Leaky gut and mental health
Stress and mental health issues are associated with inflammatory bowel diseases and leaky gut.
Stress hormones and moods can result in reduced levels of mood-boosting neurotransmitters in the brain and increase the risk of developing gut disorders, or flare ups of existing gut disorders. Several studies have found that patients with inflammatory gut conditions experienced worsening symptoms after stressful events. Chronic, or long-term, stress and depression is associated with more gut pain, leaky gut, and other inflammatory gut conditions like Crohn’s and ulcerative colitis. Stress can affect changes in the microbiota and the lining of the gut, and can further increase the gut inflammation. In animals, studies show that being under stress increases their intestinal permeability and inflammation.
We used to think that the brain sent direction down to control all parts of our bodies. We’re learning that a lot of the communication between the gut and the brain starts in the gut and goes up to the brain. Several studies show that in about half of people studied, gut symptoms arose before the mood issues did.
People who have gut disorders have a higher risk of developing anxiety or depression. Sometimes experiencing symptoms like abdominal pain, bloating, and discomfort can affect the quality of life and moods of people who have inflammatory bowel disease.Some animal models of the inflammatory gut condition colitis promoted behavioural changes that are similar to mood disorders in people. Also, mice given an SCFA called butyrate seemed to experience an antidepressant effect.
These links between the gut and mental health are because of the “microbiota-gut-brain axis.” This axis includes many connections between the two of them, including through our nerves and hormones.
When the areas of the brain associated with stress are activated, this initiates the stress response. The stress response is twofold. First, it includes the release of stress hormones (hypothalamic-pituitary-adrenal axis - HPA axis) that go through the whole body. Second, it includes activation of the “fight or flight” (autonomic) part of the body’s nervous system. Both the hormones and autonomic nervous system affect the gut. And these can affect all three layers of the gut lining.
One of the key stress hormones of this HPA-axis is from the adrenal glands (the “A” in HPA). It’s the infamous stress hormone called cortisol. Cortisol is released into the bloodstream when we’re under stress. Cortisol directly affects the gut by reducing our ability to properly digest food, and instead prioritizes survival. It essentially prepares for “fight or flight” by slowing down the “rest and digest” functions.
Mouse studies show that SCFAs may help to normalize the leakiness in not just our gut lining, but our “brain lining” (e.g. “blood-brain barrier”) too.
What you can do about leaky gut
When our “good” gut microbes are happy eating their favourite foods they have positive effects on our gut - crowding out the “bad” microbes and producing beneficial anti-inflammatory compounds like SCFAs.
The type of microbes that live in your gut is established by the time you’re 3-5 years old. About 30-40% of it can be influenced by factors such as diet.
According to Aguayo-Patron, 2017: “Diet is the main factor that influences gut microbiota composition.”
1. Eat more fresh, unprocessed and minimally processed foods
We’re talking things like:
Fruits and vegetables
Nuts and seeds
Fish
This is sometimes referred to as an “old fashioned” diet. It includes fresh and minimally processed foods that are closer to the way they’re found in nature. These promote a healthy mix of the “good” gut microbes.
One of the reasons is because these foods contain higher amounts of fibre and “resistant” starch. Sugars and easily-digested starches are broken down and absorbed into the bloodstream as sugar. Resistant starches and fibre, on the other hand, are “resistant” to this process and make it all the way through our intestines to where most of our gut microbes live.
These can then become food for our “good” gut microbes and promote their health.
Another way un-processed and minimally processed foods help our gut microbes is because of the lower amounts of trans and saturated fats, and higher amounts of healthy fats like unsaturated and omega-3 fats. Some studies show that diets high in fat tend to promote more “bad” microbes in our guts.
Another possible reason why fresh and unprocessed foods are beneficial is that some of the additives used in ultra-processed foods can also affect our gut microbiota. This leads us to the second thing you can do about leaky gut.
2 - Ditch the ultra-processed and fast foods!
