In recent years, the term "leaky gut" has garnered considerable attention. Also known as increased intestinal permeability, it's a condition in which gaps in your intestinal walls start to loosen, making it easier for larger substances, such as bacteria, toxins, and undigested food particles, to pass across the intestinal walls into your bloodstream. Studies have associated increased intestinal permeability with several chronic and autoimmune diseases, including type 1 diabetes and celiac disease.
Understanding Leaky Gut Syndrome
Leaky gut syndrome is a hypothetical condition caused by increased intestinal permeability. The digestive system consists of many organs that collectively break down food, absorb nutrients and water, and remove waste products. Your intestinal lining acts as a barrier between your gut and bloodstream to prevent potentially harmful substances from entering your body. Nutrient and water absorption mostly occurs in your intestines, which have tight junctions, or small gaps, that allow nutrients and water to pass into your bloodstream. How easily substances pass across the intestinal walls is known as intestinal permeability.
Certain health conditions cause these tight junctions to loosen, potentially allowing harmful substances like bacteria, toxins, and undigested food particles to enter your bloodstream. Alternative health practitioners claim that leaky gut triggers widespread inflammation and stimulates an immune reaction, causing various health problems that are collectively known as leaky gut syndrome. They believe leaky gut leads to various conditions, including autoimmune diseases, migraines, autism, food sensitivities, skin conditions, brain fog, and chronic fatigue.
Yet, there is little evidence to prove that leaky gut syndrome exists. As a result, mainstream physicians do not recognize it as a medical diagnosis. Although increased intestinal permeability exists and occurs alongside many diseases, it’s not clear if it’s a symptom or underlying cause of chronic disease. Leaky gut syndrome, or increased intestinal permeability, occurs when the small intestine’s lining is compromised, letting harmful substances enter the bloodstream. This can trigger inflammation, autoimmune reactions (e.g. thyroid issues, type 2 diabetes), and symptoms like digestive issues, joint pain, skin rashes, or fatigue.
Leaky gut syndrome is a theory that intestinal permeability is not only a symptom of gastrointestinal disease but an underlying cause that develops independently. If your intestinal barrier is impaired, it may be letting toxins into your bloodstream. These toxins may trigger an inflammatory response that may manifest as various diseases.
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Causes and Risk Factors
The exact cause of leaky gut is a mystery. However, increased intestinal permeability is well known and occurs alongside several chronic diseases, including celiac disease and type 1 diabetes. Zonulin is a protein that regulates tight junctions. Research has shown that higher levels of this protein may loosen tight junctions and increase intestinal permeability. Two factors are known to stimulate higher zonulin levels in certain individuals - bacteria and gluten.
However, research in healthy adults and those with non-celiac gluten sensitivity shows mixed results. While test-tube studies have found that gluten can increase intestinal permeability, human-based studies have not observed the same effect. Aside from zonulin, other factors can also increase intestinal permeability. Research shows that higher levels of inflammatory mediators, such as tumor necrosis factor (TNF) and interleukin 13 (IL-13), or the long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, may increase intestinal permeability. Furthermore, low levels of healthy gut bacteria may have the same effect. This is called gut dysbiosis.
The known causes of intestinal permeability involve systematic erosion of the intestinal lining. This is not a simple feat. Your intestinal lining has many layers of defense. And while it can be injured temporarily, it is designed to constantly repair and replenish itself. To actually wear it down enough to penetrate the lining requires a significant assault. That usually means a chronic disease, chronic drug use or alcohol abuse or radiation therapy.
The theory of leaky gut syndrome suggests that anything that injures your gut lining can lead to intestinal permeability if the injury is persistent enough. Therefore, common everyday factors such as diet and stress may cumulatively wear down your intestinal lining until it becomes permeable. Scientists aren’t sure about this, but they do agree that these everyday factors may cause inflammation in your gut lining and uncomfortable GI symptoms for you.
Dietary Strategies for Healing Leaky Gut
As leaky gut syndrome isn’t an official medical diagnosis, there is no recommended treatment. Yet, you can do plenty of things to improve your general digestive health. One is to eat a diet rich in foods that aid the growth of beneficial gut bacteria. An unhealthy collection of gut bacteria has been linked to poor health outcomes, including chronic inflammation, cancers, heart disease, and type 2 diabetes.
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Finding a diet that minimizes your gut inflammation is one of the most important steps you can take to improve a leaky gut, but finding what works for you can be confusing. The most effective place to start is by understanding that leaky gut diets aren’t “one-size-fits-all”, and the most important thing you can do is listen to your body. Intestinal inflammation caused by a poor diet is one of the main causes of leaky gut. Eating certain foods, such as gluten, can increase a protein called zonulin in the gut, which drives intestinal permeability. Remember that these are general guidelines and not every person with leaky gut syndrome will react to every single one of these foods. Additionally, some of the foods that are listed as “good” may be inflammatory specifically to you and are contributing to some of your symptoms.
