Despite the fact that I’m an integrative cardiologist, I often look first at a patient’s gut to shed light on the underlying cause of heart disease. What could the gut possibly have to do with the heart? It’s all about inflammation.
If aliens were to take a human body and analyze it cell by cell, they’d come to the conclusion that we’re mostly a mass of bacteria with just a few human cells mixed in. Each of us has more than 100 trillion bacteria inside of us — 10 times the number of human cells!
This mix of bacteria is called our “microbiome,” which begins to develop at birth and is affected by many surprising factors, including whether a birth is vaginal or via C-section, and when we first eat solid food as infants. And as adults, our lifestyle choices — what we eat, whether we’re obese, how much we exercise, how much stress we’re under, if we smoke or overuse antibiotics and other medications — also significantly affect the quality and diversity of our microbiome, for good and for bad.
This is important because in recent years we’ve become more and more aware that an imbalance of the bacteria in our microbiome, especially in the gut, can cause chronic low-level inflammation — and, more important, that this inflammation may be the cause of diseases, such as dementia, diabetes, cancer, and, yes, heart disease.
The most important part of our gut is its inner lining, a layer of cells called the epithelium, which keeps all the outside substances we ingest into our stomachs — then process through our intestines — from leaking out into the rest of the body. And because the epithelial cells feed on short-chain fatty acids that are produced by the gut bacteria around it, how healthy and diverse the microbiome is directly affects how healthy the epithelium is.
This means that any unhealthy changes in the microbiome can cause a breakdown of this protective layer — which in turn causes the gut to “leak.” It’s this “leaky gut” that causes inflammation both there in the gut and in other parts of the body. And because the surface area of the epithelium is huge — larger than a tennis court if laid out flat — this is a lot of inflammation that can travel to vital organs like the heart and arteries, causing serious illnesses like heart attacks, strokes, and even death.
Fortunately, in many instances, simple lifestyle changes can have dramatic beneficial effects on the bacteria inside us. Here, the best ways to foster a healthy gut:
Eat a fiber-rich, nutrient-dense diet that’s heavy in organic vegetables
A diet high in refined sugar and low in fiber encourages the overgrowth of “unfriendly” bacteria and other microorganisms (like candida), which then leads to a leaky gut and uncontrolled inflammation. Opt instead for a mostly organic, plant-based diet full of the colorful phytonutrients and fiber that help our microbial friends thrive.
Eat foods teeming with prebiotics (like garlic) and probiotics (like yogurt)
Some foods called “prebiotics,” particularly garlic and onions, contain inulin, a fiber that feeds our good bacteria. Certain other foods — yogurt, sauerkraut, kimchi— and supplements known as “probiotics” are already full of good bacteria, and help maintain a healthy microbiome.
Take it easy with the red meat
There’s a known connection between excessive consumption of red meat and heart disease. We’ve always assumed this was due to red meat’s high concentration of saturated fats; however, studies now show that it may not be the fat but the other chemicals in meat that are to blame.
The Cleveland Clinic’s Stanley Hazen, M.D., Ph.D., published a paper in Nature Medicine describing his findings that red meat contains certain chemicals, such as choline and carnitine, that are metabolized by gut bacteria to produce trimethylamine-N-oxide, or TMAO; and that TMAO may go on to cause atherosclerosis, the fatty buildup in heart and brain arteries that can lead to heart attacks, strokes, and even death.
And heads up, meat eaters: Hazen also found that vegans didn’t even have the particular bacteria that made TMAO.
Exercise to get your gut going
Working out releases beneficial chemicals, such as nitric oxide, that help your arteries expand, which reduces inflammation. In a study published in the journal Gut, Irish athletes were found to have a much better microbiome (that is, less inflammation and much more diverse gut bacteria) than non-athlete control subjects.
Keep your weight down
When you’re living a healthful lifestyle, eating a nutrient-rich, mostly plant-based diet, moving on a regular basis, meditating, and, most important, connecting with family and friends, weight usually stabilizes in the correct range for you.
Stop Smoking (seriously)
Smoking is the most preventable cause of death in the United States — on average, smokers die 14 years earlier than non- smokers. There are 4,000 chemicals in cigarettes, which can result in serious diseases such as heart attacks and strokes, and are a common cause of erectile dysfunction and old-looking skin. The good news is that millions of people succeed in their efforts to quit smoking every year — and you can, too.
Use Antibiotics Judiciously
When used appropriately, antibiotics are life-saving. However, inappropriate use of antibiotics, both in humans and in animals, can lead to a disruption of our microbiome.
We’re beginning to learn from a number of leading researchers, including Martin Blaser, M.D., director of NYU’s Human Microbiome Program and author of Missing Microbes: How the Overuse of Antibiotics is Fueling Our Modern Plagues, that our overreliance on antibiotics can negatively affect our friendly bacteria and may lead to diseases like asthma, food allergies, diabetes, and obesity.
Consider getting a stool test
Stool testing may reveal if a patient has the wrong bacterial mix and is at risk for heart disease, allowing us to intervene with such measures as individualized probiotics and/or nutritional interventions (like yogurts or fermented foods) that will optimize gut microflora and reduce the risk of vascular disease, heart attacks, strokes, and death.
Clear your head
Though it’s not specifically bacteria-related, forgiveness, gratitude, and love — powerful, stress-relieving emotions — can, believe it or not, help reduce the inflammation that leads to serious health problems. So relax, meditate — do anything you can to calm your inner mind.
Finally, there’s even evidence that a healthy microbiome actually signals our brain to eat healthy foods that are good for us (and for them), while a dysfunctional microbiome signals it to crave unhealthy foods, such as excessive carbohydrates and sugars — a fascinating possibility that could be a factor in the obesity epidemic that’s sweeping across Western countries.
We may be on the verge of discovering the optimal mix of gut bacteria, and that could help prevent heart disease and other illnesses.
It’s a beautiful thing when we can use garlic and yogurt to save lives.