The recommended diet for leaky gut treatment. Which foods and food components can boost the integrity of our intestinal barrier?
How to Heal a Leaky Gut with Diet
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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
Our intestinal tract is the largest barrier between us and the environment. More than what we touch or breathe, what we eat is our largest exposure to the outside world. Normally, our entire gastro-intestinal tract is impervious to what is inside of it, allowing our body to pick and choose what comes in or out. But there are things that may make our gut leaky, and chief among them is our diet.
What happens is the Standard American Diet can cause gut dysbiosis, meaning a disruption in our gut microbiome, which can lead to intestinal inflammation and a leaky intestinal barrier. Then, tiny bits of undigested food, microbes, and toxins can slip uninvited through our gut lining into our bloodstream, and trigger chronic systemic inflammation.
To avoid this dysbiosis and intestinal inflammation, plants should be preferred. Vegetarian diets gut bacteria are associated with intestinal microbiome balance, high bacterial biodiversity, and integrity of the intestinal barrier. They tend to suffer from markedly less uremic toxins, like indole and p-cresol, and because fiber is the primary food for our gut microbiome, the gut bacteria of those eating plant-based diets produce more of the good stuff: short-chain fatty acids that fulfill a protective and nourishing role for the cells lining our gut, ensuring the preservation of the intestinal barrier. Plant fiber is of prime importance to the preservation of the intestinal barrier integrity, but you can’t know for sure, until you put it to the test.
People were given whole grains, beans and lentils, fruits, vegetables, and nuts and seeds, and got a significant reduction in zonulin levels.
Zonulin is a protein responsible for the disassembling of the tight junctions between gut lining cells, and so it’s a biomarker that reflects an impairment of the intestinal barrier. In other words, zonulin is considered to be a useful marker of a leaky gut. But since adding all those plants seemed to lower levels, that may imply that appropriate fiber intake helps to maintain the proper structure and function of the intestinal barrier. But whole healthy plant foods have a lot more than fiber. How do we know it’s the fiber? And the study didn’t even have a control group. That’s why they say gut permeability might be improved by dietary fiber. To prove cause and effect, it’d be nice to have a randomized double-blind crossover study where you compare the effect of the same food with or without fiber––and here we go.
People were randomized to pasta with or without added fiber, and there was a significant drop in zonulin levels in the added-fiber group. So, fiber does indeed appear to improve gut leakiness.
Any plant foods in particular that may help? Curcumin, the yellow pigment in the spice turmeric, can help prevent the intestinal damage done by ibuprofen-type drugs, but that’s in rats. Similar protection was noted for the broccoli compound sulforaphane, but that was in mice. No human studies on broccoli yet, but there was a study on three days of the equivalent of about two to three teaspoons a day of turmeric, which did reduce the gastrointestinal barrier damage caused by exercise. Less may work, too, but no smaller doses have been put to the test.
If you ask alternative medicine practitioners what treatments they use for a leaky gut, #1 on the list, after reducing alcohol consumption, is zinc.
Zinc doesn’t just protect against aspirin-like drug-induced damage in rats; when put to the test in a randomized trial of humans, the same thing was found. The NSAID drug indomethacin caused a three-fold rise in gut permeability, as one would expect from that class of drugs, but when they were also taking zinc, this prevented the rise in permeability, strongly suggesting a small intestinal protective effect. The dose they used was massive, though: 75mg a day is nearly twice the tolerable upper limit for zinc. What about getting zinc just at regular food doses?
A significant improvement in gut leakiness even with a dose of just three milligrams of zinc, suggesting that even relatively low zinc supplementation may work. You can get three extra mg of zinc in your daily diet eating a cup of cooked lentils.
Please consider volunteering to help out on the site.
- Rohr MW, Narasimhulu CA, Rudeski-Rohr TA, Parthasarathy S. Negative effects of a high-fat diet on intestinal permeability: a review. Adv Nutr. 2020;11(1):77-91.
- Riccio P, Rossano R. Undigested food and gut microbiota may cooperate in the pathogenesis of neuroinflammatory diseases: a matter of barriers and a proposal on the origin of organ specificity. Nutrients. 2019;11(11):2714.
- Leech B, McIntyre E, Steel A, Sibbritt D. Risk factors associated with intestinal permeability in an adult population: A systematic review. Int J Clin Pract. 2019;73(10):e13385.
- Wan Y, Wang F, Yuan J, et al. Effects of dietary fat on gut microbiota and faecal metabolites, and their relationship with cardiometabolic risk factors: a 6-month randomised controlled-feeding trial. Gut. 2019;68(8):1417-29.
- Krawczyk M, Maciejewska D, Ryterska K, et al. Gut permeability might be improved by dietary fiber in individuals with nonalcoholic fatty liver disease (Nafld) undergoing weight reduction. Nutrients. 2018;10(11):1793.
