The Guardian highlighted in a recent article the potential link between emulsifiers and IBD (inflammatory bowel disease) (Guardian, 2023). Emulsifiers are commonly used in the food industry, added to ultra processed foods (UPF) including bread, chocolate, cakes, ice-cream, margarine and processed meats, to extend shelf life, to bind ingredients together and even to improve appearance, as they stop separation of liquids (Eufic, 2022). Individuals who consume diets higher in ultra processed foods have been observed to have a higher risk of developing Crohn’s disease (Chen et al., 2023; Narula et a., 2021) , and recently EFSA (European Food Safety Authority) took the measure of including food emulsifiers as a key risk factor for IBD (EFSA, 2019) . This is most likely due to multi-faceted reasons, however the role of emulsifiers has been proposed as being a key consideration due to their impact on the gut. This includes increasing the vulnerability of the gut lining to inflammatory microorganism penetration. In a study on mice, emulsifiers were demonstrated to cause intestinal permeability, a key cause of malabsorption and increased inflammation (Sandall et al., 2020). 

A small scale study including 12 patients with ulcerative colitis indicated that intake of emulsifiers  contributed to earlier relapse in patients with ulcerative colitis in remission. The study indicated that restriction of a specific dietary emulsifier, carrageenan, may benefit patients with ulcerative colitis (Bhattacharyya et al., 2017). However, due to the small participant size, this study requires repeating with a much greater number of participants to explore these findings further. 

 

Due to the chronicity and severity of IBD, it is important to seek medical advice from a doctor and dietitian regarding long term management and treatment plan.   

 

References

Bhattacharyya, S., Shumard, T., Xie, H., Dodda, A., Varady, K. A., Feferman, L., Halline, A. G., Goldstein, J. L., Hanauer, S. B., & Tobacman, J. K. (2017). A randomized trial of the effects of the no-carrageenan diet on ulcerative colitis disease activity. Nutrition and healthy aging, 4(2), 181–192. https://doi.org/10.3233/NHA-170023

 

Chen, J., Wellens, J., Kalla, R., Fu, T., Deng, M., Zhang, H., Yuan, S., Wang, X., Theodoratou, E., Li, X., & Satsangi, J. (2023). Intake of Ultra-processed Foods Is Associated with an Increased Risk of Crohn’s Disease: A Cross-sectional and Prospective Analysis of 187 154 Participants in the UK Biobank. Journal of Crohn’s & colitis, 17(4), 535–552. https://doi.org/10.1093/ecco-jcc/jjac167

 

EFSA (European Food Safety Authority), Afonso, A, Garcia Matas, R, Maggiore, A, Merten, C, Rortais, A and Robinson, T, 2019. Technical report on EFSA’s activities on emerging risks in 2017. EFSA supporting publication 2019: 16( 1):EN-1522. 59 pp. doi:10.2903/sp.efsa.2019.EN-1522

 

Eufic, 2022. What are emulsifiers and what are common examples used in food?

https://www.eufic.org/en/whats-in-food/article/what-are-emulsifiers-and-what-are-common-examples-used-in-food

 

Guardian, 2023. The truth about emulsifiers: are they destroying our gut health? Available at: https://www.theguardian.com/lifeandstyle/2023/jun/29/the-truth-about-emulsifiers-gut-health-microbiome

 

Narula, N., Wong, E. C. L., Dehghan, M., Mente, A., Rangarajan, S., Lanas, F., Lopez-Jaramillo, P., Rohatgi, P., Lakshmi, P. V. M., Varma, R. P., Orlandini, A., Avezum, A., Wielgosz, A., Poirier, P., Almadi, M. A., Altuntas, Y., Ng, K. K., Chifamba, J., Yeates, K., Puoane, T., … Yusuf, S. (2021). Association of ultra-processed food intake with risk of inflammatory bowel disease: prospective cohort study. BMJ (Clinical research ed.), 374, n1554. https://doi.org/10.1136/bmj.n1554

Sandall, A.M.; Cox, S.R.; Lindsay, J.O.; Gewirtz, A.T.; Chassaing, B.; Rossi, M.; Whelan, K. Emulsifiers Impact Colonic Length in Mice and Emulsifier Restriction is Feasible in People with Crohn’s Disease. Nutrients 2020, 12, 2827. https://doi.org/10.3390/nu12092827