INTESTINAL BARRIER PERMEABILITY AND ITS RELATIONSHIP WITH ANTHROPOMETRIC, BIOCHEMICAL, AND DIETARY VARIABLES
Lactulose, mannitol, Leaky gut, 24-hour recall, MSM, NOVA food processing classification
Background and Aims: The intestinal barrier is one of the human body's first line of immune defense, and responsible for the absorption of dietary nutrients. This study aimed to evaluate the permeability of the intestinal barrier and its associations with anthropometric and biochemical variables, usual dietary intake, and level of food processing intake.
Methods: This is a cross-sectional study involving 101 individuals > 18 years conducted between October/19 and March/23. Data collection included anthropometric (weight, height, waist, and hip circumferences) and biochemical variables, estimation of usual dietary intake (from two 24-hour recalls) using the MSM method, and assessment of food processing level, considering the NOVA classification. The Lactulose/Mannitol (L/M) test was used to assess intestinal permeability, and logistic regression was performed to assess associations between anthropometric and dietary variables and intestinal permeability.
Results: Urinary mannitol excretion showed a direct correlation with BMI and waist and hip circumferences, as well as an inverse correlation with magnesium's usual dietary intake. Urinary lactulose excretion was inversely correlated with serum retinol and total fat. The L/M ratio showed an inverse correlation with serum retinol, hip circumference, and total and saturated fat usual dietary intake, and a direct correlation with magnesium usual dietary intake. No association was found between the degree of food processing and intestinal permeability. The regression model demonstrated that higher serum retinol concentrations (AOR = 0.533; 95% CI = 0.312–0.910; p = 0.021) and higher monounsaturated usual dietary fat intake (AOR = 0.850; 95% CI = 0.742–0.974; p = 0.019) were inversely associated with the likelihood of increased intestinal barrier permeability.
Conclusions: Higher BMI, waist, and hip circumferences result in a larger intestinal absorption area, representing a physiological adaptation to allow the intestine to absorb a greater amount of nutrients that enter the lumen and become available for absorption. Usual dietary intake of total, saturated, and monounsaturated fats and serum retinol has a beneficial effect on the intestinal barrier. Regarding the degree of food processing, we found no relationship between the consumption of ultra-processed foods and intestinal permeability in our study.