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Interesting article that I read fully and my understanding is this: it's not that red meat is the culprit. It's when the carnatine found in red meat interacts with a specific type of gut bacteria...that gut bacteria metabolizes the carnatine to form TMAO which may be a biomarker for heart attacks.
More research needs to be done to determine which gut bacteria (there are millions if not billions, some healthy and some unhealthy) actually cause this reaction. My question is: does someone with a healthy gut (a very small slice of the American population) react the same way to carnatine intake? In one leg of the experiment they gave the patients a course of strong antibiotics that wiped out all of their gut bacteria (good and bad) and after that they showed no increase of TMAO in the blood after eating steak. So clearly its a certain gut bacteria that does this when it comes into contact with carnatine. Most Americans have totally unhealthy guts (due to overuse of antibiotics, diet, etc) that are abundant in bad bacteria (such as candida), and I wonder if that could be the reason for the reaction.
Additionally, my next question would be: Does the presence of TMAO in the blood alone (meaning without an inflammatory environment, and no other markers for cardio vascular disease or heart failure) indicate that someone is more likely to die of a heart attack? What about people who eat right (a paleo, anti-inflammatory diet), supplement to stave off inflammation, get good sleep, good exercise, and are able to successfully manage their stress levels? Those people would have no other factors other than some increase (MAYBE) in TMAO in their blood. Does that alone cause a heart attack.
My educated guess would be NO. But more research is needed to fully understand this. Personally, for me this changes nothing. I will still eat red meat as long as it comes from a high quality source (organic, grass fed) and I am keeping my inflammation levels low and staying generally healthy through good lifestyle choices.
The same thing happened when they tried the experiment on people with wiped out gut bacteria and with vegans, no uptick in TMAO. Vegans obviously don't have this particular gut bacteria but, is this due to not eating meat or due to the fact that most vegans tend to be extremely health conscious and thus don't eat McD's and store bought "crap-in-a-box" type of foods? Perhaps the bacteria that reacts with the carnatine only thrives in a junk food and/or high carb gut biome.
Either way it comes down to the gut bacteria, not the meat, as source of the problem.
Also doing a study on people who are already "at risk" for heart attacks is inherently difficult due to multiple confounding variables such as being overweight and having diabetes. (Not many overweight vegans).
I just took a quick look at Cordain's latest book, which I'd mentioned in another post on this topic -- in connection with vegetarianism, which this study seems to be, in a sense, recommending.
Cordain states on page 50:
... a large meta-analysis [conducted by Oxford University researchers found] ... "... no significant differences between vegetarians and non-vegetarians in mortality from cerebrovascular disease, stomach cancer, colorectal cancer, lung cancer, breast cancer, prostate cancer or all other causes combined " [Part in quotation marks from Oxford; Cordain's emphasis]
Cordain also comments (p. 55):
If vegetarian diets provide protection from cardiovascular disease, as the ADA suggests, you would expect to find a low prevalence of heart disease and stroke in India because almost one third of its population are vegetarians. ... In reality, the incidence of cardiovascular disease is much higher in india than anywhere else in the world ...
That kind of stops the hypothesis in its tracks. It may be part of the truth; it can't be the whole truth.
Here's another possible factor in heart disease -- intake of omega 3 fatty acids:
France is the only country where recommendations specifically for DHA are provided by health bodies at 120 mg for men and 100 mg for women per day. A recent survey of 4884 French men and women found that on average this target was far exceeded by estimated intakes of 273 mg/day for men and 226 mg/day for women . In addition, the total long chain omega 3 fatty acids (EPA + DHA) intakes in France are in line with the recommended nutraceutical doses for the prevention of heart disease, at an estimated 497 mg/day for men and 400 mg/day in women. The French estimates for preformed DHA (250 mg/day), predominately from seafood, are much higher than estimates from other Western countries, such as 70 mg/day in the US, 90 mg/day in Australia, and 170 mg/day in Germany. These observations may in part contribute towards the “French Paradox”, the lower incidence of heart disease despite the diet rich in saturated fatty acids
The bacteria responsible for increased TMAO levels are actually ones that thrive on a diet of whole grains ... um...
THe issue is FAR from clear, and this post really illuminates the major issues that are still unresolved.
A meta-analysis of 13 controlled trials concludes that including L-carnitine among the other therapies given in the acute setting for MI appears to significantly cut all-cause mortality and lead to fewer angina symptoms and ventricular arrhythmias ...