Effects of diet-modulated gut microbiota and microbial metabolites in atherosclerosis.
Level 5 - mechanism / opinion, no new human data
Narrative review without systematic search or meta-analytic methodology
PubMed 41946302 · doi:10.1016/j.biopha.2026.119328
What was done
This narrative review synthesizes literature on how dietary patterns (such as plant-based high-fiber versus Western high-protein diets) modulate gut microbiota composition and microbial metabolite production. It examines the molecular pathways through which metabolites—including short-chain fatty acids, bile acids, tryptophan derivatives, trimethylamine N-oxide (TMAO), and food/medicine homologous compounds—influence host lipid metabolism, endothelial function, vascular inflammation, and atherosclerotic plaque pathogenesis.
What was found
The abstract reports no quantitative metrics, effect estimates, or sample sizes. Qualitatively, it highlights that short-chain fatty acids (butyrate, propionate) reduce atherosclerosis by promoting regulatory T cell differentiation, inhibiting histone deacetylases, and improving endothelial function; bile acids modulate disease via FXR and TGR5 signaling; specific tryptophan metabolites (indole-3-propionic acid, indole-3-carboxaldehyde) are atheroprotective in preclinical models; and TMAO associates with increased cardiovascular risk in observational studies, though causal evidence in humans remains inconclusive.
Why it matters
It provides an integrated overview of the dietary-microbiome-metabolic axis in vascular disease, clarifying established preclinical mechanisms while highlighting gaps in human causal evidence.
Limits
As a narrative review, it lacks a systematic literature search, standardized study quality assessment, and quantitative synthesis. Much of the mechanistic evidence derives from preclinical animal models, human data for targets like TMAO remain primarily observational, and therapeutic strategies utilizing food and medicine homologous compounds remain clinically unvalidated.
Cited by
- supports Dietary fiber is converted by gut microbiota into short-chain fatty acids that exert protective effects on blood vessel endothelium.