Nutritional Management of Metabolic Endotoxemia: A Clinical Review

Altern Ther Health Med. 2017 Jul;23(4):42-54.


Context • Diet-induced, metabolic endotoxemia is emerging as an important contributory factor to the development of a wide range of chronic diseases, including cardiometabolic, autoimmune, psychiatric, and neurodegenerative illnesses. Emerging human clinical studies have demonstrated that diet and dietary components are potent modifiers of circulating endotoxins and can be used to reduce plasma levels significantly and improve metabolic health. Objective • The aim of the current study was to explore briefly the concept of metabolic endotoxemia and its relationship to disease development, to examine the influence of diet and dietary components on circulating endotoxins, and, finally, discuss the clinical relevance of nutritional interventions for management of metabolic endotoxemia. Design • The researcher performed a literature review of dietary and nutritional interactions with metabolic endotoxemia with a focus on studies relevant to clinical practice. Setting • The study took place at the UK College of Nutrition and Health (London, England). Results • Improving dietary quality, optimizing the intake of phytonutrient-rich foods, improving micronutrient status, consuming fermented foods, manipulating the gut microflora with prebiotics and probiotics, and using specific nutritional supplements, such as glutamine, lactoferrin, resveratrol, and berberine, have been shown to be effective in targeting metabolic endotoxemia. Conclusions • Diet, dietary components, and nutritional supplements, including prebiotics and probiotics, have demonstrated the ability to provide clinically important reductions in circulating endotoxins and improve related sequels, such as inflammation and other negative health markers. The development of personalized nutritional interventions for the management of metabolic endotoxemia is a promising area for future research due to the potential of such interventions to improve multiple aspects of human health and mitigate a wide range of chronic diseases.

Publication types

  • Review

MeSH terms

  • Anti-Infective Agents / therapeutic use
  • Berberine / therapeutic use
  • Diet Therapy*
  • Dysbiosis / metabolism
  • Dysbiosis / therapy*
  • Endotoxemia / metabolism
  • Endotoxemia / therapy*
  • Fermentation
  • Glutamine / therapeutic use
  • Humans
  • Inflammation
  • Intestinal Mucosa / metabolism
  • Lactoferrin / therapeutic use
  • Metabolic Diseases / metabolism
  • Metabolic Diseases / therapy*
  • Permeability
  • Polyphenols / therapeutic use
  • Prebiotics*
  • Probiotics / therapeutic use*
  • Vitamins / therapeutic use*


  • Anti-Infective Agents
  • Polyphenols
  • Prebiotics
  • Vitamins
  • Berberine
  • Glutamine
  • Lactoferrin