Cleveland Clinic researchers in recent years discovered the key to heart disease may be churning in our guts, or at least in a chemical process unfolding there.
Now those same researchers say they may have figured out a way to turn that key, unlocking new hope for preventing heart disease, the No. 1 killer in the U.S., and other chronic diseases which also may be linked to the gut.
Researchers in the lab brewed up a chemical hero that may make all this possible, but they later found a similar chemical that does the same job already exists naturally — in some cold-pressed extra-virgin olive and grape seed oils.
Dr. Stanley Hazen and researcher Zeneng Wang on Thursday reported their team’s findings in the research journal Cell. It’s the latest chapter in the team’s ongoing quest to unravel the mysteries of trillions of bacteria that live in our intestines, how those microbes impact our health and what science can do to manipulate them to fight disease.
“Many chronic diseases like atherosclerosis (hardening of the arteries), obesity and diabetes are linked to gut microbes,” Hazen said. “These studies demonstrate the exciting possibility that we can prevent or retard the progression of diet-induced heart diseases starting in the gut.”
The most recent discovery builds on the research team’s initial 2011 revelation that a biomarker called TMAO could predict heart disease independent of cholesterol levels and other risk factors. TMAO can also ferret out the disease in those whose heart disease might otherwise go undetected.
TMAO is produced during the digestion of choline, lecithin and carnitine, nutrients that are abundant in animal products, including red meat, egg yolks and high-fat dairy products.
People with chronic high levels of TMAO have double the risk of heart attack, stroke and death.
During an interview this week, Hazen said his team started searching for an inhibitor, a substance that could prevent TMAO from forming and, thus, perhaps stop heart disease.
In the beginning, they engineered a compound in a lab that worked to reduce TMAO production by gut microbes. But the synthetic compound was essentially what chemists refer to as a “small alcohol,” and they wondered if it might exist as a natural product.
“We literally put together take-home gift bags of vials and labels for the staff,” Hazen said. “We asked them to take samples of every alcohol in their pantry … vinegars, oils, distilled products.”
Researchers screened thousands of the samples. They found what they were looking for — DMB, a chemical which looks like the nutrient choline, but interferes with the production of TMAO — in some cold-pressed extra-virgin olive and grape seed oils.
So what does this mean for consumers?
Not much, yet.
The research team has only tested the TMAO inhibitor DMB on mice, so far. But the mice treated with DMB were fed the equivalent of a diet rich in red meat and fatty dairy and developed less atherosclerosis.
Hazen hopes doctors can someday use DMB to control TMAO much like doctors uses statins now to inhibit cholesterol.
In the meantime, Hazen said, there are steps people can take to safeguard their heart health.
He recommends following the Mediterranean diet, which studies show can reduce cardiovascular disease by 30 percent without the help of drugs. The diet involves mostly eating plant-based foods, like vegetables and fruits, whole grains and reducing red meat intake to a couple of times a month.
A linchpin of the Mediterranean diet is also switching from butter to olive oil.
Could olive oil — also the source of DMB in Hazen’s research — be the key to the Mediterranean diet’s heart health success?
It’s unclear. Without testing, there’s no way to know if a particular olive oil contains DMB, Hazen said.
In general, researchers found the highest concentrations of DMB in extra-virgin olive oils, he said, those made from the first press of the fruit, so-called cold press. Cheaper olive oil is often made from subsequent presses of the olives and can involve steam heat.
DMB has a boiling point of 143 degrees, Hazen said. So heating the oil in the process of making it, or cooking with olive oil at home can boil off the DMB.
More gut research
Hazen and his team, meanwhile, are continuing their gut research.
One thing they’re studying now is farm-raised fish.
“The weird thing we’re finding farm-raised fish with high levels of TMAO,” he said.
Some farmers, it turns out, feed their stock pellets containing the nutrient choline and TMAO to spur growth.
Researchers want to find out how that farm-raised fish may be impacting the health of people who eat it.
Amanda Garrett can be reached at 330-996-3725 or agarrett@thebeaconjournal.com.