“The way to a mans heart is through his gut microbiota” – the intestinal microbiome as a novel modifiable risk factor in cardiovascular risk”

Recent studies in animal models and in humans are linking the microorganisms which inhabit the human gastrointestinal tract with chronic diet associated diseases including cardiovascular disease (CVD). Aberrant microbiota profiles have been observed in the obese, patients with type 1 and type 2 diabetes, and fatty liver disease. Although, at least in the case of obesity, disease phenotype may be transferred upon microbiota transplant into germ-free animals, and human fecal transplant appears in the short term to reverse the metabolic syndrome, the question remains whether an aberrant gut microbiome plays a causative pathological role or occurs as a result of other disease associated characteristics such as diet or life-style. We do know however, that diet plays an important role in shaping the gut microbiome and its disease activity. Microbial metabolism of choline, phosphatidylcholine and L-carnitine results in the production of the proatherogenic metabolite trimethylamine-N-oxide. Similarly, increased gut permeability, often associated with obesity or periodontitis, leads to increased translocation of inflammatory molecules such as bacterial lipopolysaccharide from the alimentary canal, a process considered to trigger the chronic low grade systemic inflammation characteristic of type 2 diabetes, obesity and CVD. However, dietary modulation of the gut microbiota does open up the intriguing possibility of modulating CVD disease risk through food choice targeting the gut microbiome. This presentation will give an overview of current understanding of how the gut microbiota is linked to CVD and how through microbiome modulation with probiotic, prebiotic and whole grain cereal foods, CVD disease risk may be reduced