Lay Audience Article
When it comes to heart health, listen to your gut
Leticia Torres, PhD | Freelance medical writer and microbiota enthusiast
In the time it takes to read this article, approximately eight people will have died from cardiovascular disease in the United States [1]. Despite this staggering statistic, heart disease is not an inevitable part of aging, and listening to your gut could help you avoid it.
Cardiovascular disease does not appear overnight. Several risk factors, such as high cholesterol, high blood pressure, diabetes, obesity, an unhealthy diet, and smoking, contribute to its development over time [2].
Medications can help manage some of these risk factors, but keeping up with them all can be challenging—you may need one pill to treat high cholesterol, another to treat high blood pressure, and yet another to manage possible side effects. This can quickly cascade into a long list of medications, increased healthcare costs, and feeling restricted in life.
Fortunately, you have options! In addition to medications and regular exercise, which can help decrease the odds of developing cardiovascular disease or even improve its prognosis, there’s one thing you may not have considered—the health of your gut microbiota.
You’ve probably heard about the gut microbiota and its importance for regular digestion, but did you know that it also plays a significant role in heart health? Yup—research shows that what benefits the gut tends to benefit the heart, too. By keeping your microbiota healthy, you can potentially avoid cardiovascular disease and the burdens it brings [2,3].
When you
care for your gut, your heart also
benefits
The gut microbiota consists of more than 500 species of bacteria, viruses, and yeasts, all living in a community, interacting with each other and their environment—your body [2].
Your gut microbiota helps you digest food, which results in “leftovers” being produced, known as metabolites. Certain metabolites keep blood vessels fit and clean, strengthening your cardiovascular system, while others can damage vessels’ structure, contributing to cardiovascular disease [4,5].
When the gut hosts a healthy mix of microbes—mostly beneficial ones—it's considered balanced. However, if its microbes aren’t diverse, don’t break down food effectively, or aren’t distributed properly, the gut environment is said to be in a state of dysbiosis, i.e., it is unbalanced [6]. The metabolites produced by unbalanced gut microbiomes tend to be more harmful to blood vessels than those made by balanced guts. So, it’s no surprise that dysbiosis is common among people with cardiovascular disease, often worsening as their condition advances [2,7].
Fortunately, when you care for your gut, your heart also benefits. And there’s no better way to keep your gut microbiome happy than by giving it food that helps it thrive as an ecosystem.
Essentially, what you eat determines which types of metabolites are produced. For example, eating foods rich in complex carbohydrates and fiber feeds microbes that produce short-chain fatty acids (SCFAs), a beneficial metabolite [4]. SCFAs keep your cardiovascular system healthy by reducing blood pressure, helping inflamed tissues heal, and keeping your arteries clear [4]. Sources of complex carbohydrates and fiber include legumes, whole grains, fruits, vegetables, nuts, and seeds [8,9].
On the opposite end of the spectrum, eating highly processed, fatty foods (a.k.a., the standard American diet) fuels microbes that produce harmful metabolites. Among them is trimethylamine, which gets turned into trimethylamine N-oxide (TMAO) in the liver and circulates through the body, causing blood vessels to become inflamed [5]. TMAO also increases cholesterol levels and clogs arteries, which can ultimately affect the heart [5]. Lastly, a high amount of TMAO increases one’s likelihood of having a stroke [5].
In a perfect world, you would build your own microbial community to treat cardiovascular disease. But an ideal combination of microbial species has yet to be discovered, and we can’t just pop a pill to source all of the necessary microbes for a healthy heart.
Fortunately, following a microbiome-loving diet is all you need to keep your gut happy. A well-fed, balanced gut will give you a greater chance of reducing your risk of cardiovascular disease and the need for medication [3].
Include more microbiome-friendly foods in your diet to improve your heart health.
REFERENCES
1. Multiple Cause of Death Data on CDC WONDER. Accessed April 8, 2024. https://wonder.cdc.gov/mcd.html
2. Lupu VV, Adam Raileanu A, Mihai CM, et al. The Implication of the Gut Microbiome in Heart Failure. Cells. 2023;12(8):1158. doi:10.3390/cells12081158
3. Casas R, Castro-Barquero S, Estruch R, Sacanella E. Nutrition and Cardiovascular Health. Int J Mol Sci. 2018;19. doi:10.3390/ijms19123988
4. Hu T, Wu Q, Yao Q, Jiang K, Yu J, Tang Q. Short-chain fatty acid metabolism and multiple effects on cardiovascular diseases. Ageing Res Rev. 2022;81:101706. doi:10.1016/j.arr.2022.101706
5. Canyelles M, Borràs C, Rotllan N, Tondo M, Escolà-Gil JC, Blanco-Vaca F. Gut Microbiota-Derived TMAO: A Causal Factor Promoting Atherosclerotic Cardiovascular Disease? Int J Mol Sci. 2023;24(3):1940. doi:10.3390/ijms24031940
6. Kilic O, Kaya HI, Secme M, et al. The effect of heart failure on gut microbial richness and diversity. Rev Port Cardiol. 2023;42(6):543-551. doi:10.1016/j.repc.2022.06.016
7. Chakaroun RM, Olsson LM, Bäckhed F. The potential of tailoring the gut microbiome to prevent and treat cardiometabolic disease. Nat Rev Cardiol. 2023;20(4):217-235. doi:10.1038/s41569-022-00771-0
8. Contributors WE. What to Know About Resistant Starches. WebMD. Accessed April 11, 2024. https://www.webmd.com/diet/what-to-know-resistant-starches
9. How to add more fiber to your diet. Mayo Clinic. Accessed April 11, 2024. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/fiber/art-20043983