If the microbiome of those who eat a plant-based diet protects against the toxic effects of TMAO, what about altering the gut flora?
“Approximately 2,500 years ago, Hippocrates said ‘All disease begins in the gut.'” When we feed our gut bacteria with plant foods, they also provide us with beneficial nutrients like butyrate, which our gut bugs make from fiber. On the other hand, if we eat them incorrectly, they can produce harmful compounds like TMAO, which they do in cheese, eggs, seafood, and other meats.
We used to think that TMAO contributed only to cardiovascular diseases, such as heart disease and stroke, but, recently, it has been linked to psoriatic arthritis, associated with polycystic ovary syndrome, and everything in between. I’m more worried about our best killers, though. Among the top ten causes of death in the United States, we have known about its association with an increased risk of heart disease and stroke, killers number one and five, but recently, an association was also found between blood levels of TMAO and the risks of various cancers, which is our number two killer. The link between TMAO and cancer can be attributed to inflammation caused by TMAO, but it can also be oxidative stress (free radicals), DNA damage, or protein folding disorders.
What about our fourth leading killer, chronic obstructive pulmonary disease (COPD), such as emphysema? TMAO is associated with early death in patients with advanced COPD, although it is suspected that it is due to cardiovascular disease.
The stroke link is absurd—no pun intended. It is caused by high blood pressure associated with high levels of TMAO, and a greater chance of clots forming in those with atrial fibrillation. Those with higher TMAO levels also appear to have worse strokes and are four times more likely to die.
The number six killer is Alzheimer’s disease. Can TMAO even get into our brains? Yes, TMAO is present in human cerebrospinal fluid, which bathes the brain, and TMAO levels are high in those with cognitive impairment and those with Alzheimer’s disease dementia. “In the brain, TMAO has been shown to induce neuronal sensitization [meaning, deterioration with age]increase oxidative stress, impair mitochondrial function, and inhibit mTOR signaling, all of which contribute to brain aging and cognitive impairment.
The number seven killer is diabetes, and people with high TMAO levels are about 50% more likely to develop diabetes. The number eight killer is pneumonia, and TMAO predicts fatal outcomes in patients with pneumonia even without overt heart disease. Kidney disease is the ninth killer, and TMAO is closely related to kidney function and predicts fatal outcomes there as well. Within five years, more than half of chronic kidney disease patients who started with normal or high TMAO levels had died, while among those in the lowest third of levels, nearly 90% remained alive.
How can we lower TMAO levels in our blood? Because TMAO comes from food sources, we can limit our intake of choline- and carnitine-rich foods. They are widespread in food,” although we are talking about meat, eggs, and milk.” Therefore, restriction of foods rich in TMA-containing nutrients may not be effective. Can we just get a vegan fecal transplant? “Vegan donors gave investigators a stool sample this morning…”
If you remember, if you give a vegan a steak, despite all that carnitine, it doesn’t make nearly as much TMAO as a meat-eater, probably because the vegan didn’t encourage the steak-eating bugs in their intestines. Look below and at 3:40 in my video Can Vegan Fecal Transplants Include Lower TMAO Levels?.
Remarkably, even if you give vegetarians the equivalent of a 20-ounce steak every day for two months, only about half begin to increase TMAO production, which shows how far their guts have to change. The ability of vegetable feces to remove TMAO is almost non-existent. Instead of eating healthy, how about getting vegan poop?
In a double-blind, randomized, controlled trial, study subjects received either vegan feces or their own feces fed through a tube down their nose, and it didn’t work.
First of all, the vegans recruited for the study started taking TMAO on their own, unlike other studies, where they did nothing at all. This may be because the previous study required vegans to be vegan for at least a year, and this study did not. So, there wasn’t much change in the TMAO running through their bodies two weeks after they got the vegan poop, but the vegan poop they got seemed to start with a certain amount of TMAO production in the first place.
Therefore, the failure to improve after a vegan fecal transplant “may be related to the limited diversity of the microbiome base and the continuation of an omnivorous diet” after a vegan-donor transplant. What’s the point of trying to reset your microbiome if you’re going to eat meat? Well, the researchers didn’t want to switch people to a plant-based diet because they knew that alone would change our microbiome, and they didn’t want to introduce other factors. The bottom line is that there seem to be no shortcuts. We may need to eat healthy food.
Doctor’s Note
Do you want to become a donor? Find out How to Become a Fecal Transplant Super Donor.
For more on TMAO, see the related post below.
See the microbiome topic page for more.
