I recently returned from a conference where I heard an amazing presentation. Dr. Stanley Hazen of the Cleveland Clinic presented data that showed a correlation between the consumption of L-carnitine and choline and levels of a substance in the gut that has been correlated with the risk of heart disease and stroke.

Large amounts of L-carnitine are present in red meat. Choline is present in foods such as egg yolks and farm raised fish that are fed choline. What happens is that when these foods are consumed, the bacteria in the gut metabolize them and trimethylamine-N-oxide or TMAO is formed. It is the presence of this compound that has been correlated with cardiovascular risk.

TMAO makes it easier for cholesterol to attach to blood vessels and harder for the liver to discard it. In a study recently reported, Dr. Hazen and colleagues followed 4000 patients over three years. Those with the highest levels of TMAO had 2.5 times the risk of stroke and heart attack compared to those with the lowest levels.

Vegans have the lowest amount of TMAO levels. Those who are red meat eaters have the highest. Foods that reduce TMAO levels include cold pressed extra virgin olive oil, grape seed oil and Guinness stout (believe it or not!). Low dose aspirin also decreases TMAO levels.

Clearly, more research needs to be done. However, this study is another example of the power of the gut and gut bacteria. Having the healthiest gut possible requires eating foods considered to be prebiotics. Prebiotics are foods that contain fiber that arrive to the colon undigested. These include fermented foods such as kefir and sauerkraut, vegetables, legumes, and fruits that include garlic, onions, asparagus, chicory, beans and bananas. They are considered fertilizer for healthy gut bacteria. Probiotics are live bacteria that can be ingested. However, if you eat unhealthy foods, the bacteria will be relatively ineffective.

In this day and age we have so many high tech solutions to problems. For a heart attack, you can be on clot thinners and have a bypass or a stent placement. For strokes, if you get to the hospital in time, it can be reversed. How interesting it is that the ultimate solution to these health problems and their prevention can be found in something basic.

How you choose to eat has the greatest impact on your health.

There are many people with serious illnesses who cannot (at this point) conceive of changing their high fat, processed food diets. For those of you who see the mounting evidence for why a healthy, whole food diet can improve your health, I have to ask, isn’t it worth a try?