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Functional Foods for Leaky Gut and Bloating
Posted 7 months ago by Katie
As autumn approaches, there is that distinctive back-to-school vibe in the air - a time to refocus and recommit to your health goals, and finally get to the bottom of those ongoing bloating and digestive issues.
What is leaky gut?
Leaky gut, also known as intestinal permeability, is characterised by a compromised intestinal barrier which becomes unable to prevent large particles translocating through the intestinal wall into the blood stream. The intestinal epithelial lining contains a selectively permeable barrier which is controlled by tight junctions, the name for the membranes of two adjacent cells which have joined together to form a barrier. Gut barrier function plays a crucial role in human health and disease as it allows the absorption of nutrients, water, and electrolytes from the intestines into the blood stream. It also protects us from the entry of allergens, bacteria, fungi, parasites, and antigens that could provoke an immune response. But when these tight junctions are damaged there may be a loss of normal barrier function and the delicate barrier they form may become more permeable, allowing the entry of microbes, chemicals, toxins, and large undigested food molecules into the bloodstream. This is why intestinal permeability is associated with low grade metabolic endotoxemia and resulting inflammation, as when these unfamiliar substances are able to pass in to your bloodstream, your immune system is alerted in a bid to protect you, which triggers an inflammatory response.
The damage to the tight junctions resulting in a 'leaky gut' is believed to be caused by common factors such as poor food choices, chronic stress, toxic overload, bacterial imbalances in the gut microbiome, and medications such as Non Steroidal Anti-Inflammatory drugs ( NSAIDS). A number of studies have demonstrated the detrimental effects of NSAIDS on intestinal barrier function within 24 hours of ingestion, proving them to be a causative factor in the develpoment of leaky gut syndrome.1 If left unchecked these triggers can cause ongoing inflammation, common digestive complaints such as bloating, and more chronic conditions such as allergies and autoimmune conditions in the long run. Read on for an overview of this complex digestive issue...
But how do you know if you have a leaky gut?
Leaky gut symptoms
There is a broad range of symptoms associated with intestinal permeability, but if you suspect you have any signs of this complex condition, I'd first suggest discussing these with your doctor to rule out any other medical causes. If all other medical causes have been ruled out, then ideally I recommend working with a healthcare practitioner such as a nutritional therapist, who will be able to assist you in determining whether leaky gut is an issue for you, and advise you regarding a holistic approach to healing your gut.
Here a few signs to watch out for and discuss with your healthcare team:
1. Digestive issues such as gas, bloating, diarrhoea or irritable bowel syndrome (IBS).
3. Hormonal imbalances such as PMS or PCOS.
4. Diagnosis of an autoimmune disease such as rheumatoid arthritis, Hashimoto’s thyroiditis, lupus, psoriasis, or coeliac disease 2.
5. Diagnosis of chronic fatigue or fibromyalgia.3
6. Mood and mind issues such as depression, anxiety, poor memory, brain fog, ADD or ADHD.
7. Skin issues such as acne, rosacea, or eczema.
8. Diagnosis of candida overgrowth.
9. Food allergies or food intolerances (IgG). 4
From this list, we can see how intestinal permeability appears to increase the risk of developing chronic illness and serious diseases. There is growing evidence that increased intestinal permeability plays a pathogenic role in various autoimmune diseases, including coeliac disease, neuro-inflammation and type 1 diabetes.2 When the intestinal lining is compromised, not only do offensive agents penetrate into the bloodstream, but there is likely to be a deteriorated ability of the gut lining to absorb nutrients, an effect which may also contribute to poor health.
