Leaky Gut and a Damaged Fly Screen:

What is the correlation, and why are shift workers prone to it?

Leaky gut.  It sounds like a weird phenomenon – and in a way it is.

Now the technical, more scientific way to describe leaky gut is intestinal permeability, and is when space between the cells within the intestine or tight junctions of the epithelium become wider, which allows food particles to enter into the blood stream.

This causes the body to raise an inflammatory response because these food particles do not belong there, and over time, can be a contributing factor to conditions like autoimmune disease.

How Does This Relate to Shift Workers?

Animal studies have shown that long term stress and nocturnal sleep deprivation, typically associated with shift work, impacts on our gastrointestinal health by altering the delicate balance of the gut microbiome or microbiota, which can lead to dysbiosis and an overgrowth of pathogenic bacteria.

This dominance of pathogenic bacteria, impacts on tight junction proteins called ‘occludin’, which help to keep the gut “sealed”.  It was also shown to be made worse when combined with a high-fat, high sugar diet, and alcohol.

Hmm.  Me thinks that sounds very similar to a shift worker’s diet …

The best way to describe “leaky gut” or intestinal permeability, is to liken it to a fly screen.

Yes, I know this sounds a bit odd, but just stick with me here.

You see, instead of having lots of tiny holes in your gut, a “leaky gut” has lots of large holes scattered amongst the little ones which allows food particles to enter into the blood stream.

Kind of like in the image above, although this fly screen looks like some almighty mosquito has broken through the net – lol!

In addition to circadian dysregulation, or the disruption to our sleep/wake cycle, nutrient deficiencies such a low levels of vitamin D, zinc and glutamine, can also be a contributing factor to leaky gut; along with ingestion of gluten which is found in wheat, barley, oats and rye; as well as the use of certain medications such as proton pump inhibitors, non-steroidal anti-inflammatory drugs (NSAIDs), and antibiotics.

How to Test for Leaky Gut?

To test for a leaky gut, or intestinal permeability, a Lactulose/Mannitol test is conducted through a pathology lab which involves taking a urine specimen in the morning, followed soon after by consuming a drink containing two non-meatbolized sugars called lactulose and mannitol.

Mannitol are small molecules that are readily absorbed by the intestinal villi, whilst larger molecules such  Lactulose are not.  The lab will measure how much lactulose and mannitol are excreted, and if leaky gut syndrome is NOT present, the large lactulose molecules should remain in the GI tract and thus test low in the urine. If the count is high in the urine, then it is possible that leaky gut may be present.

What Can You Do To Prevent Leaky Gut?

Taking care of your gut, or gastrointestinal tract has to be a priority whilst working 24/7, purely because you are more vulnerable to developing it, as a result of the disruption to your sleep/wake cycle.

When your gut is healthy, it remains “sealed” (as opposed to being “leaky”), thereby preventing toxins and waste from within the digestive tract from getting into the bloodstream, and spreading throughout the body.

Some dietary and lifestyle strategies to help prevent the development of leaky gut include:

  • consuming more whole-food, minimally processed foods which are made up predominantly of plant-based foods.  These foods are rich in fibre which are going to feed the good gut bacteria in your digestive tract.  They include whole grains, vegetables, fruits, legumes, nuts and seeds.
  • include more polyphenol rich foods – which are plant compounds that give many fruits and vegetables their bright colours, and are high in antioxidants and anti-inflammatory properties that are great for gut health.
  • consume more prebiotic rich foods – prebiotics are food for the good gut bacteria and are rich in fructooligosaccharides (FOS) and galactooligosaccharides (GOS).  These include garlic, onions, leeks, asparagus, Jerusalem artichokes, legumes and seeds.
  • avoid refined and processed sugars as the pathogenic bacteria or “bad bugs” love them, which will help them to multiply leading to an overgrowth in your gut!


Konturek, P, Brzozowski, T & Konturek, S 2011, ‘Gut clock:  Implication of circadian rhythms in the gastrointestinal tract’, Journal of Physiology and Pharmacology, vol. 62, no. 2, pp. 139-150.

NutriPATH Integrative Pathology Services 2013, Intestinal Permeability.

Voigt, R, Forsyth, C, Green, S, Mutlu, E, Engen, P, Vitaterna, M, Turek, F & Keshavarzian, A 2014, ‘Circadian Disorganization Alters Intestinal Microbiota’, PLoS ONE, vol. 9, no. 5.

Wang, S & Wu, W 2005, ‘Effects of psychological stress on small intestinal motility and bacteria and mucosa in mice’, World Journal of Gastroenterology, vol. 11, no. 3, pp. 2016-2021.

Avocados and Inflammation:

Why They Make The Perfect Mid-Shift Snack!

This week I’m going to talk about one of my favourite shift working foods, that being the Avocado.

Whilst I don’t believe there is any one-size-fits-all diet for shift workers, I certainly believe some foods are better than others, particularly for those subjected to a life of constant sleep-deprivation.  This is because ongoing sleep deprivation has been shown to promote intestinal hyper-permability, which is essentially the fancy word for “leaky gut”.

Leaky gut is one of the main drivers behind inflammation, and more and more research is implicating inflammation in the development of various diseases such as diabetes, heart disease and cancer.  As a result, minimising inflammation in the body is absolutely key for maintaining optimal health.

From a nutritional perspective, avocados are loaded with nutrients.  They are particularly abundant in vitamin K, folate, vitamin C, potassium, vitamin E, and vitamins B5 (pantothenic acid) and B6 (pyridoxine).


HSW 34: Shift Work and Autoimmune Disease with Nutritionist Brad Leech.

