Healing leaky gut is a problem many with gut problems hope to solve. Unfortunately, most people have a skewed perspective on what leaky gut is.
Many think leaky gut is a syndrome that happens to someone. Consequently, in this paradigm, you need a cure.
But in many instances, leaky gut is simply a symptom of an underlying problem. This underlying problem may be something like inflammatory bowel syndrome.
However, in many instances, it’s a product of lifestyle. When you drink alcohol, you get leaky gut.
The standard Western diet contains many components that increase permeability. It also lacks components such as fiber that protect against it.
Circadian disruption, which can come from either shiftwork or social jet lag, also makes us more susceptible to leaky gut. In addition, sleep disturbances are also associated with leaky gut.
An interesting new study shows strong evidence that weight loss improves leaky gut in a dose dependent manner. In other words, each unit of weight loss corresponds to progressive improvements in leaky gut.
Healing leaky gut with weight loss: The mechanisms
This review gives us powerful evidence for the benefits of weight loss on leaky gut. Of the 17 studies they looked at, 14 showed improvement in leaky gut with weight loss, with one showing no change.
As far as reproducibility goes, it doesn’t get much better than that. Furthermore, there was a low risk of bias, and the studies were methodologically strong.
So what led to the improvements in intestinal permeability? What effect does weight loss have in healing leaky gut?
There are several potential mechanisms here in addition to an independent effect of weight loss:
- People often cut back on alcohol when they try to lose weight
- Calorie restriction reduces intestinal permeability, independent of weight loss
- Reduction in hyperglycemic events which may cause leaky gut
- Weight loss often leads to a shift to a more Mediterranean dietary pattern with components that reduce permeability
- Reductions in body fat reduce systemic inflammation that reinforces leaky gut
- Exercise improves intestinal permeability
Additionally, exercise training improves your ability to deal with endotoxin if it does breach the intestinal barrier.
Healing leaky gut: Reducing liver fat
Non-alcholic fatty liver disease is associated with a host of problems. In reference to the gut, it robustly changes the intestinal environment:
Non-alcoholic fatty liver disease presents with:
- Altered bile acid output
- Bacterial overgrowth
- Increased systemic inflammation
- Enhanced susceptibility to inflammation
- Impaired mucus barrier
- Altered tight junction proteins
Weight loss is the tried and true remedy for most cases of non-alcoholic fatty liver disease. Some cases are caused by other factors such as genetic conditions, exposure to toxins or some pharmaceutical drugs, and secondary to other conditions such as Wilson’s disease.
However, these causes are not nearly as common as obesity.
If healing leaky gut is something of concern to you, addressing lifestyle is key. While simple solutions such as various supplements and restriction diets are appealing, the evidence that they work is either weak, missing, or at high risk of bias.
If you are obese or overweight, it’s clear that weight loss is key to healing leaky gut. How you get there diet-wise likely isn’t as big of a factor as weight loss in general. Furthermore, if you are prone to putting on liver fat, you may be susceptible even if at a healthy weight.
In this paper, the only consistent dietary factor between groups was calorie restriction. In other words, diet quality likely mattered less than being in a calorie deficit.
This is great if you do better with a diet such as Keto or Carnivore, since fiber and polyphenol intake were not controlled for. Interestingly, there was no difference in SCFAs in the groups in this review.
However, participating in things like exercise, stress management, prioritizing sleep, and observing good circadian habits likely have an additive or synergistic effect to weight loss. Overall, maintaining a healthy weight and practicing healthy lifestyle habits are key to maintaining a healthy intestinal barrier.