Leaky gut: Diet and Dysbiosis
Two of the most important factors in the development of a leaky gut are our diet and the balance of bacteria in our gut. The integrity of the GI mucous membrane is dependent on the food choices we make every day, and recent research indicates that a microbial imbalance (dysbiosis) and/or environmental or dietary triggers, such as gluten, can cause dysfunction of the tight junctions by activating the zonulin pathway.5
Zonulin is a protein that is involved in controlling the action of the tight junctions between the cells that line your intestines. If excess levels of zonulin are triggered, it can cause the tight junctions to open too much, allowing undesirable particles to enter your blood circulation, including zonulin itself. Gluten is a protein made up of the peptides gliadin and glutenin and it is found in many grains such as wheat, spelt, kamut, rye, and barley. The prevalence of coeliac disease, an autoimmune disease caused by a reaction to gluten, and also non-coeliac gluten sensitivity, is rising and by eating wheat based products you may trigger your body to mount an immune response, whereby antibodies are produced. These antibodies mount an attack on the gluten, but also end up damaging your intestinal lining and contributing to leaky gut and digestive symptoms such as bloating, constipation, diarrhoea, malnutrition, and fat malabsorption.
The integrity of the gut lining is dependent on having a healthy intestinal mucosa and microvilli, which line the gut and allow nutrients to pass while blocking the entry of toxins. This is maintained by having a good balance of bacteria (probiotics) within our digestive systems. When the gut is dysbiotic (bacteria is not balanced), gluten proteins harm the intestinal tract, causing irritation and inflammation. Gut bacteria such as Bifidobacteria and Lactobacillus are often referred to as “good bacteria” as they exert health-promoting properties. It is proposed that increase of Lactobacillus in the gut leads to production of short chain fatty acids that improve gut health, increasing the barrier function of the gut and reducing translocation of bacterial toxins across the gut wall.
A dysbiotic gut can lead to an overgrowth of the yeast Candida which can impair our mucosal barrier. We all naturally house Candida in our guts as part of our resident microflora; however an overgrowth of Candida, typically the Candida albicans species, can be caused by contributing factors such as high sugar diets, antibiotics, and stress, can deteriorate the gut wall, damage our villi, and increase inflammation.6 Inflammation leads to increased permeability and translocation of large food particles, undigested sugars, undigested proteins, and gut microbes (parasites, bacteria, fungi) from leaking into the blood. This leaking of particles and translocation of bacteria can be the trigger for many symptoms in the body, as the immune system mounts an attack on these toxic particles in different parts of the body. A proliferation of Candida and a dysbiotic gut microbiome will exacerabate the damaging effects of gluten on the intestinal lining.
To maintain a balanced Candida population we can reduce refined sugars in our diet, include anti-microbial herbs and foods, and repopulate the gut with friendly probiotic strains such as S. boulardii, which has been shown to inhibit populations of Candida and deter them from establishing in the intestines due to its production of caprylic acid, a natural anti-fungal that is effective against yeasts.
The western-style diet, which is rich in foods such as gluten, bad fats and sugars, and medications such as antibiotics which alter the composition of the gut barrier function, does not provide the right nourishment for a flourishing 'gut garden'. To sustain a healthy 'gut garden' we have to provide it with the right nourishment in the form of nutrients, stress management, mindful eating, and reducing our exposure to environmental toxins.
Hippocrates is credited with stating, ‘All disease begins in the gut’, and the human microbiome is the gatekeeper in this symbiotic relationship between human and microbe. Everything you put in to your mouth has a direct impact on the community of microbes in our gut and so the most important consideration has to be our daily food choices. If we have unhappy communities of bacteria where the populations are tipped in favour of undesirable micro-organisms (pathogens), our overall digestive health maybe compromised. Pathogens can cause damage to the gut lining and add to intestinal permeability.
Potential causes for gut dysbiosis:
Growing evidence suggests that gut microbiota is important in modulating our gut permeability. Gut dysbiosis can be caused by certain factors in your diet and lifestyle. These include:
> Frequent antibiotic use - antibiotics destroy both beneficial and bad bacteria.
> Nutrient deficiencies.
> Dysbiosis (candida overgrowth).
> Excessive alcohol consumption.
> Frequent use of antacids and other medications.
> Chronic stress (physical and psychological).
> Previous bacterial or parasitic GI tract infections: E. coli, salmonella, parasites.
> A diet high in refined sugar, processed foods, hydrogenated fats, and trans fats.
> A low-fibre diet.
> Environmental toxins, such as pesticides and herbicides.
> C-Section birth and formula feeding.