Healthy Shift Worker Podcast Episode:

Today’s podcast is pretty cool because I got to catch up and chat with a fellow student from University, Clinical Nutritionist and Ayurvedic Herbalist Brad Leech, who has an absolute passion when it comes to all things to do with autoimmune disease, a condition which is becoming more and more prevalent in society today.

With currently 80 recognized autoimmune diseases, and over 100 conditions suspected to have an autoimmune link or mechanism, Brad’s clinical focus is on finding and treating the underlying cause of autoimmune disease in each of his patients. His philosophy includes correcting four modifiable risk factors in the development and progression of autoimmune disease which include inflammation, intestinal permeability, dysbiosis and immune dysregulation.

Unfortunately, these risk factors often present in those who work 24/7, however Brad goes into detail in some of the mechanisms behind them, and what we can do as shift workers, to help minimise our risks in order to reduce our likelihood of developing an autoimmune disease. Some of these include increasing our levels of vitamin D to assist in the regulation of our immune system; implementing anti-inflammatory dietary changes such as eliminating gluten consumption; along with ways to stimulate the vagus nerve which is part of the parasympathetic or ‘rest and digest’ arm of the nervous system, and helps to reduce inflammatory markers.

So if you have an autoimmune disease or you know someone who does, or you just want to learn how to avoid getting one, then you’re going to find this episode incredibly beneficial.

Links mentioned on the podcast:

Brad’s website

Brad’s shift working diagram

Vitamin D App

HSW 26: Gut Health and Our Microbiome with Kale Brock.

Healthy Shift Worker Episode 26:

Shift workers are notorious for experiencing gut discomfort thanks to our disruptive lifestyle, which can certainly impact on our overall health and well-being. One of which includes increasing our susceptibility to developing Leaky Gut Syndrome, otherwise known as intestinal permeability which can lead to an overgrowth of pathogens, nutritional deficiencies, allergies, autoimmune disease, irritable bowel syndrome (IBS) – to name a few.

To understand more about gut health specific to shift workers, Audra has tracked down avid surfer and “gut guru” Kale Brock who is the author of two published books – The Gut Healing Protocol and the Art of Probiotic Nutrition. Kale’s best mate also happens to be a shift worker too so can really appreciate some of our struggles!

Tune in to hear Kale explain exactly what is a “leaky gut”, and why nourishing and supporting the function of our gut lining is so incredibly important for anyone who happens to work irregular hours.

To learn more about Kale, his books, and his gut healing protocol visit – http://kalebrock.com.au

Shift Work, Leaky Gut and Alcoholic Liver Disease:

Why We Need To Go Easy On The Alcohol, When Working 24/7.

Glass of red wine with clock background

As the festive season fast approaches, I’m probably not going to win many friends (or acquire loads of social media “likes”) from writing this post considering our alcoholic consumption tends to well, increase somewhat substantially thanks to lots of work Christmas parties, family gatherings and other types of festivities.

In fact many Nutritionists would recommend you steer right away from alcohol altogether (I get it, it is a toxin after all), but I have to admit, I still enjoy a glass of wine or two every now and then.

Back in the days when I worked shift work (jeepers, it’s over 2 years ago now), an alcoholic beverage or two after a stressful day at work was even more appealing, particularly after multiple flight cancellations, airport closures and having to accommodate a whole host of disgruntled and displaced passengers!

However a study published in the PLOS One journal, uncovered a link between circadian disruption (a fancy way of saying a disruption to our sleep/wake cycle), and an increased risk in the development of alcoholic liver disease (ALD).

In other words, if your sleep is disrupted and you drink alcohol, you’re at a greater risk of developing ALD.

This animal study involved subjecting mice to a shift working environment where their internal clocks were placed out of sync with the natural light-dark cycle, along with a different group of mice which had a faulty circadian rhythm gene, or polymorphism.

Both groups of mice were fed a diet without alcohol and then with alcohol, and results showed that a combination of circadian rhythm disruption and alcohol is a destructive double hit that can lead to alcoholic liver disease.

How could this be so, you’re asking?

Well it all comes down to our gut, or our gastrointestinal tract which just so happens to be the largest organ of our immune system, and pretty much protects us from all of the “nasties” of the outside world.

And in this study, circadian rhythm disruption showed to trigger gut leakiness, which drives pathological or disease-inducing characteristics in the liver.

If you’re wondering Audra, what on earth is ‘gut leakiness?’  Well in simple terms, it’s when tiny holes in the epithelium or cells of our gastrointestinal tract develop (imagine a fly screen with a few fist punches through it), allowing large molecules to enter the blood stream, triggering an immune or inflammatory response.

Not an ideal situation!

Unfortunately for shift workers, having an optimal sleep/wake cycle appears critical for the maintenance of intestinal barrier integrity, especially in the context of harmful substances such as alcohol.

In addition, our gastrointestinal tract has it’s own circadian rhythm and whenever we deviate from a ‘normal’ sleep/wake cycle (which often occurs in those who work 247), the gut isn’t too happy.  In fact sleep deprivation and disruption is a type of physiological stress response which alone can induce a leaky gut – without factoring a “healthy” dose of alcohol to aggravate these inflammatory effects even further.

So whilst I’m not saying you should quit drinking alcohol altogether (although I’m sure many of my fellow Nutritionists would be saying “yes you need to quit!”), it’s important to recognise whilst this was an animal study, not all results can be duplicated in human clinical trials however alcohol consumption combined with working shift work has the potential to increase your susceptibility to developing alcoholic liver disease.

Maybe this year just go easy on the alcohol a little, because not only will your liver be much happier, but so too will your gut!

Audra x



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