How to help leaky gut naturally
Leaky gut aka intestinal permeability (in the science world) describes a gut that allows bacterial byproducts and toxins to 'leak' into the bloodstream, where they can travel to various parts of the body.
Its a relatively new area of research - while we know it exists and is harmful, we're still discovering exactly how it's linked to various diseases.
Leaky gut is influenced both two things - how well the protective mucus layers of the gut work, and the gut microbiome inside our large intestine.
Certain bacteria increase leaky gut via damaging the gut wall and creating inflammation , while others reduce it, by producing compounds called short chain fatty acids (SCFA) which both feed gut wall cells, and promote the growth of other healthy bacteria.
One SCFA in particular (butyrate) provides more than 70 percent of the energy consumed by to colonocytes, the cells that line the colon.
At the most basic level, this 'leakiness' has been shown to trigger off a process of chronic inflammation, which is thought to be what creates disease
Many diseases are blamed on leaky gut, however the research is very new and not conclusive in many areas
Despite this, given the importance of gut health overall, it makes sense to avoid it if possible, especially as this involves steps good for overall health!
Science shows that 'leakiness' can be caused by :
✔️Diet - high fat meals cause a prolonged increase in 'leakiness' after meals. These also promote the growth of bacteria that damage the gut wall, and reduce protective mucus
✔️ High blood sugars - this increases 'leakiness' within gut wall cells, via intracellular transport
✔️Endurance exercise - high intensity exercise causes a temporary increase in leakiness, especially endurance exercise. However regular exercise actually reduces leakiness - the key is allowing adequate rest periods for the gut to recover and 'build up' tolerance
✔️ Chronic or severe stress may alter gut permeability- it's also strongly linked to an unhealthy gut biome as it promotes the growth of ‘bad’ bacteria
✔️Drugs ie nonsteriodal anti inflammatories, hormonal contraceptives, antibiotics, protein pump inhibitors (ie omeprazole), and some chemotherapy drugs (note - please do not ever stop longterm meds without consulting your doctor)
✔️Alcohol
✔️Dietary emulsifiers - these are common food additives, and are shown to damage and alter function of the gut mucus layer. They are strongly linked with IBD in particular
So what can you do to treat leaky gut?
The key to treating leaky gut, is minimising or avoiding things that promote it as much as possible (as above), as well as including things in your diet and lifestyle to try to help it.
The following steps can help:
✔️ Try boost your fibre intake and diversity. Diets high in fibre promote a healthy gut microbiome, and improve the production of mucus gut layers as well promoting intestinal wall health. Whole grains are the main sources of fermentable fiber, but non-gluten-containing sources include fruits and vegetables that provide such as apples, sunflower seeds, oats, onion, and potatoes (these provide prebiotics such as pectin, beta-glucan, inulin, and resistant starch - all of which are food for our microbiome)
Eating legumes may give additional benefits, and aiming for as much diversity of fibre sources (ie different high fibre foods and prebiotics) promotes the biggest gut biome diversity. Please see our post on fibre and gut health for more details
✔️ Reduce and manage stress as much as you are able to, and prioritise self care (see our ‘stress’ section for tips on this)
✔️Supplements :zinc carnitine, glutamine supplements, and omega 3 all have some evidence for helping reduce permeability (glutamine is an energy source for the cells of the large intestine and have the most research backing it), although these should be used in addition to lifestyle and diet strategies, rather than as a substitute
In particular, supplementing with omega 3 can help reduce leaky gut, especially when eating meals high in saturated fat.
✔️Interestingly, ketogenic diets don't seem to have the same negative effect on gut health as eating non ketogenic diets high in saturated fat - thought to be due to the ‘metabolic flexibility ‘of our gut microbiome (ie its ability to live off different foods during times of famine)
✔️Include polyphenols in your diet, these are antioxidant compounds found in brightly colored fruits and vegetables, that help our healthy butyrate producing gut bacteria and reduce gut inflammation. Cocoa and green tea in particular appear to be helpful for this.
✔️ Avoid high sugar diets - in mouse studies, diets high in sugar decrease diversity in gut microbiota, increase intestinal permeability, and lower the concentration of short-chain fatty acids
✔️ Aim to get regular moderate exercise (and ensuring adequate rest between if you do intense exercise)
✔️ Probiotics may help, in particular Saccharomyces boulaardii (a yeast) and Bifidobacterium
✔️Time restricted eating (having an overnight period of fasting for at least 12h) is shown to improve gut barrier function and gut microbiome diversity. It literally 'gives the gut a rest' to repair
Simple changes really can help!
Plöger, Svenja, Friederike Stumpff, Gregory B. Penner, Jörg-Dieter Schulzke, Gotthold Gäbel, Holger Martens, Zanming Shen, Dorothee Günzel, and Joerg R. Aschenbach. Microbial butyrate and its role for barrier function in the gastrointestinal tract Annals of the New York Academy of Sciences 1258, no. 1 (June 2012): 52–59. https://doi.org/10.1111/j.1749-6632.2012.06553.x.