A healthcare practitioner, such as a nutritionist or nutritional therapist, can help you to determine what's driving your individual symptoms. The gut lining replenishes its cells every 3-5 days making it one of the fastest regenerative organs in the whole body, and we can assist in this regeneration if we provide the body with the correct nutrition and conditions for healing. Significant changes in gut bacteria were observed after only three days of dietary changes, as demonstrated in a study from Harvard and published in the medical journal Nature.7
We must develop a new-found respect for the ecosystem in our guts, with a mindful approach to what we are eating, and whether this food is ultimately going to support a healthy, happy community of microbes, or be detrimental to the health of our microbiome.
Leaky Gut Diet plan - heal your Gut
Any diet looking to support a leaky gut will aim to improve digestive comfort by eating foods that will help to repair the intestinal lining, regenerate the gastrointestinal mucosa, and rebalance your gut microbiome. In my practice I like to use the 4R programme, which is essentially an elimination diet that removes toxic and inflammatory foods for a certain period of time to allow the gut lining to heal. It also addresses the community of microbes in the gut with functional foods.
The 4R program is as follows:
Remove poor dietary choices and foods eaten to excess. The goal is to eliminate foods that negatively affect the environment of the GI tract, such as inflammatory and toxic foods, environmental stress, infections, and problematic microbes. I'll explain more about these foods below.
Replace with better food choices. Reintroduce the essential ingredients for optimal digestion and absorption, such as probiotics, hydrochloric acid, and fibre.
3. Reinoculate the gut
It’s critical to restore beneficial bacteria using probiotic foods/supplements to reestablish a healthy balance of good bacteria.
4. Repair the gut lining
It’s also essential to provide the nutrients necessary to help the gut repair itself. One of my favourite supplements is L-glutamine, an amino acid that helps to rejuvenate the lining of the gut wall. I also regularly use probiotic supplements with my clients as they offer a therapeutic, targeted, strain-specific approach to healing the gut when you need that extra help.
Functional foods to Heal and Seal the Gut
For good gut health we all want to be eating foods that support and nourish the growth of good bacteria and reduce inflammation in the GI tract, but for leaky gut, you can also choose foods containing nutrients which help to repair the delicate gut lining. Take a look at my top dietary recommendations for gut-healing protocols:
Bone broths - an excellent tonic for the gut, which is rich in glutamine and collagen, key proteins that are required to repair the lining of the intestines. Don't worry if you prefer to eat a vegetarian or vegan diet, as cabbage and cabbage stock are also very good sources of glutamine.
Fermented foods containing probiotics/prebiotics - take a good quality, well-researched probiotic supplement or eat fermented foods, such as sauerkraut and kimchi, both of which are rich in friendly bacteria and organic acids to help support optimal microbial balance. Probiotics modulate the immune response and downregulate inflammation, promoting gut healing. They also produce short chain fatty acids which protect the intestinal lining.
Fruit - stewed apples and pears are rich in soluble fibre and immune-enhancing polyphenols, and pineapples contain the enzyme bromelain which is anti-inflammatory, antimicrobial and supports the breakdown of foods.
High protein foods - good quality protein sources, including organic eggs, liver, and wild fish, are essential as protein is a key nutrient involved in gut repair. These foods all contain zinc and glutamine too which is good for the intestinal epithelial cells.
Spices and herbs - certain spices and herbs can help to reduce inflammation and soothe the gut lining. Ginger, turmeric, dandelion root tea, marshmallow root tea, peppermint, and licorice root tea are all great options.
Omega-3 - anti-inflammatory and gut healing, omega-3 can be found in grass fed meats, wild-caught oily fish, flaxseeds, soaked chia seeds, and algae.
Healthy fats - some good sources of healthy fats are olive oil, avocados, ghee, egg yolks, and coconut oil.
Vegetables - vegetables are rich in natural fibres, which are the main source of food (prebiotic) for our intestinal microbiome. Peel all vegetables whilst you are healing your gut, in order to reduce irritation to the gut lining.
Vitamin C - you can find this immune-boosting vitamin in green vegetables, broccoli, peppers, and berries. Vitamin C is also vital for collagen synthesis.
