Figure 1.

Diet-gut interactions and cardiovascular risk. Bacterial production of short chain fatty acids (SCFAs) may interfere with energy absorption promoting obesity, and gut barrier function promoting leakage of lipopolysaccharides (LPS) to visceral adipose tissue. Microbial metabolites such as branched chain amino acids (BCAAs) and secondary bile acids (BAs) may interfere with several metabolic pathways, contributing to obesity and insulin resistance. Trimethylamine-N-oxide (TMAO) may directly enhance atherosclerosis by interfering with cholesterol transportation and foam cell formation, as well as inducing platelet reactivity, promoting thrombosis and acute coronary events.