Effect of five dietary emulsifiers on inflammation, permeability, and the gut microbiome: a placebo-controlled randomized trial
Abstract
BACKGROUND AND AIMS
Dietary emulsifier consumption might promote intestinal inflammation, eventually leading to inflammatory bowel diseases. However human data are scarce and involve a limited number of emulsifiers. We studied the effects of an emulsifier-free diet (EFD) and specific emulsifier supplementation.
METHODS
Sixty healthy participants followed an EFD for two weeks. Then, using a randomized placebo-controlled trial design, participants continued an EFD for four weeks with the addition of either carboxymethyl cellulose (CMC), polysorbate-80, carrageenan, soy lecithin, native rice starch (NRS), or no additives administered through brownies. Effects on cardiometabolic markers, gut microbiota, intestinal inflammation and permeability were explored.
RESULTS
After two weeks of EFD, cholesterol levels decreased (p=0.00006). Under emulsifier-supplementation, alpha diversity remained stable, yet microbial composition was affected by treatment and visit. Compared to placebo, concentrations of all short chain fatty acids (SCFAs) were lower in those consuming CMC, which was mirrored by other emulsifiers although not all reaching significance. No differences in faecal calprotectin, CRP, LBP, cholesterol levels or other metabolic markers were observed between placebo and emulsifiers at the end of the intervention. Serum inflammatory and cardiometabolic proteins remained unchanged. In individuals consuming carrageenan, transcellular intestinal permeability increased (p=0.04)…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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