- Pacifico L, Bonci E, Marandola L, Romaggioli S, Bascetta S, Chiesa C. Increased circulating zonulin in children with biopsy-proven nonalcoholic fatty liver disease. World J Gastroenterol. 2014;20(45):17107-14.
- Russo F, Linsalata M, Clemente C, et al. Inulin-enriched pasta improves intestinal permeability and modifies the circulating levels of zonulin and glucagon-like peptide 2 in healthy young volunteers. Nutr Res. 2012;32(12):940-6.
- Singh DP, Borse SP, Rana R, Nivsarkar M. Curcumin, a component of turmeric, efficiently prevents diclofenac sodium-induced gastroenteropathic damage in rats: A step towards translational medicine. Food Chem Toxicol. 2017;108(Pt A):43-52.
- Yanaka A, Sato J, Ohmori S. Sulforaphane protects small intestinal mucosa from aspirin/NSAID-induced injury by enhancing host defense systems against oxidative stress and by inhibiting mucosal invasion of anaerobic enterobacteria. Curr Pharm Des. 2013;19(1):157-62.
- Szymanski MC, Gillum TL, Gould LM, Morin DS, Kuennen MR. Short-term dietary curcumin supplementation reduces gastrointestinal barrier damage and physiological strain responses during exertional heat stress. J Appl Physiol (1985). 2018;124(2):330-40.
- Leech B, Schloss J, Steel A. Treatment interventions for the management of intestinal permeability: a cross-sectional survey of complementary and integrative medicine practitioners. J Altern Complement Med. 2019;25(6):623-36.
- Sivalingam N, Pichandi S, Chapla A, Dinakaran A, Jacob M. Zinc protects against indomethacin-induced damage in the rat small intestine. Eur J Pharmacol. 2011;654(1):106-16.
- Mahmood A, FitzGerald AJ, Marchbank T, et al. Zinc carnosine, a health food supplement that stabilises small bowel integrity and stimulates gut repair processes. Gut. 2007;56(2):168-75.
- Institute of Medicine (US) Panel on Micronutrients. Dietary Reference Intakes for Vitamin a, Vitamin k, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. National Academies Press (US); 2001.
- Tran CD, Hawkes J, Graham RD, et al. Zinc-fortified oral rehydration solution improved intestinal permeability and small intestinal mucosal recovery. Clin Pediatr (Phila). 2015;54(7):676-82.
Video production by Glass Entertainment
Motion graphics by Avo Media
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
Our intestinal tract is the largest barrier between us and the environment. More than what we touch or breathe, what we eat is our largest exposure to the outside world. Normally, our entire gastro-intestinal tract is impervious to what is inside of it, allowing our body to pick and choose what comes in or out. But there are things that may make our gut leaky, and chief among them is our diet.
What happens is the Standard American Diet can cause gut dysbiosis, meaning a disruption in our gut microbiome, which can lead to intestinal inflammation and a leaky intestinal barrier. Then, tiny bits of undigested food, microbes, and toxins can slip uninvited through our gut lining into our bloodstream, and trigger chronic systemic inflammation.
To avoid this dysbiosis and intestinal inflammation, plants should be preferred. Vegetarian diets gut bacteria are associated with intestinal microbiome balance, high bacterial biodiversity, and integrity of the intestinal barrier. They tend to suffer from markedly less uremic toxins, like indole and p-cresol, and because fiber is the primary food for our gut microbiome, the gut bacteria of those eating plant-based diets produce more of the good stuff: short-chain fatty acids that fulfill a protective and nourishing role for the cells lining our gut, ensuring the preservation of the intestinal barrier. Plant fiber is of prime importance to the preservation of the intestinal barrier integrity, but you can’t know for sure, until you put it to the test.
People were given whole grains, beans and lentils, fruits, vegetables, and nuts and seeds, and got a significant reduction in zonulin levels.
Zonulin is a protein responsible for the disassembling of the tight junctions between gut lining cells, and so it’s a biomarker that reflects an impairment of the intestinal barrier. In other words, zonulin is considered to be a useful marker of a leaky gut. But since adding all those plants seemed to lower levels, that may imply that appropriate fiber intake helps to maintain the proper structure and function of the intestinal barrier. But whole healthy plant foods have a lot more than fiber. How do we know it’s the fiber? And the study didn’t even have a control group. That’s why they say gut permeability might be improved by dietary fiber. To prove cause and effect, it’d be nice to have a randomized double-blind crossover study where you compare the effect of the same food with or without fiber––and here we go.
People were randomized to pasta with or without added fiber, and there was a significant drop in zonulin levels in the added-fiber group. So, fiber does indeed appear to improve gut leakiness.
Any plant foods in particular that may help? Curcumin, the yellow pigment in the spice turmeric, can help prevent the intestinal damage done by ibuprofen-type drugs, but that’s in rats. Similar protection was noted for the broccoli compound sulforaphane, but that was in mice. No human studies on broccoli yet, but there was a study on three days of the equivalent of about two to three teaspoons a day of turmeric, which did reduce the gastrointestinal barrier damage caused by exercise. Less may work, too, but no smaller doses have been put to the test.
