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Neuropharmacology 85 , 166177 (2014)

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The subsequent TNF receptor-1-mediated activation of the myosin light-chain kinase in the intestinal epithelial cells leads to loss of epithelial tight junction proteins [20] contributing to increased intestinal permeability [156]

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Bacteria in the digestive tract get hold of the carnitine we eat and convert it into trimethylamine-N-oxide (TMAO), and it is high levels of TMAO that appear to do the dirty work, enabling cholesterol to burrow into artery walls and build up plaque