These are the quick and easy foods that are:
Ready to eat
Ready to heat
Pre-packaged
Convenient
Fast
They tend to be high in calories, fat, sugar, salt, and contain additives. These are the foods that have a lot of sugar and easily digested starches that raise our blood sugar, and not a lot of fibre and resistant starches. They have more total fat, including trans and saturated fats. And, they tend to be not very filling and promote obesity.
These types of foods also promote inflammation and gut dysbiosis - factors associated with leaky guts! People who tend to eat less of these, and more fresh and unprocessed foods tend to have happier gut microbiota, less inflammation, and a nice strong non-leaky gut lining.
3 - Pay attention to potential food intolerances
Some gut symptoms may be related to food intolerances. Certain people may have undiagnosed celiac disease, or be sensitive to gluten and can benefit from removing it from the diet. There are a lot of gluten-free foods available now, however ultra-processed gluten-free foods are still ultra-processed and should be avoided in favour for fresh and unprocessed foods.
Also, some people are intolerant to certain carbohydrates called FODMAPS (fermentable oligo-, di-, and mono-saccharides and polyols). These are found in stone fruits, legumes, lactose-containing foods, and artificial sweeteners.
Ask your health professional to see if you should be tested for food intolerances.
4 - Reduce alcohol
Alcohol can stress our friendly gut microbes and can disrupt the function of our three-layered gut lining. It can cause bacterial overgrowth, and at the same time reduce some of the friendly “good” microbes like Lactobacillus.
Some “bad” bacteria, including E. coli can produce alcohol, so this may be one of the ways that they contribute to leaky gut.
5 - Consider probiotics
Probiotics are live microorganisms that have a beneficial effect on human health. They are found in fermented foods like yogurt, kefir, kombucha, miso, kimchi, and fermented vegetables. They are also available as dietary supplements.
Infections and use of antibiotics, especially during the first months of life, can have a negative effect on our gut microbiota. If you have to take an antibiotic, ask your healthcare professional if you should also take certain probiotics to help reduce the impact on your gut microbiota.
Clinical trials are being done to test whether probiotics may benefit inflammatory gut conditions even without antibiotic use. More research is needed to confirm which amounts of which types of probiotics are the most beneficial for which conditions.
CAUTION: Before taking any supplements, make sure to read the label and pay attention to the warnings. If you are taking other supplements or medications or if you have a medical condition, be sure to consult with a knowledgeable healthcare professional first.
Leaky gut, or “intestinal permeability” is linked with many conditions of the gut, the body, and the mind. While research is still figuring out exactly how this happens and what comes first, there are definitely steps you can take today to help optimize your health.
Eat more whole, unprocessed foods, and ditch ultra-processed foods. Reduce alcohol consumption and consider probiotics. And, if you think you may have a food intolerance, be sure to speak with your healthcare professional.
References for this 3-Part Blog
Aguayo-Patrón, S. V., & Calderón de la Barca, A. M. (2017). Old Fashioned vs. Ultra-Processed-Based Current Diets: Possible Implication in the Increased Susceptibility to Type 1 Diabetes and Celiac Disease in Childhood. Foods, 6(11), 100. http://doi.org/10.3390/foods6110100
Brzozowski, B., Mazur-Bialy, A., Pajdo, R., Kwiecien, S., Bilski, J., Zwolinska-Wcislo, M., … Brzozowski, T. (2016). Mechanisms by which Stress Affects the Experimental and Clinical Inflammatory Bowel Disease (IBD): Role of Brain-Gut Axis. Current Neuropharmacology, 14(8), 892–900. http://doi.org/10.2174/1570159X14666160404124127
Fasano A. (2011). Zonulin and its regulation of intestinal barrier function: the biological door to inflammation, autoimmunity, and cancer. Physiol Rev. 91(1):151-75. doi: 10.1152/physrev.00003.2008. LINK: https://www.physiology.org/doi/pdf/10.1152/physrev.00003.2008
Holtmann G, Shah A, Morrison M. (2017). Pathophysiology of Functional Gastrointestinal Disorders: A Holistic Overview. Dig Dis, 35 Suppl 1:5-13. doi: 10.1159/000485409.
