High Steaks

Research by Dr. Stanley Hazen linking gut bacteria — produced by eating animal products — to heart attack and stroke could lead to new ways of treating, and preventing, heart disease.

>> Turns out, there’s some truth to the adage, “The way to a man’s heart is through his stomach.”

Research by Cleveland Clinic’s Stanley Hazen, MD, PhD, has linked bacteria in a person’s gut to heart disease risk. This discovery shows that the way our bodies break down choline — a common nutrient found in animal products like fatty meats and egg yolks — produces the byproduct trimethylamine-N-oxide (TMAO).

“Bacteria that live in our intestines play a role in the digestion of certain types of food to form the compound TMAO, which promotes the accumulation of cholesterol-rich plaque in the arteries,” says Dr. Hazen, Vice Chair of Translational Research for Cleveland Clinic’s Lerner Research Institute and Co-Section Head of Preventive Cardiology & Rehabilitation.

I’m not a vegan. I like a good steak.

Though unexpected — Dr. Hazen says he was as surprised as anyone — the heart-gut discovery connects several dots. Each person’s gut flora is different, which helps explain why one person can have a poor diet but not be at risk for heart disease, while someone else with an excellent diet and no family history of heart disease may experience a heart attack or stroke or need heart bypass surgery.

“Our goal is not to suggest dietary restrictions of entire food groups. Eggs, meat and other animal products are an integral part of most individuals’ diets,” Dr. Hazen says, explaining that his research may help personalize nutritional recommendations. “Our long-term goal is to discover pathways that contribute to developing heart disease and then design novel diagnostic tests and therapies to prevent and regress heart disease. Our recent studies show that measuring TMAO blood levels could serve as a powerful tool for predicting future cardiovascular risk, even for those without known risk factors.”

Got Bacteria?

>> Dr. Hazen hopes a TMAO diagnostic test that he developed — and was recently leased by Cleveland Clinic to a publically traded diagnostics company — will be introduced for clinical use in the next year.

In addition, he and his team have followed the diverging paths of his research into new studies on everything from how probiotics, supplements and healthy foods can alter TMAO levels to examining dietary interventions to the effect of portion size; for instance, eating too much, too fast seems to increase TMAO formation.

“The first step in developing a cure for a disease is understanding the culprit processes involved and who stands to benefit most from an intervention,” says Dr. Hazen, who holds the Leonard Krieger Chair in Preventive Cardiology. “We’re now focused on how to intervene and lower risk.” 

In a way, Dr. Hazen, his lab and his colleagues are the prototype of innovation at Cleveland Clinic: cross-disciplinary. Driven by creativity and curiosity. Entrepreneurial and unafraid to pursue commercialization. Focused on the greatest needs in healthcare. Perhaps most important, they follow where science leads them.

Says Dr. Hazen: “I say to people in the lab, ‘You have to be scientifically fearless.’ ”

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