Dietary Emulsifier Exposure in People With Inflammatory Bowel Disease Compared With Healthy Controls: Is There a Cause for Concern?

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  • Additional Information
    • Source:
      Publisher: Oxford University Press Country of Publication: England NLM ID: 9508162 Publication Model: Print Cited Medium: Internet ISSN: 1536-4844 (Electronic) Linking ISSN: 10780998 NLM ISO Abbreviation: Inflamm Bowel Dis Subsets: MEDLINE
    • Publication Information:
      Publication: 2018- : [Oxford] : Oxford University Press
      Original Publication: New York, NY : Raven Press, c1995-
    • Subject Terms:
      Emulsifying Agents*/adverse effects ; Inflammatory Bowel Diseases* ; Polysorbates*/adverse effects; Humans ; Male ; Female ; Adult ; Prospective Studies ; Case-Control Studies ; Middle Aged ; Australia/epidemiology ; Child ; Colitis, Ulcerative ; Adolescent ; Young Adult ; Crohn Disease ; Lecithins ; Polysaccharides, Bacterial ; Carboxymethylcellulose Sodium/adverse effects ; Aged ; Dietary Exposure/adverse effects
    • Abstract:
      Background: Emulsifiers are implicated in the pathogenesis of inflammatory bowel disease (IBD). Few studies have examined emulsifier intake in people with existing IBD. We aimed to describe the frequency of exposure to 6 selected emulsifiers in a contemporary cohort of people with IBD and compare intake with healthy controls (HCs).
      Methods: Baseline food records from participants in an Australian prospective cohort study examining the microbiome of IBD patients and HCs were analyzed. Exposure to inflammatory emulsifiers polysorbate-80 (P80); carboxymethylcellulose (CMC); carrageenan; xanthan gum (XG); lecithin (soy and sunflower) and mono- and diglycerides of fatty acids (MDGs) were determined by examining ingredient lists. Frequency of emulsifier exposure between groups (IBD vs HC, Crohn's disease [CD] vs ulcerative colitis [UC], IBD children vs adults, active disease vs remission) was examined after controlling for confounders.
      Results: Records from 367 participants were analyzed (n = 176 IBD, of which there were 101 CD, 75 UC, and 191 HC patients). In total, 5022 unique food items were examined, with 18% containing 1 or more emulsifier of interest. Inflammatory bowel disease participants had significantly higher total daily emulsifier exposure compared with HCs (2.7 ± 1.8 vs 2.3 ± 1.6, P = .02). In IBD participants, emulsifiers with the highest daily exposure were MDGs (1.2 ± 0.93), lecithin (0.85 ± 0.93), and XG (0.38 ± 0.42). There were no recorded exposures to P80.
      Conclusions: Inflammatory bowel disease participants were exposed to more emulsifiers than HCs. Intake of inflammatory emulsifiers were low or nonexistent, suggesting their presence in the food supply are not as common as frequently stated.
      (© The Author(s) 2024. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].)
    • Contributed Indexing:
      Keywords: Crohn’s disease; diet; emulsifier; food additive; inflammatory bowel disease; nutrition; observational study; ulcerative colitis
    • Accession Number:
      0 (Emulsifying Agents)
      0 (Polysorbates)
      0 (Lecithins)
      TTV12P4NEE (xanthan gum)
      0 (Polysaccharides, Bacterial)
      K679OBS311 (Carboxymethylcellulose Sodium)
    • Publication Date:
      Date Created: 20240120 Date Completed: 20240801 Latest Revision: 20240801
    • Publication Date:
      20240801
    • Accession Number:
      10.1093/ibd/izad318
    • Accession Number:
      38244236