Postprandial Fatigue, Part II: Endotoxemia, Inflammation, and Mitochondrial Dysfunction

A few weeks ago NBT Scientific Director Megan Hall and I met up to discuss the causes of postprandial fatigue, commonly known as “food coma”. We talked about two common causes, both associated with glucose dysregulation. Megan described some of the mechanisms causing hypoglycemia, including accelerated gastric emptying, periods of increased insulin sensitivity, and low hormonal states, while hyperglycemia is often associated with insulin resistance. This was such a big topic we only covered about half of it the first time around, so we’re continuing the conversation today.

On this podcast, Megan and I discuss three additional causes of postprandial fatigue: endotoxin, inflammation, and mitochondrial dysfunction. Megan describes each of these scenarios in detail, discussing some of the upstream causes that can be targeted early on to avoid problems. She also provides practical steps you can take if you’re one of the millions dozing off after lunch every day. Be sure to follow along with Megan’s outline for this podcast. 

Here’s the outline of this interview with Megan Hall:

[00:01:42] Previous podcast: Postprandial Fatigue: Is It Normal To Need A Nap After Lunch? 

[00:03:20] Hans Vink; Hyperglycemia reduces glycocalyx volume while NAC infusion prevents the reduction. Nieuwdorp, Max, et al. "Loss of endothelial glycocalyx during acute hyperglycemia coincides with endothelial dysfunction and coagulation activation in vivo." Diabetes 55.2 (2006): 480-486.

[00:03:51] Malcolm Kendrick on the glycocalyx; Podcasts: Why Cholesterol Levels Have No Effect on Cardiovascular Disease (And Things to Think about Instead) and A Statin Nation: Damaging Millions in a Brave New Post-health World.

[00:04:51] NBT Strength and Conditioning Coach Zach Moore; Podcast: How to Strength Train Without a Gym.

[00:06:21] Postprandial endotoxemia (PPE): definition, causes, downstream effects; Study: Kelly, Caleb J., Sean P. Colgan, and Daniel N. Frank. "Of microbes and meals: the health consequences of dietary endotoxemia." Nutrition in Clinical Practice 27.2 (2012): 215-225. 

[00:11:04] What to do about PPE.

[00:11:56] Probiotics; Podcasts: How to Optimise Your Gut Microbiome and Microbiome Myths and Misconceptions, with Lucy Mailing, PhD; How to Use Probiotics to Improve Your Health, with Jason Hawrelak, PhD.

[00:12:10] Megasporebiotic; Study: McFarlin, Brian K., et al. "Oral spore-based probiotic supplementation was associated with reduced incidence of post-prandial dietary endotoxin, triglycerides, and disease risk biomarkers." World Journal of Gastrointestinal Pathophysiology 8.3 (2017): 117.

[00:12:36] Chris' sister's story.

[00:13:51] S. boulardii - may help with gut barrier function; Study: Terciolo, Chloe, Michel Dapoigny, and Frederic Andre. "Beneficial effects of Saccharomyces boulardii CNCM I-745 on clinical disorders associated with intestinal barrier disruption." Clinical and experimental gastroenterology 12 (2019): 67.

[00:14:23] Additional supplements that may help with gut: Enteromend, Permaclear, GI Revive, SBI Protect.

[00:17:09] Dietary interventions for PPE.

[00:17:14] Plant polyphenols; Studies: 1. Wong, Ximena, et al. "Polyphenol extracts interfere with bacterial lipopolysaccharide in vitro and decrease postprandial endotoxemia in human volunteers." Journal of Functional Foods 26 (2016): 406-417; 2. González‐Sarrías, Antonio, et al. "The endotoxemia marker lipopolysaccharide‐binding protein is reduced in overweight‐obese subjects consuming pomegranate extract by modulating the gut microbiota: A randomized clinical trial." Molecular nutrition & food research 62.11 (2018): 1800160; 3. Kolehmainen, Marjukka, et al. "Bilberries reduce low‐grade inflammation in individuals with features of metabolic syndrome." Molecular nutrition & food research 56.10 (2012): 1501-1510. 

