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Health and the Human Microbiome

I’m personally a strong believer that the interaction between our diets and our mircobiome affects our health in more ways than we realize. I think we are just starting to scratch the surface of the ways in which our microbiome keeps us well.

Given that, I found a couple of recent medical studies quite interesting.

L-Carnitine Energy Drink IngredientFirst was a fascinating correlation between diet and heart disease.

Presence of trimethylamine N-oxide or TMAO is a strong predictor of arterial placque accumulation in patients. Arterial placque rupture is what causes heart attacks and some strokes. TMAO levels are increased in patients who ingest carnitine – which is abundant in red meat … and energy drinks (where the ingredient is listed as “L-carnitine”).
The part of the study that I found most interesting was that people who didn’t eat a diet high in red meats – vegetarians, for example – did not  produce TMAO when fed a high-carnitine diet. Researchers also found that mice which were given broad spectrum antibiotics to wipe out their intestinal flora did not produce TMAO when fed a high-carnitine diet, either.
In other words, the composition of the intestinal flora within the human gut seems to affect ones ability to produce TMAO. The study didn’t prove causation, but a diet high in red meats and/or energy drinks is correlated with elevated TMAO levels.
The hypothesis that still needs to be studied is whether a high-carnitine diet encourages the growth of flora that converts carnitine to TMAO – or whether it may inhibit growth of some intestinal flora that stop the conversion.
A link to the actual study article is here.
Similar data was published 2 years ago, so it isn’t exactly a novel concept, but I still find it fascinating.

Another study showed the relationship between weight loss and gut flora

Gastric bypass surgery causes weight loss. Initially, it was believed that the bypass itself caused the weight loss. These researchers took gut flora from mice who had undergone a gastric bypass procedure and implanted them into mice that had no surgery. The transfer of bacteria alone caused weight loss and decreased fat mass in the mice who never had the bypass surgery.

Still another diet/health study showed a correlation between intake of fruits and decreases in hot flashes during menopause.

More fruit, vegetables, pasta and red wine – similar to a “Medirerranean-style” diet – was correlated with a decrease in the incidence of hot flashes and night sweats by 20% during menopause.
When I read stories like these, I always start thinking about “causation” instead of correlation. For example, in this case does a Mediterranean-style diet cause growth of bacteria that inhibit hot flashes and night sweats? If so, do other diseases that cause night sweats (say lymphoma or tuberculosis) affect the same bacteria? And if so, could changing the bacterial flora in the gut affect those diseases?

I know. I know. Disengage the clutch, WhiteCoat. You’re thinking too hard.

Then again, I remember when I was a medical student and our highly esteemed professors taught us that most ulcers were caused by “stress” and “Type A personalities” — until Helicobacter pylori was discovered.


  1. I’m just wondering how some Australian doctor will figure out a way to ingest bacteria and loose weight/not have heart attacks, so that once again the Nobel committee can ignore his contributions to medicine, and CABG and gastric bypass will go the way of ulcer surgery and be replaced by bateriological therapies.

    When your only tool is a hammer, etc.

  2. This stuff is RIGHT up my alley! We cultured cases of H. pylori back in the day when it was supposed to be rare…and the OIC was convinced it was a contaminant! I wonder how that discussion would go, now? :) Similarly, we learned much about the normal flora and the effects in relation to “cures”. Had I known more then, I would have been more vocal about cases we saw because these studies fall in line with many observations I made. My newest thing is to find as many correlations between menopause,women who take hormones for several years and the symptoms that appear when they stop taking them. I have a relative who is in some stage of dementia, even though every test has been done to test mental capacity, there is no definitive diagnosis of Alzheimer’s or dementia. I don’t get it, and maybe it’s better that I don’t, because I look at things completely differently. However, there is nothing to lose with trying some of the things I have learned, if I could just get people with medical degrees to listen. I love these articles, WC!

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