Fatty foods may trigger ‘leaky gut’ effect

Snacking throughout the day might not be the best way to help control type 2 diabetes, especially if the snacks contain much fat.

A high-fat meal in people with diabetes and impaired glucose tolerance appears to trigger the passage of bacterial endotoxins through the intestinal wall, adding to the load of inflammatory cytokines that have already been implicated in the disease.

Because people with diabetes are often counseled to consume food in smaller but more frequent meals, this “leaky gut” effect could be compounded by this eating pattern, building up more and more of the lipopolysaccharide endotoxin — the main component of a gram-negative bacterium’s cell membrane — in the blood.

“Data highlight that these people can be exposed to as much as 126% more circulating, lipopolysaccharide after a high-fat meal,” said the University of Warwick (England). “A continual grazing routine will cumulatively promote their pathogenic condition more rapidly than other individuals due to the elevated exposure to endotoxin.”

Tested this hypothesis in 54 participants (9 non-obese controls, 15 obese subjects, 12 subjects with impaired glucose tolerance, and 18 subjects with type 2 diabetes).

The mean body mass index was 25 kg/m2 in the normal controls, 33 in the obese subject, 32 in those with impaired glucose tolerance, and 30 in those with type 2 diabetes.

Each of the subjects ate a high-fat meal composed of 75g of fat, 5g of carbohydrate, and 6g of protein after an overnight fast. Blood was drawn at baseline and at 1, 2, 3, and 4 hours after eating.

At baseline, lipopolysaccharide was already significantly higher in obese subjects and in those with diabetes and impaired glucose tolerance (mean, 5.7 endotoxin units [EU]/mL), compared with the control subjects (mean, 3.5 EU/mL).

The high-fat meal caused a significant jump in lipopolysaccharides among those with diabetes and impaired glucose tolerance. By 4 hours, those with diabetes had a mean lipopolysaccharide load of 17 EU/mL. The load increased to 8 EU/mL in those with impaired glucose tolerance. At 4 hours after the meal, the obese controls had a non-significant increase but still had a 22% more circulating lipopolysaccharide than the normal controls. This group had a slight, non-significant increase in the endotoxin.

Triglycerides followed a parallel course, increasing over the 4-hour period significantly more in those with type 2 diabetes, impaired glucose tolerance, and obesity, compared with the controls.

“A high-fat diet raises endotoxin and triglycerides over 4 hours, and this increase could be further compounded by subsequent eating during the day, potentially resulting in continually raised levels.” “The fasting studies that do might actually be masking the true impact of these circulating endotoxins and lipids.”

Research confirms that obesity, diabetes and cardiovascular disease all have an element of systemic inflammation. That her research suggests this inflammatory insult could arise, in part, from a compromised gut mucosa that allows bacterial endotoxins to enter the circulation and initiate a systemic inflammatory response.