Want a healthy heart? Cover your mouth and brush your darn teeth!

The microbial relationship to your risk for cardiovascular disease

Heart disease is currently the second leading cause of death among Canadians, and so in the interest of prevention, there is a big push to familiarize people with behaviours and characteristics that may increase their risk of developing CVD. Some of the common recommendations you’ve probably heard before include “staying physically active and keeping a healthy weight, limiting alcohol use and being smoke free, eating a healthy diet”, brushing your teeth and covering your mouth? No, those last two probably don’t sound familiar, and yes, I am actually talking about preventing cavities and the spread of colds and flus in order to prevent coronary artery disease.

Are you confused yet? Wondering what cavities and colds have to do with your heart health? It turns out that like so many other things, the microorganisms you interact with on a daily basis have a huge influence on your propensity for developing chronic diseases like coronary artery disease. This is in fact old news, research suggesting these ideas has been around for a while, but for some reason it seems to have been forgotten amongst the plethora of information being thrown around in an attempt to combat our number two killer.

Don’t get me wrong, all of the current recommendations mentioned above for preventing CVD are extremely important and effective, but we cannot forget about our microbial friends and the part they have to play. I’ve summarized here just a few of the links research has unearthed between microbes and heart disease, and what you can do to get your microbes working with instead of against you.

Cover your mouth to stop the spread of chlamydia.

I’m not talking about the sexually transmitted disease. Chlamydia pneumoniae is a close cousin of the STD chlamydia, but as it’s name suggests, it infects the upper and lower respiratory tract causing laryngitis, cough and pneumonia.

  • How is this related to heart disease you ask? Several research studies note a relationship between coronary artery disease (CAD) and C. pneumoniae infection. In one study, 79% of participants with CHD were also infected with chlamydia compared to just 4% of the healthy control group. The bacteria have actually been detected within the atherosclerotic plaques in the arteries, and the severity of atherosclerosis has been correlated with the amount of the bacteria found in the arteries. This suggests that C. pneumoniae may be contributing, among other things, to the development of plaques and the severity of heart disease.

  • How do you protect yourself? C. pneumoniae is most commonly picked up for the first time amongst kids and young adults, but being infected for a second time is much more common among the elderly (common locations of infection include schools, college dorms, nursing homes, hospitals). The bacteria are spread through air droplets or by contact of anything an infected person touches after touching their nose or mouth. What’s more, you won’t even know you’ve been infected until 3-4 weeks down the road as that is how long it takes to see symptoms.

The take home message? Cover your mouth, wash your hands.

This year’s Valentine’s candy heart message: lay off ‘em and brush your teeth.

What are cavities and gum disease? Aside from being a big public health problem, it is basically a chronic overgrowth/infection of your normal mouth bacteria who were allowed too much freedom to grow, divide and conquer.

the overgrowth is so extreme now that these unopposed bacterium have run wild in your mouth, similar to a hoard of toddlers at a birthday party hopped up on cake and ice cream who are now crawling across the ceiling and trashing your living room
  • Periodontitis (gum disease) is the next level up from cavities, the overgrowth is so extreme now that these unopposed bacterium have run wild in your mouth, similar to a hoard of toddlers at a birthday party hopped up on cake and ice cream who are now crawling across the ceiling and trashing your living room, only these toddlers are capable of dividing and making more sugar hungry toddlers the more cake they eat. The result is that they break through the walls and flood the rest of the house with garbage and sticky handprints.

  • In your body this translates to bacteria producing large amounts of an exotoxin called LPS (something released from their outer cell walls into your blood) which builds up in your blood vessels causing a massive inflammatory response from your immune system. The excess inflammation meant to clean up the sticky toddler mess damages blood vessel walls by accident, which can result in atherosclerotic plaques, and down the road, maybe even heart disease

The take home message? Cut back on your sugar intake, this is what bacteria love to eat, and when you do have sugar make sure you brush your teeth to decrease the number of bacteria allowed to grow.

Eat your fibre!

A certain species of Lactobacillus (L. plantarum 299v) which resides as part of a normal, healthy gut microbial colony is particularly skilled at fermenting (what yeast does to bread) fibre.

