TABLE 3.

Summary of clinical interventional trials of metabolic endotoxemia¹

Outcome	Sample size	Treatment(s) and control	Endotoxin	Inflammatory markers included	Reference
A high-fat meal increased plasma endotoxin concentrations and endotoxin-neutralization capacity	12 healthy adult men	Control—no mealTreatments—∼900 kcal serving of toast with butter with or without 3 cigarettes	↑2	TNF↔	Erridge et al. (40)
A high-fat, high-carbohydrate meal increased plasma endotoxin concentrations and pro-inflammatory activity	20 healthy adults	Control—oatmeal, milk, orange juice, raisins, peanut butter, and English muffin Treatment—egg muffin and sausage muffin sandwiches and 2 hash browns	↑2	TNF↔, CRP↔, NFκB↑	Ghanim et al. (41)
A high-fat meal increased plasma endotoxin concentrations and these concentrations were positively correlated with triglyceridemia	40 morbidly obese adults	Treatment—50 g fat (10 g SFA, 29.46 g MUFA, and 10.625 g PUFA)	↑2	CRP↔	Clemente-Postigo et al. (42)
A high--saturated fat meal increased plasma endotoxin concentrations and inflammation compared to a high--unsaturated fat or low-fat meal	20 healthy adults	Control—porridge made with olive oil (20% fat) Treatment—porridge made with fish oil, grapeseed oil, or coconut oil (35% fat)	↑2	IL-6↔, IL-8↔, TNF↔	Lyte (37)

¹CRP, C-reactive protein. ↑, increase; ↓, decrease; ↔, even

²Measured using the Limulus amebocyte lysate assay.