What we eat plays an important role in our health and directly affects key health markers linked to our wellbeing including lipid profile, blood sugar, and blood pressure.

More importantly, foods can alter gut microbial biodiversity, which may lead to the production of harmful byproducts. 

Recent studies indicate diets high in red meat, egg yolk, and dairy products lead to increased concentrations of trimethylamine oxide (TMAO) and phenylacetylglutamine (PAGln). These compounds can lead to an increased chance of developing cardiovascular disease due to arterial plaque deposits.

Research conducted by the Cleveland Heart Lab shows an elevated risk of developing cardiovascular disease when levels of TMAO increase in the body. This is caused by consuming foods with high amounts of choline and L-carnitine.

In turn, the gut microbiome then produces high concentrations of TMAO. (1)

In a recent study using a group of 2,225 patients with coronary artery disease, researchers found patients with elevated TMAO levels were four times more likely to experience premature death compared to those containing normal TMAO levels. (1)


"Researchers found patients with elevated TMAO levels were four times more likely to experience premature death compared to those containing normal TMAO levels."


Another gut byproduct biomarker shown to present adverse effects in cardiovascular health is phenylacetylglutamine (PAGln).

In a study conducted by Romano et al., researchers looked at correlating concentrations of PAGln and heart failure. In this study, researchers measured PAGln, left ventricular ejection fraction, and N-terminal pro-B-type natriuretic peptide in 4,085 patients in an attempt to associate high levels of these biomarkers with heart failure. (2)

What they found was elevated levels of PAGIn and phenylacetlyglycine were closely associated with the phenotypes linked to heart failure. (2)

Consequently, the future of medicine may lie in controlling the gut microbiome and the metabolites they produce. In a recent interview, Dr. Hazen (MD, PhD, Chair of the Department of Cardiovascular and Metabolic Sciences at the Cleveland Clinic) said, “The gut microbiome is a new strategy in medicine.” Dr. Hazen continued by saying his team has already developed drugs to block TMAO generation, which are showing benefits to patients with cardiovascular disease in preclinical models.(3)

Additionally, there is currently no compound for the inhibition of PAGIn.(3)

Until that "magic pill" is developed, it is highly advisable to cut back, or even eliminate, animal products from one's diet in order to reduce the concentration of these highly inflammatory substances that are exacerbating atherosclerosis and heart disease.

Due to the biodiversity of each individual’s microbiome, more research is needed to definitively correlate microbiological metabolites to disease. There is a growing amount of data to support the effects of TMAO and PAGln; however, more research is required to find other hazardous metabolites and their interactions.

Research into human health and the microbiome is a promising start to a future of personalized medicine that may be able to eliminate diseases by balancing gut dysbiosis.

By Miles Amby - R&D Microbiologist at Hardy Diagnostics

Works Cited: 1, 2, 3

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