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The Exogenous Endotoxin Theory



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The Exogenous Endotoxin Theory

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The endotoxemia (bacterial toxins in the bloodstream) that follows a meal of animal products and results in inflammation and stiffened arteries may come from the food itself, rather than from one’s own gut bacteria.

Doctor's Note

This is the second of a three-part video series exploring the mechanism behind the spike of inflammation that follows within hours of a meal containing animal products. For part one, see The Leaky Gut Theory of Why Animal Products Cause Inflammation. Food Mass Transit details intestinal transit time, and for more on chocolate, see Update on Chocolate; Healthiest Chocolate Fix; and A Treatment for Chronic Fatigue Syndrome. The chocolate thing reminds me of the nitrate story. When accompanied by phytonutrients, what could have an adverse effect ends up being beneficial; see Are Nitrates Pollutants or Nutrients? To close up this fascinating topic, I’ll explore the role fat may play in this endotoxic reaction to meat and other animal products in Dead Meat Bacteria Endotoxemia.

For more context, check out my associated blog posts: How Does Meat Cause Inflammation?; The True Shelf Life of Cooking Oils; Top 10 Most Popular Videos of the Year; Lead Poisoning Risk From Venison; Plant-Based Diets for Fibromyalgia; and Mushrooms and Immunity.

2019 Update – I just did a new video on endotoxins: Are Pre-Cut Vegetables Just as Healthy?

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  • Michael Greger M.D. NF Health Support 11 years ago edited

    This is the second video of a three-part series exploring the mechanism behind the spike of inflammation that follows within hours of a meal containing animal products. See yesterday's NutritionFacts.org video-of-the-day for part one: The Leaky Gut Theory of Why Animal Products Cause Inflammation. Food Mass Transit details intestinal transit time and for more on chocolate see Update on Chocolate, Healthiest Chocolate Fix, and A Treatment for Chronic Fatigue Syndrome. The chocolate thing reminds me of the nitrate story. When accompanied by phytonutrients, what could have an adverse effect ends up being beneficial—see Are Nitrates Pollutants or Nutrients?. Tomorrow I'll close up this fascinating topic by exploring the role fat may play in this endotoxic reaction to meat and other animal products in Dead Meat Bacteria Endotoxemia. In the meantime, there are hundreds of other videos on more than a thousand subjects for you to check out.

      • I remember reading an article back in about 1992 before I went to Med School that stated, ALL chronic diseases were the result of chronic low-grade inflammation. Proof is in the print. Fascinating to know the physiology!

        Knowledge -- it's what's for Breakfast!

        Thank you from myself and all my patients for empowering us to become healthier and happier.

          • Hemo - do you rember when the (other) doctors learned that inflammation had something to do with CVD - they immediately invented bacterial infection in the endothelium as the main cause of CVD, and suggested that the solution could be antibiotics - a pill......!

            3 times a day with your McMuffin and coffee, your Pizza Hut and cola and your KFC with milk - pus - shake. So no problemo - NOT!

              • I don't remember Stephan but I'm sure the Pharma people loved the idea of selling ABX's to anybody and everybody!

                All back to the pill.

                Recently I had someone tell me that they work for a company called "Whole Food Supplements."
                I thought that to be the ultimate oxymoron in the nutrition industry--convince people that all they have to do is take a Whole Food Supplement rather than chew it and then who cares what you eat; you're protected from the supplements.

                How can it be a Whole Food when it's been pulverized into dust and crammed into a gelatin capsule?

              • So nice to hear the docs jumping in here. I guess it just took this amazing younger generation to come along! Finally, all of us stand together, standing up to the "corporates!" Then again things were never this bad, this very bad before.

                • Solution: Say no to McToxic

                  Does white bread with sugar, a goblet of yellow fat, with some white stuff around and a thin slice of a carcinogenic pig sound like food.......?

                  No. Eat food, not food-like things.

