Introduction:

• Frustration with extreme weight loss approaches.
• Passion for healing metabolism for natural weight regulation.
• Introduction to Metabolic Endotoxemia (ME) and its link to gut health.

Understanding Metabolic Endotoxemia (ME):

• ME linked to microbiome insult, impacting gut health.
• Factors include antibiotics, c-section, lack of breastfeeding, and low-fiber diet.
• Vicious cycle: Microbiome issues lead to low fiber, worsening diversity.
• Leaky gut allows lipopolysaccharides (LPS) to trigger systemic inflammation.
• Altered hunger signaling and reduced satiety hormones contribute to obesity.

Impact of Endotoxemia:

• Metabolic syndrome features tied to ME: inflammation, insulin resistance, central fat storage, hypertension, and dyslipidemia.

Scientific Quotes on Endotoxemia:

• Gut dysbiosis induces oxidative stress and ME, major drivers of obesity.
• Oxidative stress key in developing complications of type 2 diabetes.
• Gut dysbiosis linked to chronic inflammation in coronary artery disease.

Studies and Interventions:

1. Diet High in Fiber, Polyphenols, and Functional Foods:

   • Improved metabolic markers in type 2 diabetes subjects.
   • Lowered blood sugar, cholesterol, triglycerides, and inflammation.

2. Flaxseed Intervention:

   • Lowered intestinal permeability and LPS in perimenopausal, overweight females.

3. Pomegranate Extract:

   • Reduced inflammation, improved gut bacteria, and lowered endotoxemia in overweight subjects with high cholesterol.

4. Resistant Dextrin (Prebiotic):

   • Lowered endotoxemia, improved sleep, quality of life, inflammation, and blood sugar in type 2 diabetes females.

5. Probiotic (Lactobacillus Rosis GG):

   • Improved inflammation, lowered endotoxemia, and enhanced metabolic outcomes in coronary artery disease subjects.

6. Symbiotic Intervention (Probiotic + Prebiotic):

   • Significant improvement in endotoxemia, inflammation, and metabolic markers in subjects with obesity.

Practical Applications and Recommendations:

• Testing for endotoxemia using LPS antibodies.
• Dietary focus on high polyphenol, unrefined carbs, high-fiber, and nutrient-dense foods.
• Power foods include flax seeds, chia seeds, true fermented yogurt, and pomegranate extract.
• Individualized approach for gut dysbiosis, starting with digestive support.

Conclusion:

• Emphasis on the gut-metabolism connection.
• Majority may have endotoxemia, a main driver of type 2 diabetes and obesity.
• Solutions involve optimizing gut health through diet, supplements, and personalized approaches.

References used in this episode:

1.Medina-Vera I, Sanchez-Tapia M, Noriega-Lopez L, et al. A dietary intervention with functional foods reduces metabolic endotoxaemia and attenuates biochemical abnormalities by modifying faecal microbiota in people with type 2 diabetes. Diabetes Metab. 2019;45(2):122-131.

2.Krumbeck JA, Rasmussen HE, Hutkins RW, et al. Probiotic Bifidobacterium strains and galactooligosaccharides improve intestinal barrier function in obese adults but show no synergism when used together as synbiotics. Microbiome. 2018;6(1):121.

3.Saleh-Ghadimi S, Dehghan P, Sarmadi B, Maleki P. Improvement of sleep by resistant dextrin prebiotic in type 2 diabetic women coincides with attenuation of metabolic endotoxemia: involvement of gut-brain axis. J Sci Food Agric. 2022;102(12):5229-5237.

4.Fallah F, Mahdavi R. L-Carnitine and synbiotic co-supplementation: beneficial effects on metabolic-endotoxemia, meta-inflammation, and oxidative-stress biomarkers in obese patients: a double blind, randomized, controlled clinical trial. Food Funct. 2023;14(4):2172-2187.

5.Moludi J, Kafil HS, Qaisar SA, Gholizadeh P, Alizadeh M, Vayghyan HJ. Effect of probiotic supplementation along with calorie restriction on metabolic endotoxemia, and inflammation markers in coronary artery disease patients: a double blindplacebo controlled randomized clinical trial. Nutr J. 2021;20(1):47.

6.Farhangi MA, Dehghan P, Namazi N. Prebiotic supplementation modulates advanced glycation end-products (AGEs), soluble receptor for AGEs (sRAGE), and cardiometabolic risk factors through improving metabolic endotoxemia: a randomized-controlled clinical trial. Eur J Nutr. 2020;59(7):3009-3021.

Gonzalez-Sarrias A, Nunez-Sanchez MA, Avila-Galvez MA, et al. Consumption of pomegranate decreases plasma lipopolysaccharide-binding protein levels, a marker of metabolic endotoxemia, in patients with newly diagnosed colorectal cancer: a randomized controlled clinical trial. Food Funct. 2018;9(5):2617-2622.

8. Gonzalez-Sarrias A, Romo-Vaquero M, Garcia-Villalba R, Cortes-Martin A, Selma MV, Espin JC. The Endotoxemia Marker Lipopolysaccharide-Binding Protein is Reduced in Overweight-Obese Subjects Consuming Pomegranate Extract by Modulating the Gut Microbiota: A Randomized Clinical Trial. Mol Nutr Food Res. 2018;62(11):e1800160.

9. Millischer V, Heinzl M, Faka A, et al. Intravenous administration of LPS activates the kynurenine pathway in healthy male human subjects: a prospective placebo-controlled cross-over trial. J Neuroinflammation. 2021;18(1):158.

10. Iqbal A, Prince LR, Novodvorsky P, et al. Effect of Hypoglycemia on Inflammatory Responses and the Response to Low-Dose Endotoxemia in Humans. J Clin Endocrinol Metab. 2019;104(4):1187-1199.

11. Pei R, DiMarco DM, Putt KK, et al. Premeal Low-Fat Yogurt Consumption Reduces Postprandial Inflammation and Markers of Endotoxin Exposure in Healthy Premenopausal Women in a Randomized Controlled Trial. J Nutr. 2018;148(6):910-916.

12. Madison AA, Belury MA, Andridge R, et al. Afternoon distraction: a high-saturated-fat meal and endotoxemia impact postmeal attention in a randomized crossover trial. Am J Clin Nutr. 2020;111(6):1150-1158.

13. Sant'Ana CT, Amorim AD, Gava AP, et al. Brown and golden flaxseed reduce intestinal permeability and endotoxemia, and improve the lipid profile in perimenopausal overweight women. Int J Food Sci Nutr. 2022;73(6):829-840.

14. Frank J, Gupta A, Osadchiy V, Mayer EA. Brain-Gut-Microbiome Interactions and Intermittent Fasting in Obesity. Nutrients. 2021;13(2).

15. Cani PD, Osto M, Geurts L, Everard A. Involvement of gut microbiota in the development of low-grade inflammation and type 2 diabetes associated with obesity. Gut Microbes. 2012;3(4):279-288.

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