What is Post-Prandial Endotoxemia?

Why are its eff ects on the immune system becoming a leading cause of sudden death?

By Wendy Finkelstein Physician Assistant at Hippocrates Health Institute PA-C, MMS, FAAMFM Post-prandial Endotoxemia AKA “Metabolic Endotoxemia” (ME) is becoming increasingly more common. ME is essentially an exacerbation of the leaky gut process which activates the immune system and infl ammatory cascades in the body. In severe cases, ME can overwhelm the cardiovascular system and lead to death.

What is Metabolic Endotoxemia? to fi ve hours after eating an unhealthy Metabolic Endotoxemia, like leaky gut, can start as an acute, low grade, persistent, infl ammatory driver of many underlying diseases. When the mucosal barrier of the gut lining becomes permeable, increased meal. LPS symptoms, although many go unrecognized, aff ect approximately 50% of the Western population and it is caused simply by eating high fat and caloriecrammed processed foods. toxins from food enter the bloodstream. As a result, this can exacerbate food allergies and sensitivities, cause bloating, LPS-induced Endotoxemia is linked to • Leptin resistance and weight gain gas, diarrhea, and general malaise. • Chronic constipation Our microbiome is colonized with millions of widely varying bacteria. When our diets lack diversity and are high in processed food and saturated fat, overgrowth of • • • Mood disorders such as depression and anxiety Cognitive decline and memory issues Anorexia and other eating disorders unwanted strains of bacteria thrive. • Chronic pain These bacteria increase an infl ammatory mediator known as Lipopolysaccharide (LPS). While normal LPS levels keep our immune system primed and in check, • • • Parkinson’s and Alzheimer’s disease Low testosterone Autoimmune disease LPS can increase to dangerous levels up 16 | hippocratesinst.org | Immunity and well-being

Symptoms of Metabolic Endotoxemia include:

• Food sensitivities • Histamine intolerance • Nutrient defi ciencies (B12, ferritin/ iron, minerals, and fat soluble vitamins) • Autoimmune disease • Fatigue • Anxiety and depression • Weight gain • Hyperlipidemia and high triglycerides • Insulin resistance and diabetes • Infl ammation and pain

The presence of LPS in the body causes the same signaling factors as minor infl ammation which overtime increases your risk of chronic infl ammatory conditions such as:

• Cardiovascular disease • Diabetes • Obesity • Auto-immunity • Anxiety • Depression

How can you Prevent Metabolic Endotoxemia? 1. Eat a plant-based whole food diet

As simple as it sounds, eating a plantbased whole food diet with diversity can be a challenge in today’s fast-paced society. Polyphenol-rich plants, including fruits, vegetables, and nuts, are important components of a health-promoting diet; such foods and their component phytochemicals are known to have signifi cant prebiotic eff ects in humans. Polyphenols are poorly absorbed in the upper gastrointestinal tract, but do reach the colon to be fermented by bacteria, where they can enhance the growth of benefi cial microorganisms and infl uence the physiological sequel associated with metabolic endotoxemia. 1

2. Decrease stress

Unfortunately, our bodies have become adapted to high levels of stress and cortisol. This not only drives our cravings for sugar and saturated fat, but we barely even slow down enough to chew our food. Cortisol not only increases the tendency towards infl ammation, but it lowers our immune response and causes leaky gut. In order to stop this epidemic, we must slow down and be more mindful around food. We must chew and activate our own digestive enzymes. As mentioned earlier, a poor diet will naturally release more LPS (Lipopolysaccharides) into your digestive system. The now leaky barrier loses its immune surveillance allowing foreign food additives, preservatives, and undigested food to be absorbed.

3. Probiotics

Studies have shown that just 30 days of probiotic supplementation without any other lifestyle changes such as exercise or dietary changes, can reduce LPS-induced ME by up to 45%. Aside from the benefi ts of reducing ME symptoms, probiotics are helpful to the gut in many other ways. The most important function of a true probiotic is to: • Increase immunity. • Reduce the amount of gas and bloating. • Improve your bowel movements. • Reduce the infl ammatory eff ects of processed and fatty foods. • Improve gut health associated with an unhealthy diet.

