**Gut Microbiota and CVD**

Recent studies have suggested that the gut microbiota is associated with a variety of diseases, including CVD. Although they are also affected by some genetic factors, the main factor contributing to our microbiota should be our diet. In this Special Issue, Bin-Jumah et al. nicely summarized recent findings on this matter [18]. Investigations have indicated that the gut microbiota is involved in the pathogenesis of CVD and can be considered as one of its causative factors. The gut microbiota appears to have multiple functions in humans, including energy production, maintaining intestinal homeostasis, enhancing the absorption of drugs, immune responses, defense from pathogens, and the production of microbial products, such as vitamin K, nitric oxide, trimethylamine-N-oxide (TMAO), and lipopolysaccharides. Among these properties, Bin-Jumah et al. summarized the association between TMAO and heart failure and showed that TMAO, a metabolite of the gut microbiota, may have interesting perspectives regarding how this particular metabolite contributes to the development of heart failure. They also suggested that the excessive intake of the choline of L-carnitine, which contains an intermediate precursor (TMA) of TMAO, may be harmful, especially among elderly people who have dysbiosis and muscle disorders.

#### **Obesity and CVD**

We know very well that obesity, which is greatly affected by our dietary habits, is also a major risk factor for CVD [1]. However, there is a huge gap between Asians and Caucasians in terms of the definition of "obesity". In addition, there is a paucity of data on this subject in the Asian population, where the average body mass index is much lower than that of the Caucasian population. In this Special Issue, Shiozawa et al. conducted analyses investigating an association between body mass index and stroke in the Japanese population using large health insurance databases comprising more than two million individuals. They found that overweight and obesity were associated with a greater risk of stroke and ischemic stroke in both men and women [19]. They also found that underweight, overweight, and obesity were associated with a higher risk of hemorrhagic stroke only in men. Thus, it seems that there are some gender gaps in terms of the effects of weight on CVD risk.