Bernardi, Stefano, Cristian Del Bo’, Mirko Marino, Giorgio Gargari, Antonio Cherubini, Cristina Andrés-Lacueva, Nicole Hidalgo-Liberona, et al. Polyphenols and Intestinal Permeability: Rationale and Future Perspectives Journal of Agricultural and Food Chemistry 68, no. 7 (June 2019): 1816–29. https://doi.org/10.1021/acs.jafc.9b02283.K
Karczewski, Jurgen, Freddy J. Troost, Irene Konings, Jan Dekker, Michiel Kleerebezem, Robert-Jan M. Brummer, and Jerry M. Wells. Regulation of human epithelial tight junction proteins by Lactobacillus plantarum in vivo and protective effects on the epithelial barrier American Journal of Physiology-Gastrointestinal and Liver Physiology 298, no. 6 (June 2010): G851–G859. https://doi.org/10.1152/ajpgi.00327.2009.
Keirns, Bryant H., Nicholas A. Koemel, Christina M. Sciarrillo, Kendall L. Anderson, and Sam R. Emerson. Exercise and intestinal permeability: another form of exercise-induced hormesis? American Journal of Physiology-Gastrointestinal and Liver Physiology 319, no. 4 (October 2020): G512–G518. https://doi.org/10.1152/ajpgi.00232.2020.
Hu, Dandan, Yilei Mao, Gang Xu, Wenjun Liao, Huayu Yang, and Hongbing Zhang. Gut flora shift caused by time-restricted feeding might protect the host from metabolic syndrome, inflammatory bowel disease and colorectal cancer Translational Cancer Research 7, no. 5 (October 2018): 1282–89. https://doi.org/10.21037/tcr.2018.10.18.
Mailing, Lucy J., Jacob M. Allen, Thomas W. Buford, Christopher J. Fields, and Jeffrey A. Woods. Exercise and the Gut Microbiome: A Review of the Evidence, Potential Mechanisms, and Implications for Human Health Exercise and Sport Sciences Reviews 47, no. 2 (April 2019): 75–85. https://doi.org/10.1249/jes.000000000000018
Costantini, Lara, Romina Molinari, Barbara Farinon, and Nicolò Merendino. Impact of Omega-3 Fatty Acids on the Gut Microbiota International Journal of Molecular Sciences 18, no. 12 (December 2017): 2645. https://doi.org/10.3390/ijms18122645.
Lyte, Joshua M., Nicholas K. Gabler, and James H. Hollis. Postprandial serum endotoxin in healthy humans is modulated by dietary fat in a randomized, controlled, cross-over study Lipids in Health and Disease 15, no. 1 (November 2016). https://doi.org/10.1186/s12944-016-0357-6.
Cândido, Thalita Lin Netto, Laís Emilia da Silva, Juliana Ferreira Tavares, Ana Carolina Muller Conti, Rômulo Augusto Guedes Rizzardo, and Rita de Cássia Gonçalves Alfenas. Effects of dietary fat quality on metabolic endotoxaemia: a systematic review British Journal of Nutrition 124, no. 7 (May 2020): 654–67. https://doi.org/10.1017/s0007114520001658.
Serhan, Charles N., and Bruce D. Levy.
Sholl, Jonathan, Lucy J. Mailing, and Thomas R. Wood. Reframing Nutritional Microbiota Studies To Reflect an Inherent Metabolic Flexibility of the Human Gut: a Narrative Review Focusing on High-Fat Diets mBio Edited by Danielle A. Garsin. 12, no. 2 (April 2021). https://doi.org/10.1128/mbio.00579-21.
Singh, Amit Kumar, Célia Cabral, Ramesh Kumar, Risha Ganguly, Harvesh Kumar Rana, Ashutosh Gupta, Maria Rosaria Lauro, Claudia Carbone, Flávio Reis, and Abhay K. Pandey. Beneficial Effects of Dietary Polyphenols on Gut Microbiota and Strategies to Improve Delivery Efficiency Nutrients 11, no. 9 (September 2019): 2216. https://doi.org/10.3390/nu11092216.
Peron, Gregorio, Giorgio Gargari, Tomás Meroño, Antonio Miñarro, Esteban Vegas Lozano, Pol Castellano Escuder, Raúl González-Domínguez, et al. Crosstalk among intestinal barrier, gut microbiota and serum metabolome after a polyphenol-rich diet in older subjects with leaky gut : The MaPLE trial Clinical Nutrition 40, no. 10 (October 2021): 5288–97. https://doi.org/10.1016/j.clnu.2021.08.027.
Laffin, Michael, Robert Fedorak, Aiden Zalasky, Heekuk Park, Amanpreet Gill, Ambika Agrawal, Ammar Keshteli, Naomi Hotte, and Karen L. Madsen. A high-sugar diet rapidly enhances susceptibility to colitis via depletion of luminal short-chain fatty acids in mice Scientific Reports 9, no. 1 (August 2019). https://doi.org/10.1038/s41598-019-48749-2.