‘The way to a man's heart is through his gut microbiota’ – dietary pro- and prebiotics for the management of cardiovascular risk

Abstract

The human gut microbiota has been identified as a possible novel CVD risk factor. This review aims to summarise recent insights connecting human gut microbiome activities with CVD and how such activities may be modulated by diet. Aberrant gut microbiota profiles have been associated with obesity, type 1 and type 2 diabetes and non-alcoholic fatty liver disease. Transfer of microbiota from obese animals induces metabolic disease and obesity in germ-free animals. Conversely, transfer of pathogen-free microbiota from lean healthy human donors to patients with metabolic disease can increase insulin sensitivity. Not only are aberrant microbiota profiles associated with metabolic disease, but the flux of metabolites derived from gut microbial metabolism of choline, phosphatidylcholine and l-carnitine has been shown to contribute directly to CVD pathology, providing one explanation for increased disease risk of eating too much red meat. Diet, especially high intake of fermentable fibres and plant polyphenols, appears to regulate microbial activities within the gut, supporting regulatory guidelines encouraging increased consumption of whole-plant foods (fruit, vegetables and whole-grain cereals), and providing the scientific rationale for the design of efficacious prebiotics. Similarly, recent human studies with carefully selected probiotic strains show that ingestion of viable microorganisms with the ability to hydrolyse bile salts can lower blood cholesterol, a recognised risk factor in CVD. Taken together such observations raise the intriguing possibility that gut microbiome modulation by whole-plant foods, probiotics and prebiotics may be at the base of healthy eating pyramids advised by regulatory agencies across the globe. In conclusion, dietary strategies which modulate the gut microbiota or their metabolic activities are emerging as efficacious tools for reducing CVD risk and indicate that indeed, the way to a healthy heart may be through a healthy gut microbiota.

GUT-the Trojan Horse in Remote Organs’ Autoimmunity

“…Furthermore, inorganic phosphate is highly controlled by a network of players including vitamin D, PTH, kidney, and the intestine, thus establishes a renal-skeletal-gut axis [78]. Understanding the part of the microbiota and the tight junction performance in this axis will enable novel dietary protein, fiber, prebiotic, probiotic and symbiotic strategies to attenuate the renal deterioration [79].…”

Gut Microbiota–Immune System Crosstalk

“…49 Interestingly, all these physiological processes have been studied, with some success especially in animal models, as targets for prebiotic and probiotic dietary functional foods. 50 FXR activation contributes to maintenance of intestinal integrity and reduces intestinal permeability. FXR expression in the intestine is stimulated by activation of the microbiota-sensor TLR-9 51 through recruitment of the response element interferon regulatory factor (IRF)-7 (i.e., a member of the interferon regulatory family of transcription factors involved in the antiviral innate immune response) on FXR promoter.…”

“…63 Studies highlighting the multiple roles of the BA-receptors TGR-5 and FXR suggest a complex interplay between metabolic and immune functions, which have important consequences in pathologies characterized by chronic inflammation, such as inflammatory bowel disease (IBD) and the metabolic syndrome and indeed aging. 49,50,53 Diet, especially fermentable fibers or prebiotics, probiotics with bile salt hydrolase activity or bile acid chelating plant polyphenols, will therefore mediate significant physiological effects through the gut microbiota bile acid handling, on both metabolic and inflammatory processes. Morever, as discussed below, the gut microbiota plays a central role in coordinating immunity and metabolism through the intestinal epithelium gene expression pathways.…”

Potential Health Benefits of Combining Yogurt and Fruits Based on Their Probiotic and Prebiotic Properties

“…More recently, it has been suggested that whole plant-based foods, probiotics, and prebiotics can modulate the microbiota, leading to cardiac health (3). From studies investigating the effects of diet on health, consistent healthy dietary patterns have been elucidated across diverse populations.…”

“…2 The authors reported no funding received for this study. 3 Author disclosures: A Marette is a consultant for, and his research is funded in part by, Danone Nutricia Research. Danone had no influence on the scientific integrity of the content presented.…”