Heart and Gut Health: A Dual Relationship

February 19, 2018 | Linda J. Dobberstein, Chiropractor, Board Certified in Clinical Nutrition

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Heart and Gut Health: A Dual Relationship
In the last few years, research has exploded on the wide-reaching influences of the gut flora. We see this in the case with heart disease and gut dysbiosis, the overgrowth of bad germs in the gut. Findings show a disruption in gut flora and the development of dysbiosis has an impact on high blood pressure, heart attacks, stroke and even congestive heart failure. While there are numerous causes of these disorders, gut flora plays an integral role in heart health and must not be overlooked.

One study on gut flora and heart health, was aptly entitled, “The way to a man’s heart is through his gut microbiota”. In this article, evidence showed that certain probiotic strains helped gallbladder bile acids lower cholesterol levels. This functionality occurred as a result of consuming fermentable fibers that are natural prebiotics and plant polyphenols which regulate microbial function in the gut. The conclusion of the article was “the way to a healthy heart may be through a healthy gut microbiota”.

Gut flora impacts many different things related with cardiovascular risks. Germ overgrowth and imbalanced gut bacteria negatively impacts blood sugar, diabetes, obesity which in turn profoundly influences heart health. Bacteria in the mouth and periodontal disease are directly linked with heart disease and gut microbiome health.

Certainly, the “western diet” rich in saturated fats, simple sugars, high calories, low nutrient intake is associated with a group of gut bacteria known as the Firmicutes. Firmicutes are a class of gut bacteria strongly linked with metabolic syndrome, obesity and heart disease, but the findings go even deeper. The journal Gut Microbes provides some amazing findings on how healthy flora profoundly influences heart disease:

• Heart: Beneficial gut flora provides direct protection against heart muscle injury associated with ischemia or heart attack. Healthy gut flora helps the heart recover after heart attack.

• Gut-Brain Axis: Beneficial bacteria help reduce elevated leptin levels after a heart attack.

• Oral Cavity/Periodontal Disease: Beneficial flora help reduce germ overgrowth in the mouth that are linked with cardiovascular disease. Healthy flora helps promote healthy nitric oxide levels that help blood vessels maintain healthy function. (Nitric oxide modulation is essential for blood pressure regulation.)

• Adipose Tissue: Beneficial bacteria help reduce fat cell size. Good flora helps leptin and adipokine levels in the blood stream after heart attacks.

• Liver: Healthy flora help the liver manage LDL cholesterol and bile salts.

• Gut: Health flora helps protect against and reduce gut inflammation linked with obesity. Beneficial bacteria help lower blood pressure by how blood pressure hormones are processed in the gut. It also helps lower cholesterol levels in the gut.

When was the last time or if ever has your cardiologist ever mentioned anything at all about any of these factors and hypertension, obesity, heart attack risk or recovery?

Hypertension and Gut Flora

Research continues to prove that alterations in gut bacteria contribute to the pathology of hypertension or elevated blood pressure. Human studies published in 2017 show that prehypertension and hypertension are closely linked to gut microbiome imbalances. Just a few months ago, new blood pressure guidelines were released calling for tighter blood pressure management and the push for multiple medications. There was no mention in these new guidelines of the interaction of gut flora on heart health. At least twenty percent or more of the population worldwide is affected by essential hypertension and imbalanced gut bacteria. I suspect that time will show that percentage to be considerably higher. An antihypertensive medication will not address gut flora and high blood connection at all.

Gut bacteria effect on hypertension impacts the autonomic nervous system, blood vessels linings, and inflammation. Dysbiosis or imbalanced gut flora and their metabolites are thought to increase the sympathetic nervous system activity (fight/flight) and leads to vasoconstriction. Inflammation levels increase as a result of dysbiosis and then progresses to damage the inner endothelial lining of blood vessels. Gut flora essentially regulates blood vessel function by a vast array of chemical signals. If gut flora is healthy, blood pressure is not adversely impacted.

Atherosclerosis, Heart Failure, and Leaky Gut Syndrome

Atherosclerosis and heart failure may develop if the dysregulation persists from the altered gut flora. Toxic waste products from the imbalanced gut flora lead to congestion within the blood vessels found in the gut, and then swelling in the gut wall. The progression leads to increased permeability of the gut wall, called Leaky Gut Syndrome. The end result is more inflammation and toxic burden within the entire circulatory system further driving atherosclerosis and heart failure

Butyrate which is protective fatty acid within the colon is changed with imbalanced gut bacteria Butyrate is made in the colon by healthy gut bacteria and fiber. It is essential to shutting down inflammation in the gut and maintaining the intestinal barrier. Butyrate also helps quench IL-6 and modulates nitric oxide. Loss of butyrate from the gut bacteria is thought to substantially worsen chronic inflammation in chronic heart failure

Stroke and transient ischemic attack (TIAs) studies also showed significant dysbiosis of the gut flora. Stroke and TIA patients were found to have more germ overgrowth in the gut and few beneficial bacteria present. It was identified that the worse the gut dysbiosis was, stroke and TIAs problems were markedly worse.

