Sweet, bloody consumption - what we eat and how it affects vascular ageing, the BBB and kidney health in CKD

Gut Microbes. 2024 Jan-Dec;16(1):2341449. doi: 10.1080/19490976.2024.2341449. Epub 2024 Apr 30.


In today's industrialized society food consumption has changed immensely toward heightened red meat intake and use of artificial sweeteners instead of grains and vegetables or sugar, respectively. These dietary changes affect public health in general through an increased incidence of metabolic diseases like diabetes and obesity, with a further elevated risk for cardiorenal complications. Research shows that high red meat intake and artificial sweeteners ingestion can alter the microbial composition and further intestinal wall barrier permeability allowing increased transmission of uremic toxins like p-cresyl sulfate, indoxyl sulfate, trimethylamine n-oxide and phenylacetylglutamine into the blood stream causing an array of pathophysiological effects especially as a strain on the kidneys, since they are responsible for clearing out the toxins. In this review, we address how the burden of the Western diet affects the gut microbiome in altering the microbial composition and increasing the gut permeability for uremic toxins and the detrimental effects thereof on early vascular aging, the kidney per se and the blood-brain barrier, in addition to the potential implications for dietary changes/interventions to preserve the health issues related to chronic diseases in future.

Keywords: artificial sweeteners; blood brain barrier; chronic kidney disease; cognitive decline; dysbiosis; early vascular aging; gut microbiome; red meat; uremic toxins.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Blood-Brain Barrier* / metabolism
  • Diet, Western / adverse effects
  • Gastrointestinal Microbiome*
  • Humans
  • Kidney* / metabolism
  • Kidney* / physiopathology
  • Renal Insufficiency, Chronic* / etiology
  • Renal Insufficiency, Chronic* / metabolism
  • Renal Insufficiency, Chronic* / microbiology
  • Renal Insufficiency, Chronic* / physiopathology
  • Uremic Toxins / metabolism


  • Uremic Toxins

Grants and funding

The author(s) reported there is no funding associated with the work featured in this article.