Remember, stool is more than half bacterial cells, by weight or volume. There's still an ample amount of gram negative bacteria to provide endotoxins for systemic inflammation, regardless of diet or probiotic intake.
I've studied metabolic endotoxemia intently over the past few years, and agree that it probably mediates many adverse effects of high-fat, high-added-sugar, and high alcohol diets in inflammatory chronic diseases, which were hitherto attributed to their physiology once absorbed.. In the course of this, I intently looked at every intervention I could find that has reduced circulating endotoxins. Prebiotics, dietary polyphenols, low-fat diet, low-sugar diet, and adequate intake of zinc and vitamin C all appear to help. While probiotics have mixed results in effecting intestinal barrier function as measured by laculose/mannitol and similar tests, I've yet to encounter a study where a currently commercial prebiotic improved serum endotoxin levels. The story for current prebiotics in chronic disease isn't encouraging.
Prebiotics / fermentable fiber / microbiota available carbs / FODMAPS
Keshavarzian et al, 2001. Preventing gut leakiness by oats supplementation ameliorates alcohol-induced liver damage in rats. Journal of Pharmacology and Experimental Therapeutics, 299(2), pp.442-448.
Cani et al, 2009. Changes in gut microbiota control inflammation in obese mice through a mechanism involving GLP-2-driven improvement of gut permeability. Gut, 58(8), pp.1091-1103.
Xiao et al, 2014. A gut microbiota-targeted dietary intervention for amelioration of chronic inflammation underlying metabolic syndrome. FEMS microbiology ecology, 87(2), pp.357-367.
Dehghan et al, 2014. Inulin controls inflammation and metabolic endotoxemia in women with type 2 diabetes mellitus: a randomized-controlled clinical trial. International journal of food sciences and nutrition, 65(1), pp.117-123.
Polyphenols and other phytochemicals
Ghanim et al, 2010. Orange juice neutralizes the proinflammatory effect of a high-fat, high-carbohydrate meal and prevents endotoxin increase and Toll-like receptor expression. The American journal of clinical nutrition, 91(4), pp.940-949.
Ghanim et al, 2011. A resveratrol and polyphenol preparation suppresses oxidative and inflammatory stress response to a high-fat, high-carbohydrate meal. The Journal of Clinical Endocrinology & Metabolism, 96(5), pp.1409-1414.
Goodrich et al, 2012. Chronic administration of dietary grape seed extract increases colonic expression of gut tight junction protein occludin and reduces fecal calprotectin: a secondary analysis of healthy Wistar Furth rats. Nutrition research, 32(10), pp.787-794.
Peng et al, 2013. Puerarin ameliorates experimental alcoholic liver injury by inhibition of endotoxin gut leakage, Kupffer cell activation, and endotoxin receptors expression. Journal of Pharmacology and Experimental Therapeutics, 344(3), pp.646-654.
Everard et al, 2012. Tetrahydro iso-alpha acids from hops improve glucose homeostasis and reduce body weight gain and metabolic endotoxemia in high-fat diet-fed mice. PloS one, 7(3), p.e33858.
Gu et al, 2014. Dietary cocoa reduces metabolic endotoxemia and adipose tissue inflammation in high-fat fed mice. The Journal of nutritional biochemistry, 25(4), pp.439-445.
Camargo et al, 2014. Olive oil phenolic compounds decrease the postprandial inflammatory response by reducing postprandial plasma lipopolysaccharide levels. Food chemistry, 162, pp.161-171.
Roquetto et al, 2015. Green propolis modulates gut microbiota, reduces endotoxemia and expression of TLR4 pathway in mice fed a high-fat diet. Food Research International, 76, pp.796-803.
Masumoto et al, 2016. Non-absorbable apple procyanidins prevent obesity associated with gut microbial and metabolomic changes. Scientific reports, 6, p.31208.
Low-fat diet (limited to human studies, or else I'll be here all night)
Low added-sugar diet (limited to hominoid studies)
Adequate zinc
Lambert et al, 2003. Prevention of alterations in intestinal permeability is involved in zinc inhibition of acute ethanol-induced liver damage in mice. Journal of Pharmacology and Experimental Therapeutics, 305(3), pp.880-886.
Adequate vitamin C
Tokuda et al, 2015. Ascorbic acid deficiency increases endotoxin influx to portal blood and liver inflammatory gene expressions in ODS rats. Nutrition, 31(2), pp.373-379.
Failed attempts with currently probiotics
Leber et al, 2012. The influence of probiotic supplementation on gut permeability in patients with metabolic syndrome: an open label, randomized pilot study. European journal of clinical nutrition, 66(10), pp.1110-1115.
Lee et al, 2014. The effects of co-administration of probiotics with herbal medicine on obesity, metabolic endotoxemia and dysbiosis: a randomized double-blind controlled clinical trial. Clinical Nutrition, 33(6), pp.973-981.
Positive result for Akkermansia.
Li, et al, 2016. Akkermansia muciniphila protects against atherosclerosis by preventing metabolic endotoxemia-induced inflammation in Apoe-/-mice. Circulation, pp.CIRCULATIONAHA-115.
I am enthused about results with Akkermansia, which may someday become available as a prescription probiotic, or cultured for its membrane proteins which have a similar effect in inducing mucin production. I probably have written about it elsewhere, but the interventions that increase Akkermansia parallel those that reduce endotoxemia: inulin and other oligofructans (Allium vegetables like onions, leeks, garlic), alpha-galactosides (beans), arabinoxylan (wheat/rye/barley bran, or their whole grains), fucoidan (seaweed), resistant starch (pasta, retrograded starches, high amylose corn), polyphenols (ubiquitous in fruit, esp dark colored berries), capsaicin (hot peppers). On the other hand, high protein diets reduce Akkermansia levels. I can add sources for Akkermansia changing interventions sources here later, if there's interest.
Edited by Darryl, 21 November 2017 - 07:37 PM.