The Role of Dietary Emulsifiers in Gut Health and IBD
Emulsifiers are ubiquitous in Westernized diets, and emerging evidence suggests that these food additives may be negatively impacting our gut microbiota and contributing to intestinal inflammation.
Our gut microbiota is a collection of different microorganisms that live in the human digestive tract, including bacteria, archaea and eukaryotes. These microorganisms work in balance with each other and our bodies to keep us healthy. Generally, it is understood that reduced diversity within the human gut microbiota is associated with diseases such as Inflammatory Bowel Disease (IBD), IBS, colorectal cancer, among others (1,2,3,4).
Emulsifiers are a type of food additive and can be found in almost all processed and packaged foods. Many different emulsifiers are used in food production. They work to bind together liquids that don’t normally bind together on their own, such as oil and water. Emulsifiers are found in baked goods, candies, packaged snacks, jams, yogurts, frozen treats, soups, sauces, and the list goes on. They also help to improve the texture and mouthfeel of processed foods.
A growing body of research suggests a connection between dietary emulsifiers and inflammatory diseases such as Crohn’s Disease and Ulcerative Colitis. In one study, gut microbiota (gut microorganism colonies) in human fecal samples exposed to common dietary emulsifiers such as carrageenans, locust bean gum, xanthan gum, and maltodextrin, showed an increase in the expression of pro-inflammatory molecules (5). The study also showed that polysorbate 80 and CMC had a detrimental and non-reversible effect on the diversity of the microbiota in the samples (5). A reduction in the diversity of gut microorganism colonies is referred to as dysbiosis, and studies show that individuals living with Crohn’s Disease and Ulcerative Colitis exhibit dysbiosis in the microbiota of the gut (6,7).
In a study conducted on mice, the dietary emulsifiers polysorbate 80 and CMC were shown to alter the gut microbiota and induce colitis (8). Another study examining the emulsifiers polysorbate 80 and CMC on a human gut microbiota model showed that both these emulsifiers impacted microbiota in a way that drove intestinal inflammation (9).
Emulsifiers have also been shown to promote the translocation of gut bacteria. For example, research suggests that the emulsifier polysorbate 80 has been shown to help bacteria, like E. Coli, relocate into certain layers of intestinal tissue, which in turn can trigger an inflammatory response from the immune system (10).
Given mounting evidence around the negative impact of dietary emulsifiers on the diversity of the gut microbiome, and their ability to promote intestinal inflammation, individuals living with Inflammatory Bowel Disease may benefit from reducing their consumption of these food additives. At this point in time, there are no guidelines for individuals living with IBD around limiting the intake of dietary emulsifiers. Research on certain therapeutic diets, such as the Crohn’s Disease Exclusion Diet (CDED) has shown that eliminating emulsifiers from the diet for a duration of time, in conjunction with other food additives and certain nutrients, can induce remission of Crohn’s Disease. To learn a little more about CDED, click here.
If reducing consumption of dietary emulsifiers is something you are considering, here are a few tips on how to go about it:
Prepare meals and snacks from whole foods more often
Use fresh fruits, vegetables, meats, and unflavoured nuts, seeds, beans, and whole grains to prepare your meals. Plain frozen or canned fruits and vegetables are also a great choice for meal preparation.
Make your own sauces and seasoning blends when possible
Use individual herbs and spices (eg. paprika, onion powder, thyme, oregano, cinnamon), as well as vinegars and oils to make your own spice blends and sauces. Preparing these items at home from simple ingredients can cut down your intake of dietary emulsifiers.
Rely less on take-out meals
Prepare meals and snacks from scratch at home when you can. Batch cooking larger quantities of meals, and freezing pre portioned servings can significantly reduce the amount of time spent on meal preparation.
Read ingredients lists when purchasing packaged foods and condiments
Scan the ingredients lists of packaged products before buying and compare similar products. Choose food items that are free of dietary emulsifiers when possible to do so. Current research suggests that the following dietary emulsifiers seem to have the most significant negative impact on human gut microbiota when tested in gut microbiota models: polysorbate 80, carboxymethylcellulose (CMC), maltodextrin, carrageenan, locust bean gum, xanthan gum, sorbitan monostearate, and glyceryl stearate.
Eliminating dietary emulsifiers entirely is a fairly unrealistic goal for most, if not all individuals. It is also important to consider various aspects of food and health, and balance these in a way that suits your individual needs. For example, perhaps eating out with friends on the weekends brings you joy and strongly benefits your mental health. Or perhaps making meals from scratch regularly is just not practical given a busy family life and work schedule. Further, ensuring that nutritional needs are being met is also vital. Starting slowly, and incorporating more whole foods into the diet overtime can benefit overall health, including gut health. If you are unsure where to start, inquiring with a Registered Dietitian can be a good first step.
References
Sha, S., Xu, B., Wang, X., Zhang, Y., Wang, H., Kong, X., et al. The biodiversity and composition of the dominant fecal microbiota in patients with inflammatory bowel disease. Diagn. Microbiol. Infect. Dis. 2013; 75: 245–251.
Matsuoka, K., and Kanai, T. The gut microbiota and inflammatory bowel disease. Seminars in Immunopathology. 2015; 37: 47–55.
Carroll, I. M., Ringel-Kulka, T., Siddle, J. P., and Ringel, Y. Alterations in composition and diversity of the intestinal microbiota in patients with diarrhea-predominant irritable bowel syndrome. Neurogastroenterology & Motility. 2012; 24: 521–530.
Ahn, J., Sinha, R., Pei, Z., Dominianni, C., Wu, J., Shi, J., et al. Human gut microbiome and risk for colorectal cancer. Journal of the National Cancer Institute. 2013; 105: 1907–1911.
Naimi, S., Viennois, E., Gewirtz, A.T. et al. Direct impact of commonly used dietary emulsifiers on human gut microbiota. Microbiome. 2021; 9: 66.
Chassaing B, Darfeuille–Michaud A. The commensal microbiota and enteropathogens in the pathogenesis of inflammatory bowel diseases. Gastroenterology. 2011;140:1720–8 e1723.
Chassaing B, Aitken JD, Gewirtz AT, Vijay-Kumar M. Gut microbiota drives metabolic disease in immunologically altered mice. Adv Immunol. 2012;116:93–112.
Chassaing B, Koren O, Goodrich JK, Poole AC, Srinivasan S, Ley RE, Gewirtz AT. Dietary emulsifiers impact the mouse gut microbiota promoting colitis and metabolic syndrome. Nature. 2015;519:92–6.
Chassaing B, Van de Wiele T, De Bodt J, et alDietary emulsifiers directly alter human microbiota composition and gene expression ex vivo potentiating intestinal inflammation. Gut. 2017;66:1414-1427.
Roberts, C. L. et al. Translocation of Crohn’s disease Escherichia coli across M-cells: contrasting effects of soluble plant fibres and emulsifiers. Gut. 59, 1331–1339 (2010)
By: Pauline Bakowski, MHSc, RD
Reviewed by: Cheryl Ching, MSc, RD & Kristie Pun, MHSc, RD
Disclaimer: Our blog content is for general education purposes and may not be suitable for individual health conditions. Please see your health professional or book an appointment with one of our dietitians for personalized health recommendations.
