Do all diseases really start in the intestine? The Surprising Truth

"Every disease begins in the intestine." - Hippocrates

Hippocrates, the father of modern medicine, was a wise man.

Much of his wisdom, which is now more than 2,000 years old, has withstood the test of time.

The above quote is one of them.

Obviously not everyone The disease begins in the intestine. For example, this does not apply to genetic diseases.

However, there is evidence that many chronic metabolic diseases, in fact, begin in the intestine.

This has a lot to do with the different intestinal bacteria that reside in our digestive tract, as well as with the integrity of the intestinal lining (1).

According to numerous studies, unwanted bacterial products called endotoxins can sometimes "leak" and enter the bloodstream (2).

When this happens, our immune system recognizes these foreign molecules and makes an attack against them, resulting in a chronic inflammatory response (3).

This diet-induced inflammation can trigger insulin resistance (conduction of type 2 diabetes), resistance to leptin (causing obesity), fatty liver disease, and has been strongly linked to many of the world's most serious diseases ( 4, 5, 6).

Keep in mind that this is a research area that is developing rapidly. No clear answers have yet been discovered, and the science is likely to look completely different in a few years.

What is inflammation and why should you care

Just to make sure we're all on the same page, I want to briefly explain what inflammation is.

I will not go into much detail, because inflammation is extremely Complicated.

It involves dozens of cell types and hundreds of different signaling molecules, all of which communicate in an immensely complex way.

In short, inflammation is the response of the immune system to foreign invaders, toxins or cell lesions.

The purpose of inflammation is to affect the function of immune cells, blood vessels and signaling molecules, initiate an attack against foreign invaders or toxins and begin to repair damaged structures.

We are all familiar with acute inflammation (short-term).

For example, if an insect stings you or if you hit your big toe on the door, you will become inflamed.

The area will turn red, hot and painful. This is the inflammation at play.

Inflammation is generally considered something good. Without it, pathogens such as bacteria and viruses could easily take over our bodies and kill us.

However, there is another type of inflammation that can be harmful, because it is improperly implemented against the cells of the body (7).

This is a type of inflammation that is active. all the time, and it can be present in your entire body. If it is often called chronic inflammation, low-grade inflammation or systemic inflammation (8).

For example, your blood vessels (such as your coronary arteries) may be inflamed, as may structures in your brain (9, 10).

Now it is believed that chronic and systemic inflammation is one of the Leader drivers of some of the most serious diseases in the world (11).

This includes obesity, heart disease, type 2 diabetes, metabolic syndrome, Alzheimer's disease, depression and many others (12, 13, 14, 15, 16).

However, it is not known exactly what causes the inflammation in the first place.

Bottom line: Inflammation is the response of the immune system to foreign invaders, toxins and cellular lesions. It is believed that chronic inflammation, which affects the entire body, leads to many deadly diseases.

Endotoxins: what happens in the intestine must remain in the intestine

There are many trillions of bacteria in the intestine, collectively known as the "intestinal flora" (17).

Some of these bacteria are friendly, others are not.

What we do know is that the number and composition of intestinal bacteria can greatly affect our health, both physical and mental (18).

Some of the bacteria in the intestine contain compounds called lipopolysaccharides (LPS), also known as endotoxins (19).

These are large molecules found in the cell walls of bacteria called gram-negative bacteria (20).

These substances can cause an immune reaction in animals. During an acute bacterial infection, they can cause fever, depression, muscle aches and even septic shock in severe cases (21).

However, what is not known is that sometimes these substances can "leak" from the intestine into the blood stream, either constantly or just after meals (22, 23).

When this happens, endotoxins activate immune cells through a receptor called toll-like receptor 4, or TLR-4 (24, 25).

The amounts are too small to cause symptoms of an infection (fever, etc.), but the amounts are large enough to stimulate a chronic inflammatory response, which can wreak havoc over time (years, decades).

Therefore, increased intestinal permeability, often termed "leaky gut", may be the key mechanism behind chronic inflammation induced by diet.

When the levels of endotoxins in the blood increase to levels that are 2 to 3 times higher than normal, this condition is known as "metabolic endotoxemia" (26).

Endotoxins can be transported into the bloodstream along with dietary fat, or they can leak through the tight junctions that are supposed to prevent unwanted substances from crossing the intestinal lining (27, 28).

Bottom line: Some bacteria in the gut contain cell wall components called lipopolysaccharides (LPS) or endotoxins. These substances can leak into the body and trigger an inflammatory response.

An unhealthy diet can cause endotoxemia, which can be the starting point of a chronic disease

Many of the studies on endotoxemia have injected endotoxins into the bloodstream of test animals and humans.

These studies have shown that this leads to the rapid onset of insulin resistance, a key feature of the metabolic syndrome and type 2 diabetes (29).

This also leads to an immediate increase in inflammatory markers in the blood, indicating that an inflammatory response has been activated (30).

Interestingly, studies have also shown that an unhealthy diet can cause endotoxin levels in the blood to increase.

Most of these studies were done in test animals, but there are also some studies in humans.

According to a study in humans, comparing a "Western" diet with a "prudent" low-fat diet (31):

"The placement of 8 healthy subjects on a Western-style diet for 1 month induced a 71% increase in plasma levels of endotoxin activity (endotoxemia), while a prudent style diet reduced levels by 31%."

There are also numerous studies in test animals, suggesting that a long-term "high-fat" diet can cause endotoxemia and the resulting inflammation, insulin resistance, obesity and metabolic disease (26, 32, 33).

Numerous studies in humans have also shown that endotoxin levels increase after eating an unhealthy meal. This has been observed with pure cream and with meals high in fat and moderate fats (22, 34, 35, 36, 37).

Most "high-fat" diets / meals also contained refined carbohydrates and processed ingredients, so these results should not be generalized to a real diet based on low-carbohydrate foods that include a lot of fiber.

Some researchers believe that refined carbohydrates increase endotoxin-producing bacteria, as well as intestinal permeability, exerting a "double hit" on exposure to endotoxins (38).

There is also a long-term study in monkeys that shows that a diet high in refined fructose can cause this (39).

Gluten, through its effects on a signaling molecule called zonulin, can also increase intestinal permeability (40, 41).

At the end of the day, it is currently unknown what part of the diet causes endotoxemia.

It appears to be multifactorial, involving both the dietary components and the different bacteria residing in the gut, as well as many other factors.

Bottom line: Studies in both animals and humans have shown that an unhealthy diet can increase the amount of endotoxins found in the bloodstream, which can lead to metabolic disease.

Bring the message home

Unfortunately, the inflammation is incredibly complex and the way it is linked to the diet is just beginning to be explored.

No single dietary agent has been identified, and it is likely that it is the "totality" of the diet and lifestyle that affects it.

I would like to be able to provide a list of foods to eat, or foods and ingredients to avoid, or supplements to take. But science is simply not there yet.

The best thing is to live a healthy lifestyle, with a lot of exercise and a good sleep.

A real diet based on foods with a lot of prebiotic fiber is critical, with an emphasis on minimizing processed junk foods.

A probiotic supplement may also be useful, and some studies show that probiotics can help reduce endotoxemia and the resulting inflammation (42).

Probiotic foods, such as yogurt with active or live cultures, kefir and sauerkraut, can also help.

At the end of the day, the inflammation caused by bacterial endotoxins can be the "missing link" between an unhealthy diet, obesity and all the chronic metabolic diseases that are killing us by the millions.

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