Red meat and heart dz

Article in NY times today (see http://www.nytimes.com/2013/04/08/health/study-points-to-new-culprit-in-heart-disease.html?nl=todaysheadlines&emc=edit_th_20130408&_r=0).seems that presumptive coronary heart disease culprit of carnitine (in red meat, same Latin route at "carnivore") may be only partially correct. Published in Nature Medicine (see cad red meat TMAO nature medicine 2013 in dropbox). Turns out to (maybe) be more complex:
 
--in regular meat eaters, eating a sirloin leads to an increase in TMAO (trimethylamine-N-oxide), which in lab studies leads to accumulation of cholesterol in macrophages and and also seems to decrease the ability to excrete excess cholesterol (for excruciating detail, see the paper itself), with some previous data that blood TMAO is assoc with CAD, both in humans and mice
--in vegan who had a similar meal of sirloin (presumably with a significant bribe), no increase in TMAO.
-- larger group of vegetarians given carnitine pill had no inc in TMAO.
--so, speculation that it was intestinal bacteria responsible (precursor TMA known to be produced by intestinal bacteria), and that the intestinal flora are different in vegetarians than meat-eaters -- mouse studies show that increasing L-carnitine leads to changes in intestinal bacteria.  beef has highest level of carnitine. Lesser amounts in fish, chicken, and dairy. Also in high-energy drinks for body-builders
--meat-eaters pretreated with antibiotics to sterilize colon did no have TMAO in their blood
--further analysis of 2600 pts, controlling for traditional risk factors, found that TMAO and not carnitine assoc with CAD
 
So, bottom line, might be good idea to pre-treat cows with even more antibiotics.....

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