Food Additives, a Key Environmental Factor in the Development of IBD through Gut Dysbiosis

Abstract

Diet is a key environmental factor in inflammatory bowel disease (IBD) and, at the same time, represents one of the most promising therapies for IBD. Our daily diet often contains food additives present in numerous processed foods and even in dietary supplements. Recently, researchers and national authorities have been paying much attention to their toxicity and effects on gut microbiota and health. This review aims to gather the latest data focusing on the potential role of food additives in the pathogenesis of IBDs through gut microbiota modulation. Some artificial emulsifiers and sweeteners can induce the dysbiosis associated with an alteration of the intestinal barrier, an activation of chronic inflammation, and abnormal immune response accelerating the onset of IBD. Even if most of these results are retrieved from in vivo and in vitro studies, many artificial food additives can represent a potential hidden driver of gut chronic inflammation through gut microbiota alterations, especially in a population with IBD predisposition. In this context, pending the confirmation of these results by large human studies, it would be advisable that IBD patients avoid the consumption of processed food containing artificial food additives and follow a personalized nutritional therapy prescribed by a clinical nutritionist.

Keywords: IBD; Western diet; artificial sweeteners; chronic inflammation; colorants; dysbiosis; emulsifiers; food additives; gut barrier; gut microbiota.

Figure 1

Effects of exposure of some artificial food additives on gut microbiota and gut barrier. These main findings are based on in vivo studies detailed within the manuscript. Abbreviations: CMC, carboxymethyl cellulose; HFD, high-fat diet; IL, interleukin; LPS, lipopolysaccharide; P80, polysorbate 80; ROS, reactive oxygen species; SCFA, short-chain fatty acid; TLR, Toll-like receptor; TNF, tumor necrosis factor.

Figure 2

Food additives, gut microbiota, and IBD. Abbreviations: CMC, carboxymethyl cellulose; E-171, titanium dioxide; E-950, acesulfame potassium; E-951, aspartame; E-954, saccharin; E-955, sucralose, E-961, neotame; IBD, inflammatory bowel disease; P80, polysorbate 80.