.
“An
easy way to think about the gut microbiome is like a beautiful farm garden,” Monique Richard,
a registered dietitian nutritionist and owner of Nutrition-In-Sight explained
to MNT.
“The
various gut bugs, or microbiota, are like the components of the garden, each
having their own job function to contribute to a bountiful harvest. The garden
needs components like healthy soil, clean water, proper nutrients, structure,
and tender love and care,” she continued the analogy.
According
to Dr. Lebowitz:
“If
we eat foods that feed the good bacteria — an alkaline diet high in fruits and
veggies — we will be fostering the health of a healthy microbiome. Eating foods
that contain too much refined carbohydrates, sugar, and processed foods can have the opposite
effect and feed bad bacteria which can trigger inflammation that causes disease
— and the arteries and the heart are no exception to this. If there is
inflammation in the arteries, as an example, cholesterol will stick to it.”
Richard
said it is also important to note that each person’s gut microbiota has its
function in helping process what we eat and supporting various functions of
digestion and systemic function.
“One
example includes our gut microbes breaking down compounds into what are called
“Butyrate
has many known benefits which include being anti-inflammatory and cardio-protective.
The better equipped our gut is with benefits to nurture the components of our
internal ‘garden,’ the more robust the rest of our systems will be since it is
all connected and work together,” explained Richard.
Why is fiber heart-healthy?
In addition to
following a heart-healthy diet, medical experts agree that getting enough dietary fiber is also required to keep
the gut-heart connection thriving.
“Foods
that contain fiber are pretty heart healthy — low in saturated fats, low in
sodium,” Dr. Chen explained. “And fiber itself is actually food for the gut
bacteria. So the more fiber you have, the healthier they will be. They process
the fiber and break it down.”
“Fiber-rich
foods definitely lower the risk of heart disease and stroke by quite a bit,” Dr.
Rudolph Bedford, a board-certified gastroenterologist at Providence
Saint John’s Health Center in Santa Monica, CA, told MNT. “Fiber in itself will help to not only take away
many of the bad toxins but will also lower the cholesterol level.”
“High
fiber diets are great because the microbiome breaks fiber down into beneficial
things like short-chain fatty acids which are associated with improved blood
pressure, blood sugar, less inflammation, and weight loss — all of which can
boost [cardiovascular] health,” Dr. Higgens added.
Past
studies have linked higher dietary fiber intake with
Should you take probiotics or prebiotics?
While eating
the right foods can help keep the gut microbiome healthy, there has been a lot
of talk over the past few years about taking prebiotic and probiotic supplements to
aid with gut health.
In
the most basic terms, probiotics are bacteria beneficial to the gut microbiome,
while prebiotics are food for those bacteria.
Some foods are
natural prebiotics — these include oats, bananas, onions, artichokes, spinach,
and chia seeds.
“The
problem with probiotics is that they’re a ‘food supplement,’ and much of this
is strain-dependent —in other words, what type of strains are within those
probiotics,” Dr. Bedford explained. “There’s no doubt that certain strains of
probiotics may certainly aid in gut health and may even help in decreasing your
risk of cardiovascular disease.”
“But
the fact of the matter is that there are just so many different probiotics out
there and none of this is regulated by any government agency,”he continued. “It’s
somewhat of a challenge to recommend probiotics to patients, depending upon
what it is that they’re actually getting. You should definitely speak to your
physician before you start a probiotic or prebiotic.”
Healthy gut, healthy heart
With so much evidence pointing to a link
between the gut microbiome and cardiovascular health, following a healthy diet
rich in foods that aid the good bacteria in the gut is important.
“The
gut microbiome itself may cause elevations of cholesterol levels or decreasing
cholesterol levels, increasing in other types of chemicals […] such as TMAO,
which may increase the risk of heart attacks and strokes and even
“It
appears that having a healthy gut is important to heart health, through
indirect effects — improving cardiovascular disease risk factors — and direct
effects — TMAO-promoting artery-blocking plaque,” Dr. Higgins said. “[It] also
boosts [the]
Dr.
Lebowitz advised:
“If
your diet is healthy then your diet will promote good health. Eating the right
foods, for example, fruits, veggies, and cold water fatty fish like salmon, pacific herring,
and sardines can help to reduce inflammation and your risk of heart disease.
The right nutrition can work wonders — it can even reverse some of the damage
already done.”
“The
quality of what we consume is important, but so is the environment we consume
it from,” Richard said. “Be sure to take time to sit at a table in an inviting
environment as often as you can.”
”Take
time to slowly chew your food, use your senses to observe, and enjoy the
experience of eating. When we are enjoying a meal together around a table —
away from technology and convenience — we are feeding so much more than our bodies
and gut. These practices are critically more important to the heart, mind, and
body than we can measure in a study,” she emphasized.
“It is also important to remember that all things are interconnected,” added Richard. “Nurturing our ‘internal garden’ also requires other ways the heart can thrive and be protected like exposure to nature and fresh air, loving relationships, activities that bring joy and happiness, regular activity, and sunshine.”
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