As I discuss in my video How to treat heart failure and kidney failure with diet, one option a diet that is high in animal foods such as meat, eggs, and cheese contribute Heart disease, stroke, and death are caused by the manufacture of an atherosclerosis-inducing substance called TMAO. With the help of certain intestinal bacteria, the concentrated choline and carnitine in animal products can be converted into TMAO. But wait a second. I thought arteriosclerosis, or hardening of the arteries, was about the build-up of cholesterol. Is not that the case?
“Cholesterol is still king ”, seems TMAO accelerate the process. It seems that TMAO appears increase the ability of inflammatory cells within the atherosclerotic plaque in the artery walls to attach to bad LDL cholesterol, “making the cells more prone to engulf cholesterol”. So TMAO is just “one more piece of the puzzle of how cholesterol causes heart disease”.
In addition, TMAO appears not only to aggravate arteriosclerosis, but also to contribute to strokes and heart attacks. It also contributes to it to heart and kidney failure. If you look at diabetics who have had a heart attack, a really high risk group, almost everyone who started with the most TMAO in their bloodstream developed heart failure within 2,000 days, or about five years. By comparison, only about 20 percent of those who started with moderate levels of TMAO in their blood got heart failure and none at all in the low TMAO group, as you can see at 1:21 Video.
So people with heart failure have higher TMAO levels than controls, and people with worse heart failure have higher levels than people with lower-stage heart disease. If you consequences In people with heart failure over time, within six years, half of those who started with the highest TMAO scores were dead. That finding has been since then replicated in two other independent populations of patients with heart failure.
The question is why? It’s probably just unlikely His additional atherosclerosis as this lasts for years. For most who die of heart failure, their heart muscle simply tightens or there is a fatal heart rhythm. Perhaps TMAO has toxic effects that go beyond accelerating cholesterol build-up.
What about kidney failure? People with chronic kidney disease are with a particularly “increased risk of developing cardiovascular disease”, which is presumably due to a large number of uremic toxins. These are toxins that are normally filtered out into urine by the kidneys, but can build up in the bloodstream when kidney function declines. When we think of uremic toxins, we usually think of the toxic by-products of protein Putrefaction in our intestines, which is why specially formulated herbal diets have been used for decades to treat chronic kidney failure. Indeed those who eat a vegetarian diet form less than half of these uremic toxins.
However, these are not the only uremic toxins. TMAO, which, as we discussed earlier, comes from the breakdown of choline and carnitine, which is primarily found in meat and eggs, may be increasingly Heart disease risk also in kidney patients. As? “The cardiovascular implication of TMAO appears to be due to the downregulation of reverse cholesterol transport,” meaning that this undermines our own body’s attempts to pull cholesterol out of our arteries.
And the worse our kidneys function, the higher our TMAO levels rise, and those elevated levels correlate with the amount of plaque clogging their arteries in their heart. As soon as the kidney is working again with a transplant, your TMAO levels can go down again immediately. Hence, TMAO was thought to be some sort of biomarker of declining kidney function – until an article from the Framingham Heart Study was published which found that “choline and TMAO levels are elevated in people with normal kidney function [kidney] Function predicts increased risk of developing “CKD”, chronic kidney disease. This suggests that TMAO is both a biomarker and a kidney toxin in itself.
In fact, if you follow kidney patients over time and judge their freedom from death, those with higher TMAO who even control kidney function, lived significantly shorter lives as you can see in mine at 4:44 Video. This shows This is a diet-related mechanism for progressive kidney scarring and dysfunction, “which strongly implies the need to focus prevention efforts on diet modulation” but what might that look like? Well, maybe we should “reduce food sources from TMAO production, such as some types of deep-sea fish, eggs and meat”.
It also depends on what type of gut bacteria you have. You can feed a vegan a steak and they still won’t do TMAO because they didn’t encourage the carnitine-eating bacteria. However, the researchers hope that one day they will find a way replicate “The effects of the vegetarian diet … through selective prebiotic, probiotic, or pharmacological therapies.”
For more information on this revolutionary TMAO story, please visit:
For more information on kidney failure, see Prevention of kidney failure through diet and Treatment of kidney failure through diet.
Michael Greger, MD
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