A leaky gut diet focuses on reducing inflammation and promoting the repair of the intestinal lining. Foods rich in antioxidants, omega-3 fatty acids, and fiber are essential.
Foods to Include in Your Leaky Gut Diet
A diet that promotes digestive health should focus on fibrous vegetables, fruits, fermented vegetables, cultured dairy products, healthy fats, and lean, unprocessed meats.
- Vegetables: Broccoli, Brussels sprouts, cabbage, arugula, carrots, kale, beetroot, Swiss chard, spinach, ginger, mushrooms, and zucchini.
- Roots and tubers: Potatoes, sweet potatoes, yams, carrots, squash, and turnips.
- Fermented vegetables: Kimchi, sauerkraut, tempeh, and miso.
- Fruit: Coconut, grapes, bananas, blueberries, raspberries, strawberries, kiwi, pineapple, oranges, mandarin, lemon, limes, passionfruit, and papaya. Eating one to two servings of fruit daily is a good way to obtain vitamins and minerals. You can steam apples and pears to make homemade apple sauce or fruit sauce.
- Sprouted seeds: Chia seeds, flax seeds, sunflower seeds, and more.
- Gluten-free grains: Buckwheat, amaranth, rice (brown and white), sorghum, teff, and gluten-free oats.
- Healthy fats: Avocado, avocado oil, and extra virgin olive oil.
- Fish: Salmon, tuna, herring, and other omega-3-rich fish. Increase your intake of fatty fish to 2x per week, then add in either flax, chia, or walnuts daily.
- Meats and eggs: Lean cuts of chicken, beef, lamb, turkey, and eggs. Beef, chicken, and eggs are rich in glutamine, which is one of the most abundant amino acids in the body and a major source of energy for the cells lining the gut.
- Herbs and spices: All herbs and spices. This ancient healing herb contains a potent anti-inflammatory compound known as curcumin. Try sprinkling 1 to 2 tablespoons of turmeric per day on your food for a therapeutic dose of curcumin (about 500-1,000mg).
- Cultured dairy products: Kefir, yogurt, Greek yogurt, and traditional buttermilk. Many people are sensitive to dairy but can often tolerate kefir due to its low-lactose content-but keep an eye on your symptoms while adding this one in.
- Beverages: Bone broth, teas, coconut milk, nut milk, water, and kombucha. Bone broth contains collagen and the amino acids proline and glycine that can help heal your damaged cell walls.
- Nuts: Raw nuts, including peanuts, almonds, and nut-based products, such as nut milks. Nuts are an excellent source of fiber, healthy fats, and antioxidants, all of which contribute to a healthy gut.
- Nutritional Yeast: Yes, nutritional yeast is a great addition to a gut-healthy diet.
Foods to Avoid for Leaky Gut Syndrome
Avoiding certain foods is equally important for improving your gut health. Some foods have been shown to cause inflammation in your body, which may promote the growth of unhealthy gut bacteria that are linked to many chronic diseases. To support healing, it’s crucial to avoid foods that can irritate the gut lining.
- Wheat-based products: Bread, pasta, cereals, wheat flour, couscous, etc.
- Gluten-containing grains: Barley, rye, bulgur, seitan, triticale, and oats. The prevalence of gluten sensitivity isn’t as inflated as functional health circles make it out to be, meaning not everyone needs to remove gluten from their diet-especially if they don’t have symptoms. However, gluten can be an issue in some people with a weakened intestinal lining, and many gluten-containing foods can be high in FODMAPs.
- Processed meats: Cold cuts, deli meats, bacon, hot dogs, etc. Avoiding highly processed meats, fats, sugars, and foods with emulsifiers is a good idea as they can negatively affect your gut lining, microbiome, and overall health.
- Baked goods: Cakes, muffins, cookies, pies, pastries, and pizza.
- Snack foods: Crackers, muesli bars, popcorn, pretzels, etc.
- Junk food: Fast foods, potato chips, sugary cereals, candy bars, etc.
- Dairy products: Milk, cheeses, and ice cream. Conventional cow’s milk is another food that can cause leaky gut. The component of dairy that harms your gut is the protein A1 casein.
- Refined oils: Canola, sunflower, soybean, and safflower oils.
- Artificial sweeteners: Aspartame, sucralose, and saccharin.
- Sauces: Salad dressings, as well as soy, teriyaki, and hoisin sauce.
- Beverages: Alcohol, carbonated beverages, and other sugary drinks. Excessive alcohol consumption increases gut permeability and is associated with intestinal permeability, IBD, and IBS flares. As is the case with most things concerning our health, moderation is key for preventing leaky gut.
- Charred or fried foods: Overcooked, browned, and fried foods contain advanced glycation end products (AGES) or other properties that are inflammatory and have been linked to increased intestinal permeability and poor gut health.
- Lectins: These are found in many foods, not just grains, and when consumed in smaller amounts, your body normally does just fine with them. But foods that have large amounts of lectins are more problematic.