Statins Change Gut Flora

In this upheaval with new information on heart health and gut flora, there is another stone to look under – statin cholesterol lowering medications. A groundbreaking study published August 2017 in the journal Microbiome states, “scientists describe for the first time profound changes in the microbial composition of the gut following statin treatment”. Results of this animal study showed negative changes to the diversity and metabolic profile of the gut flora and decreased production of the short chain fatty acid butyrate.

Statins negatively changed bile acids function and physiology in the gut. Higher fasting blood levels and an increase in body weight occurred. Liver metabolism genes were also adversely affected. We already know that statin drugs are linked with worsening of atherosclerosis, development of congestive heart failure, and even stroke for other reasons. This new information raises even more doubt about the efficacy of statin drug treatment.

Expect a research and Big Pharma battle to occur on statins and gut flora, as other studies applaud the use of statins as they reduce the abundance of Firmicutes – the bad family of bacteria related with obesity and metabolic syndrome. Studies do agree that gut flora is significantly changed by statins. We don’t have a deficiency of statin drugs in the body, but we can have a deficiency of healthy microflora. Who is the winner?

Findings like this raise so many more questions and especially for the individuals who have been treated with antibiotics and then weeks or months later experience a worsening of their heart health. Numerous variables exist from person to person with gut flora and cardiac disorders, but no matter how it is looked at, this new era of research shows that gut health is heavily involved with heart health. It affects nutrient production and absorption which was not mentioned in the article. It is directly linked with obesity, diabetes, liver function, and inflammation. We now see that gut dysbiosis sets off a change of signals that provoke neurovascular inflammation and leaky gut syndrome with the development and worsening of several cardiovascular diseases.

Heart and Gut Healthy Solutions

We must focus on several things to help the dual gut and heart relationship. At the crux of this is to help reduce gut and vascular inflammation and leaky gut syndrome. Probiotic and prebiotic rich foods help the gut heal as described in the article, Leaky Gut Syndrome: More Than Just a Gut Problem. I recommend supplementation with probiotics or beneficial bacteria like Lactobacillus and Bifidus and prebiotics like arabinogalactan and FOS essential to anyone with any known or suspected gut problems and a coexisting heart concern. Animal studies show good improvement of blood pressure, heart function, and heart rate variability and reduction in systemic inflammation with intake of prebiotics and probiotics

High fiber diets and fiber supplementation are also at the crux of healthy gut and heart function. High fiber consumption increases the good bacteria group Bacteroidetes while reducing Firmicutes. Remember that the Firmicutes group is associated with obesity, insulin resistance, and heart disease. High fiber intake helps reduce systolic and diastolic blood pressure, heart stiffness, and left ventricular enlargement.

The western diet fiber intake often is a paltry 8 to 10 grams per day. Recommended fiber intake is at least 25 grams to 50 grams per day. Our Fiber Helper contains oat bran fiber which qualifies for an FDA claim for its ability to reduce heart disease risk.* Fiber helps to bind onto cholesterol in the gut, but fiber like arabinogalactan is essential for gut bacteria to thrive and to help the production of the short chain fatty acid, butyrate

Reseveratrol is often used for heart health support because of its antioxidant and ability to quench inflammation and reduce C-reactive protein. Interestingly, resveratrol also helps gut bacteria, likely acting as a prebiotic. Resveratrol helps keep other inflammatory markers like TMAO (trimethylamine-N-oxide) levels healthy which may elevate in response to diets rich in red meats, dairy, and eggs. Increased TMAO levels are thought to lead to atherosclerosis, platelet aggregation, blood clots, and heart failure. Resveratrol helps increase levels of beneficial bacteria Lactobacillus and Bifidobacterium and supports bile salt activity.

The use of fish oils, EPA and DHA, tocotrienols, coenzyme Q10, magnesium, vitamin D, and other nutrients are still needed to protect and support the heart and circulatory health. Many of them also help support inflammation management in the gut. They can be used with prebiotics, probiotics and dietary fibers.

There is no doubt in my mind that healthy gut flora is the stepping stone for good health in general and is a fundamental pillar to health. Anyone with cardiovascular concerns should also consider the addition of prebiotics and probiotics to a healthy diet and nutritional regime. Management of germ overgrowth or dysbiosis in the gut needs to occur simultaneously. Noni, oregano oil, and caprylic acid help the gut naturally.

The information discussed here has focused on gut health and heart disease in adults. It is more than that though. Much of our youth today have had multiple rounds of antibiotics, were born via C-section and/or were not breastfed, fail to have probiotics and fiber in a healthy diet. They are being set up for the development of heart disease at a much earlier stage in life. Indeed, we already see heart disease in children. Information like this helps propel one towards different dietary choices. No matter what approach is taken and what cardiac diagnosis is present, gut flora must be healthy and balanced. Do you have a healthy gut?

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