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I saw this study too. Here are my thoughts:
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.
I actually just made this article the subject of my latest blog post:
The Four Pillars of Health! (Diet, Sleep, Stress Reduction, Exercise): Red Meat haters surface once again (for their monthly appearance)
What Ricky said plus:
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).
Very true Paleo Bird!
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:
Cordain also comments (p. 55):... 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]
That kind of stops the hypothesis in its tracks. It may be part of the truth; it can't be the whole truth.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 ...
Here's another possible factor in heart disease -- intake of omega 3 fatty acids:
Docosahexaenoic Acid (DHA): An Ancient Nutrient for the Modern Human BrainFrance 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
It's correlative. TMAO tends to be above normal levels in people with advanced athersclerosis. TMAO is a protection mechanism for a protection mechanism (uric acid).
Heart disease is the result of damaged carbohydrate metabolism, and always will be. Which explains why the vegan group was fine, but the other group(SAD diet full of PUFA in cells) was not.
So, keep eating your red meat and try not to take mainstream science so literally because it's always mostly wrong(think seed oils being "heart healthy")
Make America Great Again
Funny... this just came out a few days ago. L-carnitine supplementation after heart attack leads to massively improved outcomes.
L-carnitine significantly improves patient outcomes following heart attack, study suggests
A meta-analysis of controlled trials in humans and testing hard outcomes, not just biomarkers.This systematic review of the 13 controlled trials in 3,629 patients, involving 250 deaths, 220 cases of new heart failure, and 38 recurrent heart attacks, found that L-carnitine was associated with:
· Significant 27% reduction in all-cause mortality (number needed to treat 38)
· Highly significant 65% reduction in ventricular arrhythmias (number needed to treat 4)
· Significant 40% reduction in the development of angina (number needed to treat 3)
· Reduction in infarct size
I don't know if you seen it yet, but Chris Masterjohn already reviewed (debunked) the TMAO study pretty thoroughly:
Does Carnitine From Red Meat Contribute to Heart Disease Through Intestinal Bacterial Metabolism to TMAO? | Mother Nature Obeyed - Weston A Price Foundation
Thanks, PB, that is a brilliant review.