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CARDIOVASCULAR DISEASE
A common dietary component that some people even take as a supplement is converted by the gut microbiota to harmful metabolites linked to heart disease. This finding has cautionary implications.
Everyone knows that a 'bad diet' can lead to heart disease. But which dietary components are the most harmful? Some lay the blame on saturated fatty acids, others point a finger at excess carbohydrates, which also lead to obesity and insulin resistance. On page 57 of this issue, Wang et al.1 outline a remarkable chain of events that links diet, intestinal bacteria and liver metabolism to the generation of a chemical that promotes the build-up of arterial plaque and cardiovascular disease.
Intestinal bacteria currently hold centre stage for their role in maintaining digestive health2. Although the main focus has been on detailed molecular characterization of the gut microbiome3, there is increasing interest in the impact of these seemingly innocuous gut microorganisms on metabolic disease in humans. Indeed, recent evidence4,5 has implicated gut microbiota in insulin resistance and non-alcoholic fatty-liver disease.
A burgeoning area of research is metabolomics - an unbiased approach to identifying and measuring the small-molecule metabolites in a system - and determining the relationship of the metabolome to disease. Nonetheless, the scope of the blood metabolome that arises from the gut microbiome has not been fully defined; this knowledge could lead to insights connecting diet, the gut microbiota and disease.
Wang et al.1 tell a compelling story - which starts with a metabolomics approach - of their search for circulating small molecules associated with coronary heart disease. They screened blood from patients who had experienced a heart attack or stroke and compared the results with those from blood of people who had not.
The authors found major differences in choline, betaine and trimethylamine N-oxide (TMAO) - three metabolites of the...