                  • So what is the explanation for inflammation caused by certain plant foods? I follow a plant based diet and have lupus. I have noticed that certain foods - wheat, soy, tomatoes, red peppers give me joint pain and it is common for people with lupus to be sensitive to night shade vegetables (tomatoes, eggplant, potatoes, bell peppers). Is bacteria found in these foods as well?

                      • BVG can't you just have food sensitivities to those foods?

                          • I guess I didn't explain my question well. I clearly have food sensitivities, so I'm wondering what the mechanism is behind them to see if I can do anything about it. For example, if it's a leaky gut, then I can work on healing my gut.

                              • The only way to prevent the reaction to foods you are sensitive to, is not to eat them. Continuing to consume foods that you are already sensitive to causes a continual low inflammatory response in your body, and there we are again...inflammation. Eating foods you are sensitive to is one of the leading causes of autoimmune diseases.

                            • Does the leaky gut theory still apply to the development of plant food sensitivities? What is the mechanism behind the development of inflammatory responses to wheat, soy, and certain plant foods? If these are cut out of the diet long enough, and the leaky gut healed, would it be possible to one day reintroduce these foods back in one's diet?
                              Thanks!

                                • It might explain some but it is still possible to have reactions to plant foods or substances. This can occur on your skin such as the common photo-sensitivity reaction many folks get if they rub lime juice on their skin and expose the skin to sun light or true allergies which can be mediated in the gut without the substances getting into the body itself. There are differences between sensitivities and true allergies. If you have true allergic reactions to plant substances it is best to avoid these altogether and only reintroduce the food under the care of and with the recommendation of a physician who is an allergy specialist. It is difficult to be more specific without knowing the symptoms and foods involved. Best to work with your physician on this one. Good luck.

                                    • Alot of americans have sensitivities to wheat and dairy, the reason is that on the SAD diet they consume these same food several times a day, day after day, year after year. The immune system cannot handle the constant exposure to a food item well, and will develop antigens against it. This does not always show in lab work, but will show in skin tests. Another way to find out if you have a sensitivity towards a food is to not eat the food for a couple of weeks, how do you feel? Less fatigued, foggy, swollen? Did the reddishness on your face disappear? If you had a positive response to removing the food from your diet then you have a sensitivity to it. Which means, every time you consume it there is an inflammatory response in your body, this will cause foggy thinking, fatigue, degradation of your arteries, edema. Chronic digestion will cause high bloodpressure, stroke, diabetes, certain cancers, etc. Once you become sensitive towards something, it is now a part of your immune response. Some therapies are out that that can help, LDA ‎or Subcutaneous immunotherapy. The best thing to do is to avoid the foods.

                                        • Avoidance of the foods is one stop in the process to heal the gut. Most food sensitivities are due to food antigens (allergens) leaking across the gut barrier (increased permeability) into the blood stream causing a hypersensitivity reaction. The first step in treating food sensitivities/allergies is to heal the gut; and avoidance of the suspected allergens is part of that initial protocol to allow the gut to heal.

                                      • There's no end to the evil of Mc Foods.

                                          • April Lillie 11 years ago

                                            Phew! Dark chocolate remains safe! You scared me there for a little whole :)

                                              • HELL yes April! LOVE my 90% dark Lindt and am now incorporating cocoa powder into many snacks...like dipping some walnut halves into cocoa powder, etc...!

                                                  • Much of of the focus on endotoxins in the literature is on gram-negative bacteria native to our digestive tracts, which in aggregate contain upwards of a gram of LPS in their cell walls (citation lost). When these bacteria die, their LPS is released.

                                                    Saturated fats, like those in palm, coconut, and cocoa oil, seem to increase endotoxin transit through the intestinal wall:
                                                    http://www.nutritionandmeta...

                                                    That said, vegans may harbor less gut endotoxins, as their colonic microbiota have significantly less gram-negative E. coli or Enterobacteriaceae:
                                                    http://www.hablemosclaro.or...