Butyrate-rich foods - butyrate is a short chain fatty acid found in foods such as wholegrains, butter, ghee, artichoke, underripe bananas, dandelion greens, beans, legumes, parmesan, nuts/seeds, and fermented foods. It plays a key role in maintaining intestinal barrier function, and is also produced in our guts by friendly resident bacteria, through the fermentation of carbohydrates and fibre. It supports the healing and sealing of the gut and can prevent leaky gut syndrome and IBS-related symptoms, such as bloating, pain, and changeable bowels.
Bad foods for a permeable gut
> Food sensitivities/intolerances - avoid foods that you know you react to and that cause symptoms. Common culprits are spicy foods, coffee, dairy, wheat, gluten, soy, alcohol, and fried foods.
> Refined sugar - all forms of sugar will wreak havoc on your digestive system, because pure sugars support the growth of problematic bacteria and yeasts which further damage your gut, so should be avoided during any gut healing programme. This includes artificial sweeteners such as aspartame and sucralose, as these can also disrupt your gut microbiome. You also want to avoid white cane sugar, high fructose corn syrup, and glucose. Naturals sugars such as raw honey and maple syrup should also be reduced during the initial stages of gut healing.8
> Pro-inflammatory foods - refined vegetable oils (sunflower, rapeseed), GMO foods (corn, soy), non-organic dairy, and meat are also ones to look out for.
This programme is a great way to get started on your road to a happy gut, but if symptoms persist I would always recommend working with a registered nutritionist or similar healthcare practitioner, who can identify your unique triggers and guide you through this programme with an individualised approach. A healthcare practitioner can also prepare you for any side effects or symptoms that may occur during the initial stages of healing.
You may also be interested in reading the following articles:
Research and consolidation by Katie Wheaton, registered Nutritional Therapist, DIP NT, mBANT, CNHC, mANP.
1 Bjarnason, I, Takeuchi, K. (2009) Intestinal permeability in the pathogenesis of NSAID-induced enteropathy. 'Journal of Gastroenterology', [online] Volume 44 (19):pp. 23-29. Available at: https://www.ncbi.nlm.nih.gov/pubmed/19148789
2 Quinghui, M. et al. (2017) Leaky Gut as a Danger Signal for Autoimmune Disease. 'Frontiers in Immunology', [online] Volume 8, 598. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440529/ [Accessed: 3/9/2018]
3 Maes, M, Leunis, JC. (2008) Normalization of leaky gut in chronic fatigue syndrome (CFS) is accompanied by a clinical improvement: effects of age, duration of illness and the translocation of LPS from gram-negative bacteria. 'Neuro Endocrinology letters'. [online] Volume 29 (6) pp. 902-910. Available at: https://www.ncbi.nlm.nih.gov/pubmed/19112401 [Acessed 3/9/18)
4 Perrier, C, Cothesey, B. (2011) Gut Permeability and Food allergens. 'British Journal for Allergy and clinical Immunology', [online] Available at: https://www.ncbi.nlm.nih.gov/pubmed/21070397 [Accessed 3/9/18/)
5 Hollon, J. et al. (2015) Effect of Gliadin on Permeability of Intestinal Biopsy Explants from Celiac Disease Patients and Patients with Non-Celiac Gluten Sensitivity. 'Nutrients', [online] Volume 7(3), pp. 1565-1576. Available at:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4377866/ [Accessed 3/9/18]
6 Yan, L et al. (2013) Disruption of the intestinal mucosal barrier in Candida albicans infections. 'Microbiological Research', [online] Volume 168 (7), pp. 389-395. Available at: https://www.sciencedirect.com/science/article/pii/S0944501313000293?via%3Dihub [Accessed: 6/10/18]
7 Lawrence, D A. et al. (2014) Diet rapidly and reproducible alters the human gut microbiome. 'Nature', [online] Volume 505, pp. 559-563. Available at:https://www.nature.com/articles/nature12820 [Accessed 3/9/18]
8 suez, J, et al. (2014) Artificial sweeteners induce glucose intolerance by altering the gut microbiota. 'Nature'. [online] Volume 514, pp.181-186. Available at:https://www.nature.com/articles/nature13793 [Accessed 6/10/18]
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