Ask the Pharmacist

Q) Besides the usual advice, lose weight, eat better, exercise more and take my pills as prescribed are there any other less painful ways to improve my cardiovascular (CV) health?

A) In fact,  there are a number of so-called alternative methods to improving CV health that are relatively inexpensive and may be less challenging for some to commit to then the tried and true ones listed above.

They all have varying degrees of science to support their effectiveness and it is a fact that not all cardiologists buy into them as being worthwhile but meditation, acupuncture and, the focus of our topic today, improving one’s gut health all may be beneficial to reducing your risk of a heart attack or stroke.

We have previously discussed the microbiome (the term scientists use for the trillions of microorganisms that inhabit the insides of our bodies, principally within our intestines) with respect to its possible role in improving mental health and, in a similar vein, there is a growing body of evidence to support that taking care of this part of our body can also aid us cardiovascularly.

A recent study out of England was among the first to provide evidence that poor gut diversity (meaning that their intestines lack the typical broad range of different types of microorganisms) was associated with hardening of the arteries in females. Artery hardening is a known risk for heart disease and heart attacks amongst other CV related disorders.

The researchers looked at data from 617 middle-aged female twins and measured the degree of artery stiffness they exhibited. It was found that those who had the least diversity in their bacterial species seemed to have the worst scores when it came to the condition of their arteries. The researchers were able to figure out which particular types of bacteria seemed to be responsible (due to their relative lack of abundance) for this risk and were not surprised to see that they were the same ones whose presence has been linked to lower obesity rates.

The link between gut bacteria and artery hardening in fact seemed to be stronger than other well established ones such as those between arterial damage and excessive weight or insulin resistance. The key to this may be related to inflammation. Healthy stomach and intestines seem to have a beneficial effect in lowering the amount of inflammation within our body and it is this chronic, low-level inflammation that many believe is responsible for the damage the inner lining of our blood vessels experience as they gradually stiffen.

Further evidence comes from an examination of a substance known as TMAO (trimethylamine N-oxide) and heart attacks and strokes.  TMAO is produced when our gut breaks down dietary choline, an ingredient we consume when we eat eggs or red meats. People with higher TMAO levels were found to have a 62% greater chance of developing serious cardiovascular events than those with the lowest levels. In fact, the risks of TMAO seemed to extend beyond just CV events as an analysis of more than 2000 people with heart disease found that those with higher levels of TMAO had a fourfold greater risk of dying from any cause over the next 5 years.

While dietary fat may have gotten more blame than it should have over the last few decades, it still seems to play an adversarial role in our heart health and our microbiome is intimately involved with this. So, if our microbiome is so important, how do we maintain it in a healthy state?

One option is to take a probiotic supplement but they can be expensive and the jury is still out on whether they truly deliver on their promise. Dietary choices are probably a more effective and less expensive means to increasing gut diversity.

One suggestion is to aim for more than 40 grams of fibre per day which is about double the average that most of us consume. As well, try to change up the types of fruits and vegetables you consume as they all have unique impacts on the differing species that constitute our biome and will help some to thrive more than others.

Fermented foods such as kefir (a sour milk drink available in most grocery stores containing five times as many microbes per serving as live culture yogurt), sauerkraut, kimchi (a Korean dish made from cabbage, garlic and chilli) and soy-based products such as tempeh and soy sauce (the low sodium variety of course) are also excellent choices.

As for food choices to avoid, it should come as no surprise that the usual culprits when it comes to poor dietary habits in general make this list. Artificial sweeteners such as aspartame, saccharine and sucralose as well as processed foods seem to disrupt our microbiome and lower its diversity providing yet one more reason foods containing these should be left on the grocery store shelf. In general, be kind to your stomach. The sage old advice that you are what you eat, has never been more factually based than it appears to be now.