- Sugar: Added sugar is another substance that can wreak havoc on your digestive system when eaten in large amounts. Sugar can feed the growth of yeast, candida and bad bacteria, which further damages your gut.
Sample 7-Day Leaky Gut Diet Plan
Below is a healthy 1-week sample menu for improving your digestive health. It focuses on incorporating foods that promote the growth of healthy gut bacteria while removing foods that are notorious for causing uncomfortable digestive symptoms. Some menu items contain sauerkraut, a type of fermented cabbage that is easy, simple, and inexpensive to prepare. This diet follows the Heal and Seal phase’s elimination diet, avoiding common triggers (gluten, dairy, sugar, processed foods, citrus, nightshades) and emphasizing gut-healing foods like bone broth, collagen-rich proteins, and low-starch vegetables.
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Monday
- Breakfast: Blueberry, banana, and Greek yogurt smoothie
- Lunch: Mixed green salad with sliced hard-boiled eggs
- Dinner: Beef and broccoli stir-fry with zucchini noodles and sauerkraut
Tuesday
- Breakfast: Omelet with veggies of your choice
- Lunch: Leftovers from Monday’s dinner
- Dinner: Seared salmon served with a fresh garden salad
Wednesday
- Breakfast: Blueberry, Greek yogurt, and unsweetened almond milk smoothie
- Lunch: Salmon, egg, and veggie frittata
- Dinner: Grilled lemon chicken salad with a side of sauerkraut
Thursday
- Breakfast: Gluten-free oatmeal with 1/4 cup of raspberries
- Lunch: Leftovers from Wednesday’s dinner
- Dinner: Broiled steak with Brussels sprouts and sweet potatoes
Friday
- Breakfast: Kale, pineapple, and unsweetened almond milk smoothie
- Lunch: Beet, carrot, kale, spinach, and brown rice salad
- Dinner: Baked chicken served with roasted carrots, beans, and broccoli
Saturday
- Breakfast: Coconut-papaya chia pudding - 1/4 cup of chia seeds, 1 cup of unsweetened coconut milk, and 1/4 cup of diced papaya
- Lunch: Chicken salad with olive oil
- Dinner: Roasted tempeh with Brussels sprouts and brown rice
Sunday
- Breakfast: Mushroom, spinach, and zucchini frittata
- Lunch: Sweet potato halves stuffed with spinach, turkey, and fresh cranberries
- Dinner: Grilled chicken wings with a side of fresh spinach and sauerkraut
Additional Strategies for Gut Health
Although diet is key to improving gut health, there are plenty of other steps you can take. Aside from diet, try taking a probiotic supplement, reducing your stress levels, sleeping more, avoiding smoking, and limiting alcohol intake to improve your gut health.
- Take a probiotic supplement. Probiotics contain beneficial bacteria that are naturally present in fermented foods. Taking a probiotic supplement, which you can find online, may improve gut health if you don’t get enough probiotics through your diet. Probiotics for leaky gut are also a powerful way to heal your gut lining, reduce intestinal inflammation, balance your microbiome, and reduce leaky gut symptoms. I recommend getting probiotics in both food and supplement form. By only following part of the protocol in treating leaky gut syndrome by removing the damaging irritants, you may fail to re-inoculate the gut with beneficial bacteria that will keep bad bacteria at bay.
- Reduce stress. Chronic stress has been shown to harm beneficial gut bacteria. Activities like meditation or yoga can help.
- Avoid smoking. Cigarette smoke is a risk factor for several bowel conditions and may increase inflammation in the digestive tract. Quitting smoking can raise your count of healthy bacteria and reduce your count of harmful gut bacteria.
- Sleep more. Lack of sleep can cause a poor distribution of healthy gut bacteria, possibly resulting in increased intestinal permeability.
- Limit alcohol intake. Research has shown that excessive alcohol intake may increase intestinal permeability by interacting with certain proteins.
Other Considerations
If you think you have leaky gut syndrome, consider getting tested for celiac disease, as the two disorders can have overlapping symptoms. Some people also find that diets like the Gut and Psychology Syndrome (GAPS) diet may ease leaky gut symptoms. However, this diet is incredibly restrictive, and no scientific studies support its health claims.
Some foods seem to be in a “gray area” when it comes to worsening or promoting digestive health. You may choose to eliminate eggs and legumes at first and then to try reintroducing them after several weeks.
Supplements for Leaky Gut
In a leaky gut treatment plan, there are many supplements that support digestive health as well as protect the gut lining from further damage.
- Probiotics (50-100 billion units daily): This is the most important supplement to take because it helps replenish good bacteria and crowds out bad bacteria.
- L-Glutamine: Critical for any program designed to heal leaky gut, glutamine powder is an essential amino acid supplement that has anti-inflammatory properties and is necessary for the growth and repair of your intestinal lining.
- Licorice Root: An adaptogenic herb that helps balance cortisol levels and improves acid production in the stomach, licorice root supports the body’s natural processes for maintaining the mucosal lining of the stomach and duodenum.