Nutritional considerations to counteract gastrointestinal permeability during exertional heat stress

Intestinal barrier integrity and function are compromised during exertional heat stress (EHS) potentially leading to consequences that range from minor gastrointestinal (GI) disturbances to fatal outcomes in exertional heat stroke or septic shock. This minireview provides a concise discussion of nutritional interventions that may protect against intestinal permeability during EHS and suggests physiological mechanisms responsible for this protection. Although diverse nutritional interventions have been suggested to be protective against EHS-induced GI permeability, the ingestion of certain amino acids, carbohydrates, and fluid per se is potentially effective strategy, whereas evidence for various polyphenols and pre/probiotics is developing. Plausible physiological mechanisms of protection include increased blood flow, epithelial cell proliferation, upregulation of intracellular heat shock proteins, modulation of inflammatory signaling, alteration of the GI microbiota, and increased expression of tight junction (TJ) proteins. Further clinical research is needed to propose specific nutritional candidates and recommendations for their application to prevent intestinal barrier disruption and elucidate mechanisms during EHS.

Automated summary

This minireview discusses nutritional interventions that may protect against intestinal permeability during exertional heat stress (EHS), including certain amino acids, carbohydrates, and fluid intake, as well as developing evidence for polyphenols and pre/probiotics. Plausible physiological mechanisms of protection include increased blood flow, epithelial cell proliferation, and modulation of inflammatory signaling. Further clinical research is needed to propose specific nutritional candidates and recommendations for preventing intestinal barrier disruption during EHS.