Warning: Poor health may give you a heart attack

Warning: Poor Gut Health May Give You a Heart Attack

Written by: Vincent Pedre M.D. | February 2, 2024 | Time to read 6 min

As the America's #1 Gut Doctor my mission is to enlighten people globally about the critical importance of gut health and its far-reaching effects on our overall health. 

At first, you may wonder why a functional gut expert is talking about heart health? 

Well, first of all, it’s American Heart Health Month, so we want to highlight the importance of heart health for overall well-being in February. 

I would probably not be wrong if I guessed that each of you reading this blog post has been touched by someone who had some sort of heart issue. For me, it was a high school classmate. His father had gone in for a routine heart check-up and stress test, but subsequently suffered a massive heart attack right after the test, and unexpectedly passed away. He was probably in his late 40’s or early 50’s—too young to die from a totally preventable illness.

Through my journey, I've shared insights on how our  emotional well-being, such as depression, can originate from our gut  due to its significant role in producing serotonin, the key hormone that influences our mood. I've explored the concept of a  leaky gut , which can lead to persistent inflammation, trigger an overactive immune response, and potentially result in autoimmune disorders. Moreover, I've shed light on the intricate connection between certain gut microbes and the challenge of shedding extra weight.

All of these interconnections make logical sense when you look at the underlying mechanisms. But it may not feel as intuitive to say that your gut could be responsible for a heart attack.

In alignment with American Heart Health Month, I'm dedicated to highlighting the pivotal yet often overlooked link between gut health and heart disease, emphasizing the critical role our gut plays in maintaining heart health.

Here we go…

Dietary Habits and Their Impact on Heart Health

Despite the growing awareness around various health conditions such as Alzheimer’s and type 2 diabetes, heart disease silently remains the leading cause of death globally, affecting both genders and claiming over 17.9 million lives each year. 

The influence of our dietary choices on heart health has been acknowledged for many years, with dietary modifications being a cornerstone recommendation for managing conditions such as high cholesterol, hypertension, and atherosclerosis. That said, most resources tend to gloss over exactly why this connection exists and how it actually works.

This is because until not long ago, we didn’t exactly understand how this connection works. But in recent years, researchers have uncovered more details as to why the strong connection between diet and heart disease exists — and surprise! It has everything to do with the gut bacteria.

"As it turns out, the science of the gut microbiome explains why diet can affect our heart health."

Dr. Pedre

Here’s what I mean: In the last few years, researchers have published several studies done on people and animals that have linked specific gut bacteria to an increased risk for heart attack and stroke. Consuming foods rich in nutrients like L-carnitine (found abundantly in red meat) and phosphatidylcholine (present in eggs, cheese, and shellfish) encourages the growth of certain inflammatory gut bacteria. Now, hold on and keep reading, because this is not to say that eating red meat, eggs, shellfish, or even cheese for that matter is always the underlying cause for atherosclerosis (blocking of the arteries), and heart disease.

These bacteria bullies, in turn, produce higher levels of a compound known as  trimethylamine or TMA ( for short). If it stopped there, it probably wouldn’t be so bad. But the issue arises when TMA is metabolized in our livers to another compound that doubles the risk of having a heart attack or stroke.

The Critical Role of TMAO in Cardiovascular Health

Once in the body, TMA is quickly transformed by the liver into something called trimethylamine N-oxide (TMAO) . And here’s where the bad news comes in: While it’s totally normal for gut bacteria to produce metabolites like TMA, the specific metabolite TMAO has been linked to a  significantly increased risk of heart attacks, strokes, and other cardiovascular emergencies

And it can only be produced in the liver by a process called biotransformation — in this case, by an enzyme known as flavin monooxygenase or FMO ( for short). Don’t you love all of these medical acronyms? LOL. Why is this important? Because people can have genetic differences in how active their FMO enzyme is, leading to more or less conversion of TMA to TMAO.

This newly discovered link isn’t a weak one, either. Studies have shown that people with higher TMAO in their blood are twice as likely to have a heart attack, stroke , or other cardiovascular emergency than those with normal TMAO levels, regardless of blood cholesterol levels. The results of a recent study also showed that people with high blood levels of TMAO were more likely to die prematurely. High TMAO has also been connected to heart failure and chronic kidney disease.


TMAO, that enigmatic compound that could be coursing through your arteries and veins, possesses a remarkable ability to transform your platelets into sticky agents of trouble, increasing the likelihood they will adhere to artery walls and precipitate acute blockages—a harrowing scenario that can lead to a heart attack or stroke.

But the intrigue deepens when we delve into the correlation between red meat consumption and TMAO production. The more red meat graces your plate, the more you unwittingly cultivate a thriving population of "meat-eating" bacteria in your gut, potentially triggering a surge in TMAO levels. It's a perplexing cycle, perpetuated by our dietary habits and the intricate workings of our microbiome.

The act of indulging in copious servings of red meat and animal-derived products isn't merely a culinary pleasure; it orchestrates a profound transformation within the ecosystem of your gut microbiota, potentially fueling a cascade of TMAO production. The implications are staggering, challenging conventional wisdom and beckoning us to reassess the impact of our dietary choices on heart health. Indeed, it's enough to make one's mind reel in astonishment. 