If you ask alternative medicine practitioners what treatments they use for a leaky gut, #1 on the list, after reducing alcohol consumption, is zinc.
Zinc doesn’t just protect against aspirin-like drug-induced damage in rats; when put to the test in a randomized trial of humans, the same thing was found. The NSAID drug indomethacin caused a three-fold rise in gut permeability, as one would expect from that class of drugs, but when they were also taking zinc, this prevented the rise in permeability, strongly suggesting a small intestinal protective effect. The dose they used was massive, though: 75mg a day is nearly twice the tolerable upper limit for zinc. What about getting zinc just at regular food doses?
A significant improvement in gut leakiness even with a dose of just three milligrams of zinc, suggesting that even relatively low zinc supplementation may work. You can get three extra mg of zinc in your daily diet eating a cup of cooked lentils.
Please consider volunteering to help out on the site.
- Rohr MW, Narasimhulu CA, Rudeski-Rohr TA, Parthasarathy S. Negative effects of a high-fat diet on intestinal permeability: a review. Adv Nutr. 2020;11(1):77-91.
- Riccio P, Rossano R. Undigested food and gut microbiota may cooperate in the pathogenesis of neuroinflammatory diseases: a matter of barriers and a proposal on the origin of organ specificity. Nutrients. 2019;11(11):2714.
- Leech B, McIntyre E, Steel A, Sibbritt D. Risk factors associated with intestinal permeability in an adult population: A systematic review. Int J Clin Pract. 2019;73(10):e13385.
- Wan Y, Wang F, Yuan J, et al. Effects of dietary fat on gut microbiota and faecal metabolites, and their relationship with cardiometabolic risk factors: a 6-month randomised controlled-feeding trial. Gut. 2019;68(8):1417-29.
- Krawczyk M, Maciejewska D, Ryterska K, et al. Gut permeability might be improved by dietary fiber in individuals with nonalcoholic fatty liver disease (Nafld) undergoing weight reduction. Nutrients. 2018;10(11):1793.
- Pacifico L, Bonci E, Marandola L, Romaggioli S, Bascetta S, Chiesa C. Increased circulating zonulin in children with biopsy-proven nonalcoholic fatty liver disease. World J Gastroenterol. 2014;20(45):17107-14.
- Russo F, Linsalata M, Clemente C, et al. Inulin-enriched pasta improves intestinal permeability and modifies the circulating levels of zonulin and glucagon-like peptide 2 in healthy young volunteers. Nutr Res. 2012;32(12):940-6.
- Singh DP, Borse SP, Rana R, Nivsarkar M. Curcumin, a component of turmeric, efficiently prevents diclofenac sodium-induced gastroenteropathic damage in rats: A step towards translational medicine. Food Chem Toxicol. 2017;108(Pt A):43-52.
- Yanaka A, Sato J, Ohmori S. Sulforaphane protects small intestinal mucosa from aspirin/NSAID-induced injury by enhancing host defense systems against oxidative stress and by inhibiting mucosal invasion of anaerobic enterobacteria. Curr Pharm Des. 2013;19(1):157-62.
- Szymanski MC, Gillum TL, Gould LM, Morin DS, Kuennen MR. Short-term dietary curcumin supplementation reduces gastrointestinal barrier damage and physiological strain responses during exertional heat stress. J Appl Physiol (1985). 2018;124(2):330-40.
- Leech B, Schloss J, Steel A. Treatment interventions for the management of intestinal permeability: a cross-sectional survey of complementary and integrative medicine practitioners. J Altern Complement Med. 2019;25(6):623-36.
- Sivalingam N, Pichandi S, Chapla A, Dinakaran A, Jacob M. Zinc protects against indomethacin-induced damage in the rat small intestine. Eur J Pharmacol. 2011;654(1):106-16.
- Mahmood A, FitzGerald AJ, Marchbank T, et al. Zinc carnosine, a health food supplement that stabilises small bowel integrity and stimulates gut repair processes. Gut. 2007;56(2):168-75.
- Institute of Medicine (US) Panel on Micronutrients. Dietary Reference Intakes for Vitamin a, Vitamin k, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. National Academies Press (US); 2001.
- Tran CD, Hawkes J, Graham RD, et al. Zinc-fortified oral rehydration solution improved intestinal permeability and small intestinal mucosal recovery. Clin Pediatr (Phila). 2015;54(7):676-82.
Video production by Glass Entertainment
Motion graphics by Avo Media
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Title
How to Heal a Leaky Gut with Diet
LicenseCreative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)
Content URLDoctor's Note
For more on preventing gut dysbiosis, check out Gut Dysbiosis: Starving Our Microbial Self.
If you missed the previous video, see Avoid These Foods to Prevent a Leaky Gut.
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