The association between heart failure, cardiovascular disease, and fibrosis with a metabolic marker TMAO is key to preventing and reversing these chronic conditions. TMAO contributes to CVD development by inducing platelet aggregation, foam cell formation and promoting inflammatory responses by activating the NLRP3 inflammasome. Therefore, the close monitoring of this marker and posterior dietary approaches to reduce TMAO are needed to improve our patientβs health.
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Nowadays, the measurement of TMAO in combination with the NT-proBNP marker can provide enhanced prediction efficiency of death/HF within one year. Furthermore, the current information and limited information do not validate the use of TMAO on acute heart failure, and more information is needed to understand the clinical applications.
On the other hand, studies of TMAO in CHF have more valid information, and its association has in-depth studies. TMAO levels can rise 3.4-fold higher in HF patients when compared to individuals without this condition. This information also suggests that TMAO can predict an increased risk of 5-year mortality, even after adjusting for traditional risk factors.
The answer is always to treat the gut. There is growing evidence showing the relation among gut dysbiosis, high levels of circulating TMAO, and the presence of HF, suggesting a clear gut- TMAO- HF axis.
Our dietary patterns relate closely to our circulating TMAO levels, and nutritional diet therapy has always played a key role in CVD prevention. Besides this, our intestinal microbiotaβs composition goes through numerous changes in our life cycle, and dietary interventions can modify its bacterial constituents. Therefore, our western diet, constituted by high animal protein food, saturated fats, and high sugar, provides all the precursors of TMAO and contributes to dysbiosis.Β
On the contrary, the Mediterranean diet provides a wide array of fresh fruits and vegetables, whole grains, nuts, and a limited quantity of alcohol, eggs, and meat contributes to an optimal gutβs colonization. The Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean diet have a strong association with reducing HF prevalence and preventing secondary cardiac events. Plant-based diets can reduce the risk of developing cardiovascular disease; their components: nuts, vegetables, and whole grains, provide a higher fiber content that promotes a healthy microbiome.
The adverse effects of TMAO on cardiac insufficiency and HF remodeling show that a diet with low choline content (reduced meat and fat) combined with high fiber alleviates ventricular remodeling and improves cardiac function. Finally, these studies conclude that tight monitoring of TMAO levels, reducing meat ingestion, and augmenting the dietary fiber intake can prevent and treat HF by modifying the gut microbiota.
The supplementation of probiotics, prebiotics, and fiber is no surprise when treating the gut. Nevertheless, recent studies provide us with specific information on how to improve TMAO levels in patients suffering from cardiac conditions with bacterial strains and phytochemicals.
TMAOβs role in metabolic conditions is a growing topic, raising questions and producing new answers all the time. The close monitoring of this marker correlates to the gut, metabolic and cardiovascular health. Furthermore, elevated TMAO levels associate with inflammation, which in turn contributes to chronic complications. Therefore, TMAO ensures a new and promising way to prevent heart failure while treating the gut.
In the role of prevention, we need all the help that we can get. Indeed, as technology progresses, new findings allow us to find new inflammatory contributors, which clinicians can monitor closely. The production of TMAO and its harmful effects are associated with the dietary intake of meats, eggs, fish, and dairy. However, this means that we can shift our intake and improve this metabolic marker.- Ana Paola RodrΓguez Arciniega, MS
References:
Zhang, Yixin et al. βTMAO: how gut microbiota contributes to heart failure.βΒ Translational research: the journal of laboratory and clinical medicineΒ vol. 228 (2021): 109-125. doi:10.1016/j.trsl.2020.08.007
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Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, CTG*
email:Β coach@elpasofunctionalmedicine.com
phone: 915-850-0900
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Professional Scope of Practice *
The information herein on "Dietary Approaches to Reduce TMAO" is not intended to replace a one-on-one relationship with a qualified health care professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional.
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Our information scope is limited to Chiropractic, musculoskeletal, acupuncture, physical medicines, wellness, contributing etiological viscerosomatic disturbances within clinical presentations, associated somatovisceral reflex clinical dynamics, subluxation complexes, sensitive health issues, and/or functional medicine articles, topics, and discussions.
We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system.
Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.*
Our office has reasonably attempted to provide supportive citations and has identified the relevant research studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.
We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez, DC, or contact us at 915-850-0900.
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Dr. Alex Jimenez DC, MSACP, RN*, CCST, IFMCP*, CIFM*, ATN*
email: coach@elpasofunctionalmedicine.com
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Dr. Alex Jimenez DC, MSACP, RN* CIFM*, IFMCP*, ATN*, CCST
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