Hold on, carnivores! The story isn’t as black and white as you may think when it comes to meat consumption.

Research reveals a tantalizing revelation: a discernible 25% variance in metabolite composition between omnivores and vegans, with adherents of a plant-focused lifestyle boasting a corresponding 25% reduction in heart disease risk. The symmetry of these figures is nothing short of remarkable, prompting a reconsideration of the underlying mechanisms at play. While causation remains elusive, the correlation between alterations in gut microbiota and their metabolites and the harmful effects of red meat and animal products on cardiovascular health is undeniable.

However, we need to look at the summation of the diet, as well as the quality of the red meat (or other foods) being consumed.

So can you have your red meat and eat it, too?! Follow the steps below if you want to continue to enjoy red meat, but want to avoid unhealthy TMAO levels.

5 Steps to Reduce TMAO Levels

1. The Mediterranean Diet

While the consumption of red meat may precipitate a surge in TMAO levels, emerging evidence suggests that embracing the Mediterranean diet can mitigate this effect. Bursting with an abundance of fresh fruits, verdant vegetables, and the liquid gold of olive oil, this culinary approach introduces 3-dimethyl-1-butanol (DMB), a potent compound that curtails TMAO production from carnivorous gut.

3. Make Red Meat A Treat

Rather than bid adieu to red meat entirely, revere it as an occasional delicacy—reserved for weekends, festive occasions, or special outings. By coupling it with an array of plant-based delights, you thwart excessive TMAO production and maintain a harmonious balance within your gut microbiome. Remember, opting for grass fed varieties ensures a healthier profile, sidestepping the inflammatory omega-6 fats prevalent in conventionally raised cuts. We’ve got a blog post coming up just about this, so stay tuned.

3. Enjoy Raw Dairy, Pasteur-Raised Eggs & Poultry in Moderation

While dairy, eggs, and poultry exhibit milder TMA-producing tendencies compared to their red meat counterparts, moderation is key. Prioritize high-quality sources such as organic, raw cheeses, probiotic-rich grass fed kefir, free-range poultry, and eggs sourced from pasture-raised hens, which tend to be richer in heart-healthy omega-3 fatty acids. Adhering to these guidelines ensures you reap the benefits without tipping the scales towards excessive TMAO production.

4. Beware of L-Carnitine-Containing Supplements & Beverages

Exercise vigilance when perusing labels, steering clear of supplements and energy drinks laden with ingredients like choline, phosphatidylcholine, or L-carnitine, which can inadvertently exacerbate TMAO production, unless your health practitioner has a good reason you should be taking this for other health matters. For individuals with mitochondrial disorders, this diligence is especially crucial to mitigate potential risks. Exploring alternative options ensures your dietary choices align with your health goals, minimizing the likelihood of TMAO-related complications.

5. Exercise

Beyond its physical benefits, regular exercise exerts a positive influence on gut microbiome diversity, potentially mitigating TMA production. Whether it's a brisk nature walk, an invigorating HIIT session, or an exuberant dance routine, prioritize activities that elevate your heart rate and ignite your zest for life. By embracing movement as a form of therapy (just as important as your diet), you cultivate a resilient microbiome and safeguard against TMAO-related health concerns.

You can further fortify your gut health and support your heart with a delicious addition to your daily routine:  Chocolate Nourish  — plant-based protein powder designed to nourish your body from the inside out.

  • Elevate your morning smoothie or post-workout shake with  Chocolate Nourish . Packed with wholesome ingredients like pea protein, brown rice protein, and a blend of superfoods, each serving delivers a burst of essential nutrients to fuel your day. Plus, its rich chocolate flavor makes it a delightful treat for your taste buds.

  • Chocolate Nourish provides a convenient and delicious way to incorporate plant-based proteins into your diet. Plant proteins offer numerous health benefits, including supporting muscle growth and repair, promoting satiety, and contributing to overall heart health. By choosing Chocolate Nourish, you're not only nourishing your body but also supporting sustainable and compassionate food choices.

By incorporating Chocolate Nourish into your daily routine, you're not only treating your taste buds to a decadent delight but also taking proactive steps to support your gut and heart health . So why wait? Embrace the delicious synergy of Chocolate Nourish and elevate your wellness journey today.


In essence, a Happy Gut Life transcends the mere elimination of food groups; it's a holistic approach that celebrates diversity and balance. By nurturing your gut with an abundance of plant-based foods and embracing moderation in your consumption of red meat and animal products, you foster a symbiotic relationship with your microbiome—one that promotes optimal health and vitality. So savor the flavors of grass fed red meat with plant-based nourishments to compliment it, relishing its nutritional bounty, secure in the knowledge that your gut is singing a harmonious tune of contentment and well-being.

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1 comment

Thank you for this amazing article. I just got your book The Gutsmart Protocol and the QR code lead me to this. Didn’t realize the potential danger of L-Carnitine.

Wayne Harvey

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