[00:17:36] Sulforaphane; Studies: 1. Yanaka, Akinori, Junya Sato, and Shun Ohmori. "Sulforaphane protects small intestinal mucosa from aspirin/NSAID-induced injury by enhancing host defense systems against oxidative stress and by inhibiting mucosal invasion of anaerobic enterobacteria." Current pharmaceutical design 19.1 (2013): 157-162. 2. Yanaka, Akinori. "Role of sulforaphane in protection of gastrointestinal tract against H. pylori and NSAID-induced oxidative stress." Current pharmaceutical design 23.27 (2017): 4066-4075.

[00:17:53] Hormetea.

[00:20:20] Dietary oil composition plays a role in endotoxin transport; Study: Mani, Venkatesh, James H. Hollis, and Nicholas K. Gabler. "Dietary oil composition differentially modulates intestinal endotoxin transport and postprandial endotoxemia." Nutrition & metabolism 10.1 (2013): 6.

[00:21:55] Supporting detoxification; Studies: 1. Fox, Eben S., Peter Thomas, and Selwyn A. Broitman. "Hepatic mechanisms for clearance and detoxification of bacterial endotoxins." The journal of nutritional biochemistry 1.12 (1990): 620-628 (SciHub); 2. Munford, Robert S. "Invited review: detoxifying endotoxin: time, place and person." Journal of endotoxin research 11.2 (2005): 69-84.

[00:22:20] Enterosgel.

[00:24:04] Inflammation; Study: Mo, Zhenzhen, et al. "Endotoxin May Not Be the Major Cause of Postprandial Inflammation in Adults Who Consume a Single High-Fat or Moderately High-Fat Meal." The Journal of Nutrition 150.5 (2020): 1303-1312.

[00:25:51] Lucy Mailing on gut barrier integrity: Article: Is a high-fat or ketogenic diet bad for your gut? Discussed on NBT Forum post.

[00:26:26] Food sensitivities; Studies: 1. Ohtsuka, Yoshikazu. "Food intolerance and mucosal inflammation." Pediatrics International 57.1 (2015): 22-29; 2. Wilders-Truschnig, M., et al. "IgG antibodies against food antigens are correlated with inflammation and intima media thickness in obese juveniles." Experimental and clinical endocrinology & diabetes 116.4 (2008): 241.

[00:27:58] IL-1 and postprandial fatigue; Study: Lehrskov, Louise L., et al. "The role of IL-1 in postprandial fatigue." Molecular metabolism 12 (2018): 107-112.

[00:29:05] Mitochondrial dysfunction and glucose dysregulation; Study: Sergi, Domenico, et al. "Mitochondrial (dys) function and insulin resistance: From pathophysiological molecular mechanisms to the impact of diet." Frontiers in physiology 10 (2019): 532.

[00:29:54] Normal vs pathological biochemistry.

[00:32:53] TCA cycle and electron transport chain.

[00:33:21] Insulin resistance is a cellular antioxidant defense mechanism; Study: Hoehn, Kyle L., et al. "Insulin resistance is a cellular antioxidant defense mechanism." Proceedings of the National Academy of Sciences 106.42 (2009): 17787-17792.

[00:35:02] Blood sugar dysregulation and mito dysfunction; Studies: 1. Stefano, George B., Sean Challenger, and Richard M. Kream. "Hyperglycemia-associated alterations in cellular signaling and dysregulated mitochondrial bioenergetics in human metabolic disorders." European journal of nutrition 55.8 (2016): 2339-2345; 2. Rolo, Anabela P., and Carlos M. Palmeira. "Diabetes and mitochondrial function: role of hyperglycemia and oxidative stress." Toxicology and applied pharmacology 212.2 (2006): 167-178; 3. Kaikini, Aakruti Arun, et al. "Targeting mitochondrial dysfunction for the treatment of diabetic complications: pharmacological interventions through natural products." Pharmacognosy Reviews 11.22 (2017): 128.

