A seven-year clinical trial of over 1,000 coronary heart disease patients found that people with higher spikes in blood-borne bacterial toxins (LPS) after eating faced a 42% greater risk of suffering another major cardiovascular event. The Mediterranean diet reduced these toxic spikes more effectively than a standard low-fat diet, partly by reshaping the gut microbiome toward a healthier profile. This research suggests that measuring postprandial endotoxemia — essentially how much bacterial toxin leaks into circulation after a meal — could become a practical tool for personalizing secondary cardiovascular prevention, and that choosing the Mediterranean diet over a low-fat approach may be a meaningful protective strategy for heart disease patients.