Holzer, P., Farzi, A., Hassan, A. M., Zenz, G., Jačan, A., & Reichmann, F. (2017). Visceral Inflammation and Immune Activation Stress the Brain. Frontiers in Immunology, 8, 1613. http://doi.org/10.3389/fimmu.2017.01613
Kelly, J. R., Kennedy, P. J., Cryan, J. F., Dinan, T. G., Clarke, G., & Hyland, N. P. (2015). Breaking down the barriers: the gut microbiome, intestinal permeability and stress-related psychiatric disorders. Frontiers in Cellular Neuroscience, 9, 392. http://doi.org/10.3389/fncel.2015.00392
Lamprecht, M., Bogner, S., Schippinger, G., Steinbauer, K., Fankhauser, F., Hallstroem, S., … Greilberger, J. F. (2012). Probiotic supplementation affects markers of intestinal barrier, oxidation, and inflammation in trained men; a randomized, double-blinded, placebo-controlled trial. Journal of the International Society of Sports Nutrition, 9, 45. http://doi.org/10.1186/1550-2783-9-45
Lerner, A & Matthias, T. (2015). Changes in intestinal tight junction permeability associated with industrial food additives explain the rising incidence of autoimmune disease. Autoimmun Rev, 14(6):479-89. doi: 10.1016/j.autrev.2015.01.009.
Lerner, A., Neidhöfer, S., & Matthias, T. (2017). The Gut Microbiome Feelings of the Brain: A Perspective for Non-Microbiologists. Microorganisms, 5(4), 66. http://doi.org/10.3390/microorganisms5040066
Mu, Q., Kirby, J., Reilly, C. M., & Luo, X. M. (2017). Leaky Gut As a Danger Signal for Autoimmune Diseases. Frontiers in Immunology, 8, 598. http://doi.org/10.3389/fimmu.2017.00598
Slyepchenko, A., Maes, M., Jacka, F.N., Köhler, C.A., Barichello, T., McIntyre, R.S., Berk, M., Grande, I., Foster, J.A., Vieta, E. & Carvalho, A.F. (2017). Gut Microbiota, Bacterial Translocation, and Interactions with Diet: Pathophysiological Links between Major Depressive Disorder and Non-Communicable Medical Comorbidities. Psychother Psychosom, 86(1):31-46.
Sturgeon, C., & Fasano, A. (2016). Zonulin, a regulator of epithelial and endothelial barrier functions, and its involvement in chronic inflammatory diseases. Tissue Barriers, 4(4), e1251384. http://doi.org/10.1080/21688370.2016.1251384
Wikipedia. Bacteroidetes. Accessed May 22, 2018.
Wikipedia. Firmicutes. Accessed May 22, 2018.
Wilms, E., Gerritsen, J., Smidt, H., Besseling-van der Vaart, I., Rijkers, G. T., Garcia Fuentes, A. R., … Troost, F. J. (2016). Effects of Supplementation of the Synbiotic Ecologic® 825/FOS P6 on Intestinal Barrier Function in Healthy Humans: A Randomized Controlled Trial. PLoS ONE, 11(12), e0167775. http://doi.org/10.1371/journal.pone.0167775
World Health Organization, Food and Agriculture Organization. Probiotics. Accessed May 22, 2018.
Xiao, L., van’t Land, B., van de Worp, W. R. P. H., Stahl, B., Folkerts, G., & Garssen, J. (2017). Early-Life Nutritional Factors and Mucosal Immunity in the Development of Autoimmune Diabetes. Frontiers in Immunology, 8, 1219. http://doi.org/10.3389/fimmu.2017.01219