Table 2.

Selective evidence on the association between long-term diet and endotoxemia.

Clinical Trials
Reference	Sample Characteristics at Baseline	Endotoxemia Assessment	Nutritional Assessment	Analysis Design	Results
Laugerette F. et al., Mol Nutr Food Res, 2014 [46]	18 healthy subjects (mean age 31 y, all men)	Plasma LPS quantified by LAL	Overfeeding with +70 g of lipids to the usual daily diet with 46.3% from saturated fatty acids during 8 weeks	Controlled trial	Postprandial levels of LPS compared to baseline
					No difference in fasting levels of LPS after overfeeding period compared to baseline
Breusing N. et al., J Am Coll Nutr, 2017 [50]	15 healthy subjects (age 20–29 y, all men)	Plasma LPS quantified by LAL	Overfeeding (+50% of the energy requirement) during 1 week, caloric restriction (−50% of the energy requirement, 3.5% fat) during 3 weeks and hyper-caloric refeeding (+50% of the energy requirement) with either low- or high-glycemic index diet during 2 weeks	Randomized crossover study	Fasting levels of LPS after overfeeding period (+30.8% compared to baseline)
					Normalization of fasting levels of LPS levels with the caloric restriction diet
					Fasting levels of LPS after hyper-caloric refeeding period (+24.7% compared to baseline)
López-Moreno J. et al., J Agric Food Chem, 2017 [48]	75 subjects with metabolic syndrome (mean age 56 y)	Plasma LPS quantified by LAL	Four diets (High-saturated-fatty acids diet (HSFA, 38% fat with 16% SFA, 12% MUFA and 6% PUFA), High MUFA (HMUFA, 38% fat with 8% SFA, 20% MUFA and 6% PUFA), Low-fat high complex carbohydrate (LFHCC, 28% fat) and LFHCC n-3 supplemented with n-3 PUFA) during 12 weeks	Randomized controlled trial	Postprandial levels of LPS after HSFA diet compared to baseline
					No difference in postprandial LPS levels after HMUFA, LFHCC and LFHCC n-3 diets
					No difference in fasting levels of LPS between all 4 groups of diet after intervention
López-Moreno J. et al., Exp Gerontol, 2018 [47]	20 healthy subjects (mean age 67 y, 50% men)	Plasma LPS quantified by LAL	Mediterranean diet enriched in MUFA with virgin olive oil (38% fat) or SFA-rich diet (38% fat) or low-fat high-carbohydrate diet enriched in n-3 PUFA (CHO-PUFA diet, 30% fat) during 3 weeks	Randomized crossover study	Postprandial levels of LPS after CHO-PUFA
					No difference in postprandial levels of LPS after Mediterranean diets enriched in MUFA or SFA
					Fasting levels of LPS after CHO-PUFA diet compared to Mediterranean diets enriched in MUFA or SFA
Pendyala S. et al., Gastroenterology, 2012 [49]	8 healthy subjects (mean age 60 y, 38% men) hospitalized for the study	Plasma LPS quantified by a neutrophil priming method	Western-type diet (40% fat with 20.8% from saturated fat, 20% protein and 40% carbohydrates) or Prudent-type diet (20% with 5.8% from saturated fat, 20% protein and 60% carbohydrates) during 1 month	Randomized crossover study	Fasting levels of LPS after Western-type diet (+71% compared to baseline)
					Fasting levels of LPS after prudent-type diet (−38% compared to baseline)
Observational studies
Reference	Sample Characteristics at Baseline	Endotoxemia Assessment	Nutritional Assessment	Analysis Design	Results
Amar J. et al., Am J Clin Nutr, 2008 [51]	130 subjects below the LPS detection threshold (mean age 55 y), 44 subjects between 9–39 U/mL (mean age 54 y) and 27 subjects under 39 U/mL (mean age 53 y), all healthy men	Plasma LPS quantified by Kinetic-QCL TM test	3 days of food-record diary	Cross-sectional	Fasting levels of LPS with fat and total energy intake
Kallio KA. et al., Acta Diabetol, 2015 [52]	2452 subjects (mean age 52 y)	Serum LPS quantified by LAL	24 h dietary recall	Cross-sectional	Fasting levels of LPS with total energy intake in lean healthy subjects
					No significant association between fasting levels of LPS and fat intake, and among subjects with obesity, metabolic syndrome, diabetes or coronary heart disease
Röytiö H. et al., Br J Nutr, 2017 [53]	88 overweight pregnant women (mean age 30 y)	Serum LPS quantified by LAL	Three groups based on 3 days of food-record diary (low fibre (<25 g/j) and moderate fat intake (25–40%) n = 57, high fibre (>=25 g/j) and moderate fat intake (25–40%) n=18 and low fibre (<25 g/j) and high fat intake (>=40%) n = 13)	Cross-sectional	No significant association between fasting levels of LPS and fat intake
					No difference in fasting levels of LPS levels among the three diet groups
Ahola AJ. Et al., Sci Rep, 2017 [54]	668 patients with type 1 diabetes (mean age 45 y, 44% men)	Serum LPS quantified by LAL	Food frequency questionnaire and3 days of food-records diary	Cross-sectional	Fasting levels of LPS with higher adherence score of fish, healthy snack and modern diets
					No difference in fasting levels of LPS levels for sweet, cheese, vegetable or traditional diets
					No difference in fasting levels of LPS levels for energy, macronutrients and fibre intake
Pastori D. et al., J Am Heart Assoc, 2017 [55]	704 patients with nonvalvular atrial fibrillation treated by vitamin K antagonists (mean age 74 y, 57% men)	Serum LPS quantified by ELISA	Short food frequency questionnaire	Cross-sectional	Fasting levels of LPS with higher adherence to a Mediterranean diet
					Fasting levels of LPS with higher consumption of fruits and legumes
					No difference in fasting levels of LPS levels for the consumption of olive oil, vegetables, fish, wine, meat and bread

Abbreviations: AD Alzheimer’s Disease; LPS Lipopolysaccharide; LAL Limulus Amebocyte Lysate; SFA Saturated fatty acids, MUFA monounsaturated fatty acids, PUFA polyunsaturated fatty acids.