The gut microbiome influences cardiometabolic health. One large-scale study (n=893) provides evidence that certain families of gastrointestinal bacteria can either positively or negatively affect cardiovascular health.1 Different compositions in the gut microbiome were correlated to both BMI and lipid levels, independent of genetics, age, and gender.1 Lower levels of bacterial families Christensenellaceae and Rikenellaceae, class Mollicutes, genus Dehalobacterium, and kingdom Archaea correlated with high BMI.1 The researchers estimated that 4.5-6% of BMI, triglycerides, and HDL variations could be explained by these variations in the microbiome, independent of other risk factors.1
Although not conclusive, animal studies with fecal transfers allow us to better investigate the nature of causation between the microbiome and various diseases. One such analysis transplanted fecal microbiota from human donors to germ-free mice.2 The healthy human controls had a much richer and more diverse microbiome than the individuals with pre-hypertension and hypertension, who had overgrowth of bacteria such as Prevotella and reduced populations of bacteria correlated with improved health.2 After fecal transplantation, the germ-free mice soon exhibited elevated blood pressure.2
One mechanism by which the microbiome affects the rest of the body is through generation of metabolites that alter host physiology.3,4 After 16S rRNA gene sequencing in 531 Finnish men, gut microbiota correlated with fasting serum levels in fatty acids, amino acids, lipids, and glucose.5 Of note is the connection with a metabolite associated with coronary artery disease and stroke.5 Other interactions can occur through the trimethylamine/trimethylamine N-oxide pathway, the short-chain fatty acids pathway, and bile acids pathways.3 The microbiome affects metabolism, and may contribute to insulin resistance.5,6
In individuals with metabolic syndrome, arterial stiffness predicts cardiovascular risk.7 Further, in a study of 617 women, analysis of the microbiome accounted for 8.3% of the variation in arterial stiffness, while visceral adiposity and insulin resistance only accounted for 1.8%. Butyrate-producing Ruminococcaceae bacteria were negatively correlated with arterial stiffness.7
This research is exciting in part because the microbiome changes in response to diet.8,9 Nutrition is an important part of the microbiome-cardiometabolic equation.10 Treating the gut using diet, probiotics, prebiotics, and other therapies may reduce risks for many cardiometabolic patients. IFM’s Cardiometabolic Food Plan, which is taught at the Cardiometabolic Advanced Practice Module (APM), provides an easily personalized patient education resource to improve nutrition and cardiac health, in part by effects on the microbiome.
- Find out more about the Cardiometabolic Food Plan
- See how one clinician, Shilpa P. Saxena, MD, approaches cardiometabolic conditions
- Fu J, Bonder MJ, Cenit MC, et al. The gut microbiome contributes to a substantial proportion of the variation in blood lipids. Circ Res. 2015;117(9):817-824. doi:1161/CIRCRESAHA.115.306807.
- Li J, Zhao F, Wang Y, et al. Gut microbiota dysbiosis contributes to the development of hypertension. Microbiome. 2017;5(1):14. doi:1186/s40168-016-0222-x.
- Tang WH, Kitai T, Hazen SL. Gut microbiota in cardiovascular health and disease. Circ Res. 2017;120(7):1183-1196. doi:1161/CIRCRESAHA.117.309715.
- Tang WH, Hazen SL. The gut microbiome and its role in cardiovascular diseases. Circulation. 2017;135(11):1008-1010. doi:1161/CIRCULATIONAHA.116.024251.
- Org E, Blum Y, Kasela S, et al. Relationships between gut microbiota, plasma metabolites, and metabolic syndrome traits in the METSIM cohort. Genome Biol. 2017;18(1):70. doi:1186/s13059-017-1194-2.
- Pedersen HK, Gudmundsdottir V, Nielsen HB, et al. Human gut microbes impact host serum metabolome and insulin sensitivity. 2016;535(7612):376-381. doi:10.1038/nature18646.
- Menni C, Lin C, Cecelja M, et al. Gut microbial diversity is associated with lower arterial stiffness in women. Eur Heart J. 2018;39(25):2390-2397. doi:1093/eurheartj/ehy226.
- Wu GD, Chen J, Hoffmann C, et al. Linking long-term dietary patterns with gut microbial enterotypes. Science. 2011;334(6052):105-108. doi:1126/science.1208344.
- David LA, Maurice CF, Carmody RN, et al. Diet rapidly and reproducibly alters the human gut microbiome. Nature. 2014;505(7484):559-563. doi:1038/nature12820.
- Bennett BJ, Hall KD, Hu FB, McCartney AL, Roberto C. Nutrition and the science of disease prevention: a systems approach to support metabolic health. Ann N Y Acad Sci. 2015;1352:1-12. doi:1111/nyas.12945.
Assessing cardiometabolic risks has evolved over time. Simultaneously, primary care is still the proposed central hub for evaluating cardiometabolic risks and intervening.1-3 In the video below, Shilpa P. Saxena, MD, IFMCP, an IFM educator, explains the shift in her thinking for addressing cardiometabolic risk in her patients since medical school.Read More
Assessing cardiometabolic risks has evolved over time. Simultaneously, primary care is still the proposed central hub for evaluating cardiometabolic risks and intervening.1-3 In a video, Shilpa P. Saxena, MD, IFMCP, an IFM educator, explains the shift in her thinking for addressing cardiometabolic risk in her patients since medical school.Read More