HomeHealthcareThe role of ultraprocessed foods in inflammatory bowel disease

The role of ultraprocessed foods in inflammatory bowel disease

Ultraprocessed foods can promote the onset and worsening of inflammatory bowel disease. The hypothesis, supported by extensive scientific literature, is retraced by a Belgian study through the analysis of the function performed by each non-nutritive substance typical of ultra-processed foods in the manifestation of intestinal inflammation. (1)

Ultraprocessed foods and inflammatory bowel disease

Ultraprocessed foods are industrial products ready for consumption characterized by

– high amounts of sugar, saturated fat and salt,

– low amounts of protein, fiber, vitamins and minerals,

– presence of various preservatives, stabilizers and thickeners, emulsifiers, artificial sweeteners and dyes,

– unrepeatable industrial processes in domestic kitchens: hydrogenation, hydrolization, extrusion, fractionation, etc. Processes that aim to create highly appetizing, ready-to-eat, highly profitable and long-lasting foods.

Generically, it's about snack, pastries, soft drinks, ready meals, processed meats. Products that fall into group 4 of the Nova classification. To recognize them at a glance, just use nutritional label decoding systems, such as the app Yuka, Based on NutriScore.

Regular consumption of ultraprocessed foods is correlated with increased risk of chronic noncommunicable diseases (Non-Communicable Diseases, NCDs), such as obesity, diabetes, cardiovascular disease, cancer, and inflammatory bowel disease, including Crohn's disease and ulcerative colitis. (2)

The role of diet

These intestinal pathologies they seem to occur in individuals genetically predisposed to the occurrence of a certain interaction between the microbiota, the immune system and environmental factors such as smoking, antibiotic use and diet.

Particularly, western diet – namely the 'Western diet' high in fat, sugar and salt (HFSS, high in fat, sugar and salt) and full of additives – is considered a crucial factor in the onset and worsening of inflammatory bowel disease.

Not by chance, the incidence of these pathologies increases with the diffusion of the consumption of ultra-processed foods in the newly industrialized regions, Africa and South America, and stabilizes (in some it decreases) in western countries such as Europe and North America, the researchers point out.

Ingredients enemies of the intestinal barrier

A systematic review in question reviews the substances recognized in scientific literature as capable of influencing the intestinal barrier and increasing intestinal permeability and promoting inflammation. A harmful action that can manifest itself with an alteration of the components of the barrier (mucous layer, epithelial cells, immune cells) or alter the composition of the microbiota.

Emulsifiers and thickeners

Emulsifiers such as carrageenan, carboxymethylcellulose, polysorbate-80, mono and diglycerides of fatty acids are very common in ultraprocessed foods. And beware, not only in chocolates or snack, but even in milk snacks so loved by children, ice cream, fresh pasta, spreadable cheeses, as we have reported several times. (3)

These additives have been identified through studies vitro and on animals, as harmful to each component of the intestinal barrier and therefore promoters of inflammatory bowel diseases.

Clinical Studies on humans confirm the evidence. The researchers cite four in which the consumption of emulsifiers caused alteration of the microbiota, thinning of the intestinal mucus, worsening of intestinal inflammation and an increase in recurrence.

Azo dyes

The azo dyes they are still very prevalent in foods, especially in candy, dairy products and beverages. Are known to promote neuro-behavioral abnormalities in children, such as hyperactivity.

Two of these synthetic dyes, Red 40 and Yellow 6, are considered safe for human consumption, according to WHO. However, a recent study (He et al.) in guinea pigs showed that the two azo dyes can trigger or aggravate inflammatory bowel disease.

In our investigations on the market we found Red 40 (E 129, Allura Red or Allura Red) in the alcohol pops Breezer Ruby Grapefruit and Bacardi Breezer Peach. The Giallo Arancio (Yellow 6o Giallo Sunset, Sunset Yellow, E110) we instead identified in Ginger San Benedetto and in Aperol.

