India is a hotbed of metabolic diseases with more than 13% of Indian populations suffering from/at risk of life threatening cardiovascular diseases.
The current healthcare system uses standard of care plasma level investigations to measure specific blood biomarkers that has helped effectively manage cardiovascular diseases to some extent.
Recent research has found that the human microbiome plays a key role in our cardiovascular health. Dysbiosis in gut & oral microbiome & harmful metabolites secreted by them could trigger onset of different cardiovascular diseases.
Humans as superorganisms
We are superorganisms. We are not one single organism, but a container for a trillion of microorganisms living on & inside our body. While we acquire 25,000 genes from our parents which defines our ancestry, lineage & rare genetic disorders, we get 20 million genes from microbes living in our gut, mouth, skin, reproductive organs, scalp & more. Whether it is microbial or human, our genes are static but how those genes are expressed are dynamic, ever evolving changes based on our exposure to the external environment. Epigenetically, we are more microbial than human, since microbes govern 99% of our biology.
While the gut is the largest site for permanent settlement of microbes, there is mounting evidence that microbes living at different sites inside our mouth are equally important. Oral microbiome is the first line of defense against the external environment & is the first one to interact with our lifestyle & nutrition choices.
These interactions enables microbes to pre-digest the food so that it’s easily available for absorption in stomach & small intestine as well as release biochemical signals to different parts of the body communicating the substrates & molecules coming their way, in order to start various biological processes including absorption of nutrients, release of insulin & more.
Oral microbes synthesize molecules in foods to produce chemical byproducts that regulates blood pressure, potentiates insulin signalling & delivers oxygen & nutrients to tissues & organs.
However when the oral microbiome is dysregulated, the microbes secretes inflammatory & toxic byproducts that trigger inflammation in mouth & rest of the body. These byproducts could erode our gums & teeth & translocate to other body organs which could lead to various diseases such as cardiovascular diseases, type 2 diabetes, dementia & more.
The oral microbiome- Cardiovascular Disease connection
Oral microbes secrete one of the most essential signalling molecule-nitric oxide(NO) which activates a compound called cyclic GMP which dilates the blood vessels, regulates blood pressure, inhibits inflammation & oxidative stress, prevents plaque deposition in arteries & inhibits blood clotting.
Our Body utilises two pathways to produce nitric oxide :
1. Oral Microbiome: Specific oral microbes sense dietary nitrate & expresses specific genes that activate certain proteins that synthesise nitrate into nitrite. This nitrite travels & is protonated in stomach acid to produce nitric oxide.
2. Endothelium Pathway: We have endothelial cells lining our blood vessels that are capable of producing nitric oxide. Specific enzyme called endothelial nitric oxide synthase when coupled with endothelial cells can convert L-arginine in the presence of oxygen into nitric oxide along the lining of blood vessels & L-citrulline.
Since the production of nitric oxide by the first pathway declines by 10% every decade starting from the age of 23, by the time we attain an age of 50 our body’s ability to produce nitric oxide using the first pathway falls by 50%. Therefore promoting beneficial oral microbiome functions becomes all the more important.
Disruption in oral microbiome functions could lead to functional loss of nitric oxide production which triggers plaque deposition in arteries, high blood pressure, oxidative stress, followed by lack of blood flow & sticking of white blood cells to the lining of blood cells. Finally blood platelets activate & plaque are formed that disrupts the blood supply in that area, leading to onset of cardiovascular diseases.
The gut microbiome- Cardiovascular Disease connection
The flood of chemicals reaches the gut after the food is predigested by our oral microbes. Our gut microbes interact with these chemicals & can synthesise them into metabolic byproducts that communicate with our immune cells. If the gut microbiome is imbalanced, it could secrete harmful & pro-inflammatory byproducts such as LPS, TMAO, P-cresol, Indoxyl Sulphate, secondary bile acid & more which stimulates immune system, triggers upregulation of inflammatory & cytokines, leading to development of cardiovascular diseases.
Strategies to improve your heart health
Some of hacks which you should consider to improve your metabolic & heart health:
- Stop using antiseptic mouthwash & fluoride laden toothpaste since it interferes with oral microbiome functions required for production of nitric oxide.
- Reduce the consumption of sugar & processed foods.
- Have healthy fats in your diet to maintain your cell membrane’s structure & fluidity.
- Have green vegetables in your diet.
- Spend at least 20 minutes in sunlight daily.
- Consume foods high in polyphenols antioxidant, inulin dietary fibre & fermented foods
- Get at least 45-60 minutes of physical exercise daily.
Authored by Sushant Kumar, Founder & CEO-Genefitletics
Citations
https://pubmed.ncbi.nlm.nih.gov/15722114/
https://www.sciencedirect.com/science/article/pii/S0033062005800015
https://pmc.ncbi.nlm.nih.gov/articles/PMC10219307/
https://pubmed.ncbi.nlm.nih.gov/28754616/
https://pubmed.ncbi.nlm.nih.gov/18305466/
https://www.sciencedirect.com/science/article/pii/S0092867420301604