  • When this happens regularly, the fermented fibre byproduct is able to produce multiple anti-inflammatory effects in the body such as lowering systolic blood pressure, cholesterol, LDL and other inflammatory markers; all significant risk factors in developing cardiovascular disease. In this particular study, the effects were especially significant in cigarette smokers, who’s daily habit introduces multiple inflammatory insults to healthy tissue, and an increase in the risk of developing CVD.

As a reminder, some examples of great dietary sources of fibre include peas and legumes, beans, chia and flax seeds, avocados, artichokes and more. L. plantarum 299v is also added to some probiotic formulations, and regular supplementation with these has also shown benefit.

For more information on how you can decrease your risk of developing coronary artery disease and build up your own healthy microbial community, see a qualified health care professional for individualized guidance.

 

References:

Heart Disease in Canada. Government of Canada. https://www.canada.ca/en/public-health/services/publications/diseases-conditions/heart-disease-canada.html Last Modified 2017. Retrieved 2018.

Mustapha IZ, Debrey S, Oladubu M, Ugarte R. Markers of Systemic Bacterial Exposure in Periodontal Disease and Cardiovascular Disease Risk: A Systematic Review and Meta-Analysis. Journal of Periodontology. 2007;78(12):2289-2302 https://doi.org/10.1902/jop.2007.070140

Janket SJ, Baird AE, Chuang SK, Jones JA. Meta-analysis of periodontal disease and risk of coronary heart disease and stroke. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;(95):559–569.

Ishihara K, Nabuchi A, Ito R, Miyachi K, Kuramitsu HK, Okuda K. Correlation between detection rates of periodontopathic bacterial DNA in coronary stenotic artery plaque corrected and in dental plaque samples. J Clin Microbiol. 2004;(42):1313–1315.

Nakano K, Nemoto H, Nomura R, Inaba H, Yoshioka H, Taniguchi K, Amano A, Ooshima T. Detection of oral bacteria in cardiovascular specimens. Journal of molecular oral microbiology. 2008;24(1):64-68

Beck J, Garcia R, Heiss R, Vokonas PS, Offenbacher S. Periodontal Disease and Cardiovascular Disease. Journal of Periodontology. 1996;67(10):1123-1137. https://doi.org/10.1902/jop.1996.67.10s.1123

Chlamydia pneumoniae infection. Centers for Disease Control and Prevention. https://www.cdc.gov/pneumonia/atypical/cpneumoniae/about/causes.html Last modified 2016. Retrieved 2018

Muhlestein JB, Hammond EH, Carlquist JF, Radicke E, Thomson MJ. Karagounis LA. Woods ML. Anderson JL. Incidence of Chlamydia Species Within the Coronary Arteries of Patients With Symptomatic Atherosclerotic Versus Other Forms of Cardiovascular Disease. JACC. 1996;27(7):1555-1561

Naruszewicz M, Johansson ML, Zapolska-Downar D, Bukowska H. Effect of Lactobacillus plantarum 299v on cardiovascular disease risk factors in smokers. The American Journal of Clinical Nutrition. 2002; 76(6):1249–1255. https://doi.org/10.1093/ajcn/76.6.1249

Spahr A, Klein E, Khuseyinova N, Boeckh C, Muche R, Kunze M, Rothenbacher D, Pezeshki G, Hoffmeister A, Koenig W. Periodontal Infections and Coronary Heart DiseaseRole of Periodontal Bacteria and Importance of Total Pathogen Burden in the Coronary Event and Periodontal Disease (CORODONT) Study. Arch Intern Med.2006;166(5):554–559. doi:10.1001/archinte.166.5.554

Joshipura KJ, Rimm EB, Douglass CW, Trichopoulos D, Ascherio A, Willett WC. Poor Oral Health and Coronary Heart Disease. Journal of Dental Research. 1996;75(9): 1631-1636

Tonetti MS, VanDyke TE and on behalf of working group 1 of the joint EFP/AAP workshop and. Periodontitis and atherosclerotic cardiovascular disease: consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases. J Clin Periodontol. 2013;40(suppl. 14): S24–S29. doi: 10.1111/jcpe.12089

Li X, Kolltveit KM, Tronstad L, Ingar Olsen. Systemic Diseases Caused by Oral Infection. Clin. Microbiol. 2000;13(4): 547-558. doi: 10.1128/CMR.13.4.547-558.2000

#Hearthealth #Cardiovasculardisease #Microbes #Microbiome #Bacteria #Pneumonia #OralHealth #Sugar #ColdFlu

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