                                                    Also, low-fat and high fiber diets are both associated with reducing gram-negative Fermicutes and increasing gram-positive Bacteroidetes. Here's a good recent review:
                                                    http://www.ncbi.nlm.nih.gov...

                                                    Dietary fiber also reduces gut endothelial permability, reduces LPS transit into the blood, and probably reduces the time any LPS is in contact with the intestinal wall (http://www.ncbi.nlm.nih.gov... Note: probiotics + fiber are in clinical use treating septicemia, the most common cause of death in ICUs).

                                                    Perhaps cocoa (and coconut, palm) fats would have negligible effect on serum endotoxins for those eating a low-fat, high-fiber vegan diet, and avoiding injudicous antibiotic use. It's a study that we'll probably never see.

                                                    • It sounds to me like we're redefining "leaky gut" syndrome then to not include any gut leakage? It's simply toxins in the animal proteins consumed that are wreaking havoc?

                                                      • This is worth sharing with anyone you know who is affected, directly or indirectly, with heart disease. Or anyone who you would like to see not suffer from cardiovascular diseases.

                                                          • What the heck is Twitter anyway? Is it what happens to the body when we eat animal products? Because all those uppercase number symbols leaves me confused, just like I feel when I have eaten meat?

                                                              • Doc, how would eggs contain endotoxins? Are eggs themselves not sterile?

                                                                  • Dr. G,

                                                                    Not that you aren't busy but I was just perusing the citations, and I linked into another related article at PubMed:

                                                                    Stimulants of Toll-like receptor (TLR)-2 and TLR-4 are abundant in certain minimally-processed vegetables.
                                                                    http://www.ncbi.nlm.nih.gov...

                                                                    Excerpts from above link:

                                                                    Interestingly it states, "Of 5 classes of MPV's (Minimally Processed Vegetables) 3 classes of related vegetable products considered to be likely to contain a high microbial load, diced onion and bean sprouts (endobacterial spoilage or fecal contamination?) contained the highest levels of stimulants of TLR2 and TLR4.

                                                                    "The accumulation of TLR-stimulants in MPVs correlated well with growth of enterobacterial spoilage organisms.

                                                                    "In conclusion, the modern trend towards eating

                                                                    >>>> minimally processed vegetables (MPV's) rather than whole foods <<<<

                                                                    is likely to be associated with increased oral exposure to stimulants of TLR2 and TLR4."

                                                                    OK, my questions are (if you are too busy to respond I understand completely and this may be a good topic for your Ask the Doc Blog):

                                                                    1) what is the difference between MPVs compared to Whole Foods?

                                                                    A whole food is a minimally processed vegetable, or isn't it. Maybe it means something different in Britain where the study was performed.

                                                                    2) Clearly I will not knowingly eat Spoiled foods but are the TLR stimulants (LPS's and such) able to be washed or cleaned off in some way?

                                                                    2a) If not are there some MPV's we should avoid?

                                                                      see more
                                                                      • Dbloch 11 years ago

                                                                        If I eat organic non-fat yogurt, do I avoid the endotoxins since the yogurt has no fat?

                                                                          • You have alot more to worry about with dairy then just endotoxins. Your exposing your body to xenoestrogens and insulin like growth factor which are great at promoting tumor growth, throwing hormone balance off and accelerating the aging process.
                                                                            http://nutritionfacts.org/v...

                                                                              • What about just half a cup of yogurt a day and no other dairy?

                                                                                  • I cannot comfortably recommend half a cup of yogurt a day knowing the harmful side affects it entails. If you really like yogurt, then you can find soy yogurt or almond yogurt that tastes close to exactly the same but is much healthier for you.

                                                                                      • You can find a source of whole, raw, organic milk and pasteurize it yourself or not and make your own yogurt. It is not hard to do. Then you can control the environment and cleanliness of it.

                                                                                  • So, you either get endotoxins from meat products or mycotoxins from plant-based foods.