[00:36:26] How to support mitochondria.

[00:36:46] Low-carb diet; Study: Miller, Vincent J., Frederick A. Villamena, and Jeff S. Volek. "Nutritional ketosis and mitohormesis: potential implications for mitochondrial function and human health." Journal of nutrition and metabolism 2018 (2018).

[00:37:04] Exercise; Studies: 1. Oliveira, Ashley N., and David A. Hood. "Exercise is mitochondrial medicine for muscle." Sports Medicine and Health Science 1.1 (2019): 11-18; 2. Memme, Jonathan M., et al. "Exercise and mitochondrial health." The Journal of Physiology (2019); 3. Huertas, Jesus R., et al. "Stay fit, stay young: mitochondria in movement: the role of exercise in the new mitochondrial paradigm." Oxidative Medicine and Cellular Longevity 2019 (2019).

[00:37:31] TRE or fasting, CR; Study: Lettieri-Barbato, Daniele, et al. "Time-controlled fasting prevents aging-like mitochondrial changes induced by persistent dietary fat overload in skeletal muscle." PloS one 13.5 (2018): e0195912.

[00:38:03] Dietary polyphenols; Studies: 1. Sun, Chongde, et al. "Dietary polyphenols as antidiabetic agents: Advances and opportunities." Food Frontiers 1.1 (2020): 18-44; 2. Teixeira, José, et al. "Dietary polyphenols and mitochondrial function: role in health and disease." Current medicinal chemistry 26.19 (2019): 3376-3406.

[00:38:47] Eat berries before a carb rich meal; 1. Törrönen, Riitta, et al. "Berries reduce postprandial insulin responses to wheat and rye breads in healthy women." The Journal of nutrition 143.4 (2013): 430-436; 2. Xiao, Di, et al. "Attenuation of postmeal metabolic indices with red raspberries in individuals at risk for diabetes: A randomized controlled trial." Obesity 27.4 (2019): 542-550.

[00:39:34] Eat fatty fish; Studies: Lanza, Ian R., et al. "Influence of fish oil on skeletal muscle mitochondrial energetics and lipid metabolites during high-fat diet." American Journal of Physiology-Endocrinology and Metabolism 304.12 (2013): E1391-E1403; 2. de Oliveira, Marcos Roberto, et al. "Omega-3 polyunsaturated fatty acids and mitochondria, back to the future." Trends in food science & technology 67 (2017): 76-92.

[00:39:53] Sleep; Studies: 1. Rodrigues, Nathane Rosa, et al. "Short-term sleep deprivation with exposure to nocturnal light alters mitochondrial bioenergetics in Drosophila." Free Radical Biology and Medicine 120 (2018): 395-406; 2. Schmitt, Karen, et al. "Circadian control of DRP1 activity regulates mitochondrial dynamics and bioenergetics." Cell metabolism 27.3 (2018): 657-666.

[00:40:16] Supplements to support mitochondria; Study: Wesselink, E., et al. "Feeding mitochondria: potential role of nutritional components to improve critical illness convalescence." Clinical nutrition 38.3 (2019): 982-995.

[00:42:22] Outline for this podcast. 

[00:42:25] Dr. Josh Turkett’s 4-quadrant model.

[00:44:47] 35% of pharmaceuticals cause mito dysfunction; Studies: 1. Meyer, Joel N., and Sherine SL Chan. "Sources, mechanisms, and consequences of chemical-induced mitochondrial toxicity." (2017): 2-4; and 2. Dykens, James A., and Yvonne Will. "The significance of mitochondrial toxicity testing in drug development." Drug discovery today 12.17-18 (2007): 777-785.

[00:45:08] Environmental pollutants; Podcast: Environmental Pollutants and the Gut Microbiome, with Jodi Flaws, PhD.

[00:45:22] Psychological stress; Podcast: Germline Exposures with Jill Escher.

[00:46:35] Support NBT on Patreon.

[00:46:51] Book a free 15-minute starter session with one of our coaches.