Micronutrients & recovery
The presence of uncultured gut bacteria encoding the ismA gene (cholesterol dehydrogenase) metabolizes intestinal cholesterol into coprostanol, which is poorly absorbed, thereby significantly reducing both fecal and serum total cholesterol levels in humans.
This paper identifies a specific group of gut bacteria (encoding the ismA gene) that converts cholesterol into a form (coprostanol) that your body doesn't absorb, lowering your blood cholesterol. The effect is as strong as your genetic predisposition. While you cannot currently prescribe these specific uncultured bacteria, this highlights that your gut microbiome is a key lever for heart health. Future interventions may target these bacteria to lower cholesterol without drugs.
Individuals harboring coprostanol-forming microbes have significantly lower fecal cholesterol levels and lower serum total cholesterol with effects comparable to those attributed to variations in lipid homeostasis genes.
Why this rating
Strong mechanistic validation (enzyme characterization) and robust observational association in large human cohorts (HMP2, PRISM), though causal inference relies on correlation rather than randomized controlled trials of bacterial transplantation.
Source
Cholesterol Metabolism by Uncultured Human Gut Bacteria Influences Host Cholesterol Level
Douglas J. Kenny et al. · Cell Host & Microbe · 2020
DOI 10.1016/j.chom.2020.05.013
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