                                                                                      • Yep, makes sense why the "starvation" diet prolongs life by reducing all organ damage. We eat too damn much!! We take in too many toxins for our bodies to handle past 50 years old.

                                                                                          • Tell that to my grand mother who died at 96 due to cancer. Yeah, ovarian cancer ran in the family and majority of her sisters died before 50 but she was different due to she had her daily oatmeal and spinach.

                                                                                            Now, she did die of lung cancer which she quit smoking in their 40s. she also said she was tired of living so go figure lol.

                                                                                            • Not all plant based foods have myctoxins but even if they did, the positive outweights the negative.

                                                                                              Its more like you either get endotoxin buildup in your body from meat products or mycotoxin buildup from plant based food in your toilet. That meat eater either stays constipated or eat some metamucil.

                                                                                              I wonder if the buildup of endo toxins effect a change in mood. I definitely know it causes ibs

                                                                                                • Alan NF Health Support > A A 7 years ago

                                                                                                  AA,

                                                                                                  Endotoxins have a distinct effect on one's mood. There is a distinct activation of inflammatory pathways that alter our neurochemistry. http://www.sciencedirect.co...

                                                                                                  If you're interested in correlating your diet and it's effects, with your mood, consider doing some urinary neurochemical testing. Easy and not overly expensive but very revealing and you don't need a physician's prescription to order.

                                                                                                  Dr. Alan Kadish Moderator for Dr. Greger

                                                                                                • Very interesting! In looking at the original article by Erridge in 2011 you referenced, if I read the charts correctly it appears the TLR2 and/or TLR4 are high is some animal products but not all. For example, none or low amounts found in 2 beef samples, 2 lamb samples, 2 sausage samples (where I'd expect high levels) 1 turkey sample, 2 milk samples. But yogurt, ice cream, a second turkey sample, pork and cheese were relatively high. Next question is the source of the endotoxins. Are they a result of CAFO (confined animal feeding operations)? Why one turkey and not the other? Why ice cream and not milk? Why NOT sausage? Is it possibly like the fecal contamination where a high percentage of meat samples are contaminated but it is not a property of meat from healthy animals?

                                                                                                    • The endo toxins are there because its an animal product. The animal makes these toxins to slowly kill the predator that would be eating it.

                                                                                                      The only way to get it out is to boil it, cut it, dip it in acid, put it in a base, extract the fat from the meat... Re check to see if toxins are left. If not, redo.

                                                                                                      The meat industry is creating taste and texture numbing ingredients to put in the meat so it would still taste and feel the same even if it looks like 2 week old meat.

                                                                                                      • You sacred me a bit which the news about dark chocolate. I was like "Noooooooooo!" Thanks for the good news.

                                                                                                          • I wonder how you would account for the numerous health benefits of live, fermented food products such as kimchi, saeurkraut, fermented dairy products, etc. These foods must contain FAR more lipopolysaccharide than cooked meats and such, and thus should theoretically increase the endotoxin load substantially over even meats.

                                                                                                            The research however even shows probiotics may DECREASE endotoxemia and intestinal permeability.
                                                                                                            http://www.ncbi.nlm.nih.gov...

                                                                                                            • Why is it that beef products did not appear to cause endotoxemia in the study cited?

                                                                                                              http://journals.cambridge.o...

                                                                                                                • Tian Collen 11 years ago

                                                                                                                  Question for the doc: Does organic meat (or other animal products) also transmit endotoxins? I've followed your videos for some time and you ever say. Grass feed, grass finished organic beef?

                                                                                                                  • Would cocoa powder also have such endotoxins?

                                                                                                                      • So, saturated fat is safe in moderation, as long as it's not consumed with animal flesh.

                                                                                                                          • I am on the Ornish program, except that I also do not eat any dairy or egg whites (complete Vegan). However, I do eat natto for breakfast everyday and I do add copious amounts of Sriracha to my food. Should I be concerned because both of these product are fermented? Thank you.


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