From its dark days as a concept dismissed by most Drs and scientists as being suitable only for the more eccentric alternative medicine crowd, the idea that the gastrointestinal tract may have varying levels and quality of exclusionary capacity has slowly become mainstream-ish.
A paper out in the prestigious Nature Journal – Obesity, has raised the question that altered visceral adiposity – ‘fat around the middle’ may be initiated and promoted by altered barrier integrity.
The author’s state:
Increased visceral fat, as opposed to subcutaneous/gluteal, most strongly relates to key metabolic dysfunctions including insulin resistance, hepatic steatosis, and inflammation. Mesenteric fat hypertrophy in patients with Crohn’s disease and in experimental rodent models of gut inflammation suggest that impaired gut barrier function with increased leakage of gut-derived antigens may drive visceral lipid deposition.
They confirm this via two groups of female subjects and conclude that in relation to visceral adiposity and metabolic syndrome that improving the quality of gut permeability may help in the management of these conditions.
Practitioner used to the functional medicine approach to patient management and well-being promotion have utilised this concept for over 20 years and have demonstrated many times that the reduction of antigen exposure via bacterial and food matter translocation across the delicate mucous membranes has a positive effect in many often diverse areas of symptomatology.
In part the resolution of barrier integrity has become a mainstay of the management of chronic non infectious diseases as well as the assistive resolution of post infectious dysbiotic changes to the bacterial mileau in the gut that either contributes to altered permeability or in some cases drives it.
 Gummesson A, Carlsson LM, Storlien LH, Bäckhed F, Lundin P, Löfgren L, Stenlöf K, Lam YY, Fagerberg B, Carlsson B. Intestinal permeability is associated with visceral adiposity in healthy women. Obesity (Silver Spring). 2011 Nov;19(11):2280-2. doi: 10.1038/oby.2011.251. Epub 2011 Aug 18. View Abstract