4. Lactoferrin

This multifunctional protein can inhibit pathogens from securing to the host by binding to the lipopolysaccharide of the bacterial wall, ultimately resulting in bacterial cell lysis. Lactoferrin promotes the growth of benefi cial bacteria, such as Lactobacillus and Bifi dobacterium. Lactoferrin can both upregulate and downregulate the infl ammatory response. It can bind to lipopolysaccharides, and microbial signals present in the intestine and can block their attachment to toll-like receptors. 2

5. Glutamine

The amino acid glutamine is considered an important nutritional intervention for leaky gut because it plays a principal role in gastrointestinal function, in particular in the maintenance of the integrity of

Plant-based nutrition, specifi c micronutrient supplementation along with a lifestyle that rewards self-care, mindfulness, and meditation are the best predictors of longevity, free of disease.

the intestinal epithelium, and nutritional reduce the integrity of the intestinal depletion has been shown to result in epithelium and alter the immune responses. increased intestinal permeability and Zinc helps with villous atrophy, which is translocation of endotoxins. associated with leaky gut. Some evidence Supplementation with glutamine has also been shown to reduce endotoxemiainduced infl ammation. 3 from human studies has suggested that zinc supplementation alone, or as part of an integrated treatment, can reduce intestinal permeability and circulating endotoxins. 6. Berberine A quaternary ammonium salt, berberine has many known cardiovascular and gut Vitamin A helps to heal the tight junctions and improve the barrier function which decreases permeability. implications. It mitigates overgrowth of bacteria and high cholesterol through its inhibition of endotoxin-induced infl ammation. ME is, at its root cause, a condition of a poor microbiome. It causes a leaky permeable intestinal lining which actives the immune system. In some 7. Evidence-based interventions to reduce LPS-induced endotoxemia medical circles, it is considered to be the number one cause of morbidity and mortality worldwide. It has been linked • Physical exercise to the underlying cause of obesity, • • • Quercetin Curcumin Sulforaphanes heart disease, autoimmunity, diabetes, Alzheimer’s, and many other serious health conditions. Plant-based nutrition, specifi c micronutrient supplementation • Resveratrol along with a lifestyle that rewards self-care, • • EPA DHA omega fatty acids Bifi dobacteria sp. mindfulness, and meditation are the best predictors of longevity, free of disease. • Megaspore probiotic Wendy Finkelstein is a board certifi ed Physician Assistant. She is also a certifi ed psycho-spiritual life coach and 8. Zinc, magnesium, Vitamin A, and C All play a role in the microbiome and its role in infl ammation caused by endotoxins. a Fellow in Metabolic, Nutritional, Anti-Aging, and Functional Medicine. Wendy has a graduate degree in theology, extensive knowledge in exercise physiology, and has a Master’s degree in Medical Science. A defi ciency in zinc has been shown to 18 | hippocratesinst.org | Immunity and well-being

References

1. Cani PD, Bibiloni R Kraut C, et al. Changes in the gut microbiota control metabolic endotoxemia-induced infl ammation in high fat diet induced obesity and diabetes in mice, Diabetes, 2008;57 (6):1470-1481 2. https://www.sciencedirect.com/topics/neuroscience/ lactoferrin 3. https://www.researchgate.net/publication/319749744_ Nutritional_Management_of_Metabolic_Endotoxemia_A_ Clinical_Review

Additional information

Erridge C, Attina T, Spickett CM, et al. A high-fat meal induces low-grade endotoxemia: Evidence of a novel mechanism of postprandial infl ammation. Am J Clin Nutr. 2007;86(5):1286-1292 Ghanim H, Abuaysheh S, Sia CL, et al. Increase in plasma endotoxin concentrations and the expression of Toll-like receptors and suppressor of cytokine signaling-3 in mononuclear cells afer a high-fat, high-carbohydrate meal: Implications for insulin resistance. Diabetes Care. 2009;32(12):2281-228 Maes M, Kubera M, Leunis JC. The gut-brain barrier in major depression: Intestinal mucosal dysfunction with an increased translocation of LPS from gram negative enterobacteria (leaky gut) plays a role in the infl ammatory pathophysiology of depression. Neuro Endocrinol Lett. 2008;29(1):117-124 Pastor Rojo O, López San Román A, et al. Serum lipopolysaccharide-binding protein in endotoxemic patients with infl ammatory bowel disease. Infl ammatory Bowel Disease 2007;13(3):269-277 https://www.jillcarnahan.com/2018/04/30/what-ismetabolic-endotoxemia-a-toxic-overload-from-within/