(Although this post is directed toward people concerned about diabetes, it is relevant for anybody that wants to avoid one of the main drivers of degenrative disease and accelerated aging.)

If you or somebody you love is struggling with diabetes, pre-diabetes, or Metabolic Syndrome, no doubt you've been told to focus on doing things to lower your blood sugar, like reducing carbohydrate consumption, changing the types of carbohydrates that you eat, exercising more, and taking insulin or other drugs.

But your blood sugar is still too high, and you are tired of having to worry about whether this condition is going to get worse and cause serious disease.

Or maybe your blood sugar is "well-managed", but you wish you could eat more freely, stop monitoring your sugar, stop taking medications, and live a life free of all of this.

The truth is that you can be free of all of this if you identify and reverse the cause(s).

The Role of "Metabolic Endotoxemia" in Diabetes

One of the main causes of diabetes is "metabolic endotoxemia", which is a state of systemic inflammation associated with an elevated level of bacterial endotoxin in the blood coming from gram-negative bacteria in the gut. The most well-known endotoxin  from gram-negative bacteria is lipopolysaccaride (LPS).

Chronic low-grade inflammation is a feature of many chronic conditions including type 2 diabetes, non-alcoholic fatty liver disease (NAFLD), chronic kidney disease, atherosclerosis, neurodegenerative disease, cancer, and more.

Gram-Negative Bacteria and Intestinal Hyperpermeability

The amount of bacterial endotoxin produced in the gut increases if there are more gram-negative bacteria than normal in a healthy gut microbiome, which is a microbiome balance generally referred to as "dysbiosis".

And the amount of endotoxin produced in the gut increases if gram-negative bacteria in the gut are fed foods that are not fully digested and absorbed in the small intestine, like resistant starches and soluble fiber.

Then the amount of endotoxin that gets from the gut into the bloodstream increases if the intestinal lining becomes more permeable than normal (intestinal hyperpermeability / leaky gut).

Higher dysbiosis, higher endotoxin production, and a leaky gut can occur without symptoms in the gut. So the presence or absence of gut symptoms is not a reliable indicator of this condition.

Endotoxin Promotes Diabetes, and Diabetes Promotes Endotoxin

Diabetes appears to have a bidirectional relationship with endotoxin. In other words, endotoxin promotes diabetes, and diabetes promotes endotoxin.

Elevated blood endotoxin causes mitochondrial dysfunction, activates immune system oxidative and inflammatory processes, and causes abnormal liver function.

All of this reduces the body's ability to metabolize glucose and fats, lowers metabolic rate, and promotes fat storage and dyslipidemia (abnormal blood lipids like triglycerides and cholesterol).

Interestingly, the level of endotoxin has been observed to be much higher in type 1 diabetics than in type 2 diabetics. This makes sense because type 1 diabetes is typically considered an autoimmune condition, and autoimmune diseases are also associated with increased levels of endotoxin in blood.

Drugs that lower blood sugar tend to lower blood endotoxin. This is probably a result of the fact that chronically elevated blood sugar increases gut permeability, enabling more bacterial endotoxin to enter the blood.

Elevated blood sugar also promotes intestinal dysbiosis, leading to higher production of endotoxin.

Endotoxin Ages You Faster

It is probably no surprise that anything that promotes systemic inflammation, diabetes, weight gain, nonalcoholic fatty liver disease, heart disease, neurodegenerative disease, cancer, autoimmune disease, etc would age you faster.

However, it might surprise you to learn that research has shown that the benefits of caloric restriction, the most agreed-upon way to promote longevity, are probably due to the reduction of endotoxin in the blood.

Did you catch that? The most "well-established" promoter of longevity that so many health influencers endlessly talk about, (caloric restriction) does not seem to work via restricting calories!

Rather, it seems to extend life by reducing endotoxin production and entry into the blood. This is a blockbuster discovery!

So if you normalize your intestinal microbiome and permeability, and possibly alter what you eat so that you're not feeding endotoxin-producing bacteria, then you probably do not need to restrict calories as part of your approach to living as long as you can while aging gracefully. 

