Flawed study leads to some wrong impressions

There are times when the reporting of a news item may infer a conclusion quite different from reality. Unfortunately this happens not infrequently in the reporting of medical research. A case in point is the recent release of the medical study suggesting that the consumption of red meat, specifically one component of red meat — carnitine, may increase the production of a compound linked with heart disease.

Heart disease is a serious medical condition for both men and women. Medical therapy for heart disease is expensive and may carry significant morbidity as well as mortality. Ideally, prevention is the best medicine. For decades, medical researchers have tried to identify those food items that increase the risk of heart disease. To a great extent, we have been very successful in determining what foods increase the risk of heart disease and what foods lower the risk of heart disease. However, we have also made some stunning errors.

For example, saturated fat and cholesterol were believed to be bad for the heart. In response to this, we began to recommend margarine and endorse low-fat diets. Then we found out that there's more to the etiology of heart disease than saturated fat and cholesterol. In addition, margarine wasn't all that good and some low-fat dietary approaches have their own drawbacks.

There is an increasing body of research exploring the health benefits of good bowel bacteria. Personally, I believe this is a wonderful area of research with great potential of inexpensively preventing not only heart disease, but many other chronic illnesses.

The study in question, published in the medical journal Nature Medicine, suggested that type of bacteria in the bowel may actually increase the risk of heart disease. It was hypothesized that the wrong kind of bacteria process a specific compound, carnitine, into a potentially heart toxic compound trimethylamine oxide.

What they attempted to demonstrate is that carnitine eaten by vegetarians is processed very differently than carnitine eaten by people who eat meat and vegetables. However, the study was flawed in so many ways — far too many for me to elucidate them in this column — that any conclusions linking red meat or carnitine to an increased production of TMAO (and ultimately coronary artery disease) would be fanciful.

Carnitine is composed of two amino acids, lysine and methionine. It aids in the conversion of fatty acids and energy and is absolutely necessary for our health. It is not only found in red meat, but also in many vegetables. Contemporary medical research involving heart health has suggested that carnitine may reduce the risk of coronary artery disease and death by at least 27 percent. In addition, one recent study suggested that carnitine may improve function in those with Lou Gehrig's disease.

To suggest that dietary carnitine increases risk of heart disease would be a gross simplification and misinterpretation of a very small and flawed study. Much more medical research is needed before any conclusions can be made.

Ÿ Patrick B. Massey, M.D., Ph.D is medical director for complementary and alternative medicine for the Alexian Brothers Health System. His website is www.alt-med.org.