Emulsifiers and Inflammation

A recent study of 92,000 French adults suggests that people who eat lots of emulsifiers in processed foods are at significantly increased risk for certain cancers. Those who ate the most foods with an emulsifier called carrageenan, had a 32 percent increased risk for breast cancer, and those who ate the most mono- and diglyceride emulsifiers had a 46 percent increased risk for prostate cancer (PLoS Med, Feb 2024;21(2):e1004338). Certain emulsifiers have been shown to increase markers of inflammation and growth of colon cancer cells in tissue cultures (Front Nutr, Aug 2, 2023;10:1197686). Other studies found that people who eat the most food with emulsifiers, such as ice cream and processed cheeses, which often contain the emulsifiers, microcrystalline cellulose and carboxymethylcellulose, are at significant risk for heart attacks (BMJ, Sept 6, 2023:382:e076058). A study in mice showed that emulsifiers can disrupt intestinal bacteria to cause inflammation and weight gain (Nature, Mar 2015;519(7541):92-6), and that emulsifiers may increase risk for inflammation, ulcerative colitis, Crohn’s disease, weight gain, central obesity, insulin insensitivity, and diabetes.

Why Are Emulsifiers Added?
Emulsifiers are food ingredients that help prolong shelf life and keep other ingredients from separating. More than 150 different emulsifiers are available and are often added to:
• chocolate, ice cream, margarine and salad dressing such as mayonnaise to keep the oily layer from separating from the water layer
• processed meat, to help keep proteins, water and fat from separating
• pastas, bread, cookies and other baked goods, to help preserve freshness, shelf life, volume and softness
• ice cream, frozen yogurt and sorbet, to make them smoother, delay melting, and to keep them together when thawed and refrozen
• prescription and non-prescription drugs to keep medications in liquid form and to help pills dissolve in the stomach after you take them
• many foods that are marketed as “healthful,” such as low-fat yogurt, plant-based milks and some plant-based meats
• many low-fat foods such as low-fat dairy products in which the fat is replaced with emulsifiers.

Functions of Emulsifiers
Your intestines contain more than 100 trillion bacteria which is about two to four pounds of your body weight. The healthful bacteria are happy with the food you eat so they stay in your colon. The harmful bacteria are not satisfied with the food that you eat, so they try to penetrate your colon cells and find food there. However, a thick layer of mucus covers your intestinal lining to help prevent bacteria from penetrating your colon cells. Emulsifiers are detergent-like molecules that can break down this thick mucus layer and allow the harmful colon bacteria to penetrate the inner linings of your intestinal cells (Sci Rep, (2019) 9:172-14) . Your immune system responds by staying active all the time, to cause inflammation (Biochem Soc Trans, 2018;46:1099-106) and then starts to attack and destroy your own cells (Cancer Res, (2017) 77:27-40). Emulsifiers decrease the healthful colon bacteria and increase those associated with inflammation (Food Res Int, Apr 2024:182:114157). Thus, inflammation may be the reason for the marked increase in inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease, obesity and metabolic syndrome, which have occurred over the last half century (Nat Rev Gastroenterol Hepatol, 2020;17:76-7).

My Recommendations
The most healthful diet is plant-based with lots of vegetables, fruits, whole grains, beans, nuts and other seeds. Processed foods that come in packages often have added sugar and salt that increase risk for heart attacks and diabetes. Emulsifiers added to foods can enhance taste and absorption, delay food from becoming stale and prevent the oil from separating out from water, but emulsifiers also may harm you by increasing the growth of harmful bacteria that try to enter your colon cells, increase inflammation, and possibly increase your risk for heart attacks, certain cancers, obesity and immune diseases.