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According to the World Stroke Organization, globally, 1 in 4 adults over the age of 25 will have a stroke in their lifetime. So, how exactly can we reduce our risk? Well, according to a recent study from Cleveland Clinic, focusing on our gut health can help to protect us from severe strokes.

Gut health and stroke risk

The state of our gut can influence our health in a number of ways, from our immune system to our mental health. That said, a recent study suggests that certain gut microbes can cause a profound change in stroke severity. 

The study

The study, published in Cell Host & Microbe, Recently, was done by a group of researchers from the Cleveland Clinic. For the purpose of the study, the researchers transplanted various microbial communities into multiple murine stroke models in an effort to better understand the causal role of gut microorganisms in stroke.

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The theme of the study isn’t a new one for study author Dr. Hazen, who also happens to be chair of the Department of Cardiovascular & Metabolic Sciences and director of Cleveland Clinic’s Center for Microbiome & Human Health.

For him and his team, the study builds on more than a decade of research related to the gut microbiome’s role in cardiovascular health and disease, including the adverse effects of TMAO (trimethylamine N-oxide) – a byproduct produced when gut bacteria digest certain nutrients abundant in red meat and other animal products.

How was the study done? 

For the study, Dr. Hazen and his team compared brain damage in preclinical stroke models between those with elevated or reduced TMAO levels.

“Functionality after a stroke – which occurs when blood flow to the brain is blocked – is a major concern for patients,” said Dr. Hazen, who is also co-section head of Preventive Cardiology & Cardiac Rehabilitation in Cleveland Clinic’s Miller Heart, Vascular & Thoracic Institute. “To understand if choline and TMAO affect post-stroke functionality, in addition to stroke severity, we compared performance on various tasks pre-stroke, and then both in the short- and long-term following stroke.”

What did the study find?

It appears that those with higher levels of TMAO not only had more extensive brain damage but also faced a greater degree of motor and cognitive functional deficits following stroke. 

stroke | Longevity LIVE

“In this study, we found that dietary choline and TMAO produced greater stroke size and severity, and poorer outcomes in animal models,” said Dr. Hazen, “Remarkably, simply transplanting gut microbes capable of making TMAO was enough to cause a profound change in stroke severity…This new study…for the first time provides proof that gut microbes in general – and through TMAO specifically – can directly impact stroke severity or post-stroke functional impairment,”

The study also revealed that CutC, a gut microbe enzyme critical to TMAO production, drove heightened stroke severity and worsened outcomes.

 So what now?

Simple: focus on your gut.

Dr. Weifei Zhu, Ph.D. has also led the study. She believes that targeting the CutC gut microbe enzyme may help prevent stroke. 

“When we genetically silenced the gut microbe gene that encodes CutC, stroke severity significantly diminished,” she said. 


“Ongoing research is exploring this treatment approach, as well as the potential for dietary interventions to help reduce TMAO levels and stroke risk, since both a Western diet and a diet rich in red meat are known to elevate TMAO levels. Switching to plant-based protein sources helps to lower TMAO.”

Switching to plant-based protein sources won’t only help to lower TMAO levels, but it could also have amazing benefits for your health.


Zhu, W., Romano, K. A., Li, L., Buffa, J. A.,et al. (2021). Gut microbes impact stroke severity via the trimethylamine N-oxide pathway. Cell host & microbe, S1931-3128(21)00230-4. Advance online publication. ttps://

Pie Mulumba

Pie Mulumba

Pie Mulumba is a beauty and wellness writer who has a passion for poetry, equality, natural hair, and skin-care. With a journalism degree from Pearson's Institute of Higher Education, and identifiable by either her large afro or colorful locks, Pie aspires to continuously provide the latest information, be it beauty or wellness, on how one can adopt a healthy lifestyle on a day-to-day basis.

The content in this editorial is for general information only and is not intended to provide medical or other professional advice. For more information on your medical condition and treatment options, speak to your healthcare professional.