Titanium dioxide

Titanium dioxide (TiO 2, E171) is used as a food additive for its whitening and lightening properties. It is mainly added to confectionery, candy and chewing gum, white sauces and icings, but also toothpastes and pharmaceuticals.

It's composed one third from nanoparticles (<100 nm) which accumulate in vital organs, especially the liver and spleen. It is neurotoxic, causes inflammation and induces alterations in the intestine (colon and rectum) which over time can evolve into tumors. And it is genotoxic, that is, capable of damaging DNA.

In Europe from 7.2.22 it is forbidden to add it to foods and food supplements, but it remains in medicines and toothpastes, as we have seen.

Artificial sweeteners

In vitro and animal studies vitro and animal studies have shown that artificial sweeteners, such as sucralose, aspartame and saccharin, can interact with different components of the intestinal barrier and promote intestinal inflammation.

Human studies instead they are scarce and contradictory. For this reason, synthetic sweeteners remain widely present in foods labeled as 'with no added sugar'.

Sale

Ultraprocessed foods they typically contain a very high salt content. Edible salt or sodium chloride (NaCl) is 40% sodium and 60% chloride.

WHO recommends not consuming more than 5 g of salt per day, but this threshold is often exceeded. This despite the fact that the link between excessive salt intake and hypertension, other cardiovascular diseases and a higher risk of premature death.

The authors of the study report that both studies vitro  is in vivo suggest that excessive salt intake may also modulate the immune system, and in this way be involved in the development of inflammatory bowel disease.

Phosphate

The phosphate inorganic is often present in ultra-processed foods using various food additives, added with an emulsifying function (e.g., sodium phosphate, E 339) or antioxidant (e.g., phosphoric acid, E338).

These additives they are authorized in a hundred foods and recent studies have found a generalized increase in the level of phosphate in the blood vessel walls of the population, a condition that increases cardiovascular risk.

The only studywith experiments vitro e in vivo, identified by the researchers shows that excessive dietary phosphate intake can exacerbate intestinal inflammation. (4)

Conclusions

'Preclinical studies show that different components non-nutritive of UPF (ultraprocessed foods, ed) can negatively affect the intestinal barrier. They can induce dysbiosis, negatively affect the mucus layer, increase the permeability of the intestinal epithelium or interact directly with the immune system. 

Based on these results, a diet low in UPF (ultraprocessed foods, ed) could potentially induce remission or control symptoms in patients with IBD (inflammatory bowel disease, ed). 

However,Human data are still limited and nutritional studies are needed to evaluate the clinical potential of new dietary therapies for IBD patients. In the meantime, it is reasonable to advise our IBD patients to reduce their UPF intake', the researchers conclude.

Footnotes

(1) Vissers Eva, Wellens Judith, Sabino João. Ultra-processed foods as a possible culprit for the rising prevalence of inflammatory bowel diseases. Frontiers in Medicine, flight. 9, 2022. https://www.frontiersin.org/articles/10.3389/fmed.2022.1058373

(2) The correlation between regular consumption of ultra-processed foods and non-communicable diseases is so marked that it prompted a group of expert nutrition scientists to appeal to the UN to urge governments to adopt nutritional policies to contain such consumption. See Dario Dongo, Andrea Adelmo Della Penna. Ultraprocessed foods, the worst evil. Appeal of scientists in the British Medical Journal. GIFT (Great Italian Food Trade).

(3) See previous articles by Marta Scratched on GIFT (Great Italian Food Trade):

(4) Sugihara K, Masuda M, Nakao M, Abuduli M, Imi Y, Oda N, et al. Dietary phosphate exacerbates intestinal inflammation in experimental colitis. J Clin Biochem Nutr. (2017) 61:91–9. doi: 10.3164/jcbn.16-117

Marta Strinati

Professional journalist since January 1995, he has worked for newspapers (Il Messaggero, Paese Sera, La Stampa) and periodicals (NumeroUno, Il Salvagente). She is the author of journalistic surveys on food, she has published the book "Reading labels to know what we eat".

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