But you do need to have other strategies for keeping endotoxin low.

Reversing Metabolic Endotoxemia

Reversing metabolic endotoxemia requires a normal gut microbiome, normal gut permeability, and normal blood sugar. Sometimes this can be achieved with simple dietary changes and supplements, but other times there is more to it.

An almost bewildering number of factors can be at play in the gut, and no one dietary appraoch works for everybody.

Here are some of the influences that can affect the gut side of the equation:

• Reduced transit time of food through the small intestine due to factors like altered vagus nerve function, jawbone cavitations, low production of stomach acic and/or bile, etc
• Altered vagus nerve function caused by factors like mold toxicity, head or neck trauma, craniocervical instability, forward head posture, etc
• Nasal and/or oral dysbiosis
• Food sensitivities or allergies
• Drugs like nonsteroidal antiinflammatories and proton pump inhibitors
• Glyphosate and other toxins in food
• Genetically modified food (especially GMO corn)
• Consumption of hyperprocessed foods
• High blood sugar
• High cortisol
• Insomnia or sleep apnea
• Toxins like heavy metals

Many people struggle endlessly to fix their gut health because they have not fully identified and addressed all of the factors driving their gut challenges. They have been taught to focus their efforts directly on the gut with herbs, probiotics, and nutrients to heal the gut lining. But sometimes this is not enough.

When it comes to the diet part of the equation, some people do well with low-carb, high-fat diets while others do well with high-carb, low-fat diets. And the best approach for some might be to cycle between the two. That's what I do, and I let my body guide me.

In all cases, it's important to keep in mind what feeds gram-negative bacteria, which is mainly soluble fiber and resistant starch from foods like whole grains, legumes, green plantains, rice or potatoes that have been cooled, and others.

Only people that produce a lot of starch-digesting enzymes (largely dependent on genetic inheritance) and have low levels of gram-negative bacteria in the colon should eat much or any of these foods if they want to minimize endotoxin.

A Few Quick Tips

On a side note, you may be able to suppress your level of gram negative bacteria with each meal by eating fermented vegetbles with the meal because the bacteria in fermented food are gram-positive, and they can compete with gram-negative bacteria as they pass through your gut.

Polyphenols in foods also tend to suppress the production of endotoxin, so eat colorful vegetables and fruits that agree with you. Raw carrots are uniquely effective at reducing endotoxin production, so consider eating a carrot with every meal.

And surprisingly, although saturated fat brings more endotoxin into the bloodstream, this may actually be protective because saturated fat largely neutralizes endotoxin's pro-inflammatory effect on the immune system while delivering endotoxin to the place where it can most effectively be dismantled (the liver) and prevented endotoxin from accessing other parts of the body. Polyunsaturated fats do not have saturated fat's endotoxin-binding effect.

When endotoxin is not bound by saturated fat and brought into the body via the absorption of the saturated fat, endotoxin remaining in the gut promotes intestinal hyperpermeability, inflammation, and direct entry unbound into the blood and all tissues of the body. This route of entry by endotoxin is far more inflammatory than entering bound to saturated fat.

So the usual concern about saturated fat consumption in the presence of gut dysbiosis may be misguided because saturated fat appears to reduce the endotoxemic effects of endotoxin. However, more research should be conducted in case the net influence of saturated fat in conjunction with endotoxin differs from one context to another.

Escape Endotoxemia

Metabolic endotoxemia chains you to a set of disease processes from which you cannot escape until you get at the root causes driving it. But once you eliminate it and any other causes driving diabetes, you will regain much more freedom with what you eat, and you can stop pricking your finger multiple times a day, injecting insulin, taking medications, or worrying about the long-term consequences of chronically elevated blood sugar.

If you would like help with identifying the cause(s) of gut dysfunction, diabetes, or other health challenges, download the Bio-Individual Blueprint Roadmap, watch the video, and schedule a time to chat.