Inflammatory Bowel Disease and Additive Emulsifiers

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I completed my Summer Studentship at the Department of Nutrition and Dietetics at King’s College London, under the supervision of Professor Kevin Whelan and Dr Megan Rossi. On the side, I run Fight the Fads with Harriet Smith and Caroline Day. A nutrition platform that aims to remove the fear and confusion over nutrition often created by the social media. You can find FTF on Twitter and Instagram and you can also find me on my personal Twitter account

Project Title: Inflammatory Bowel Disease and Additive Emulsifier

About the project:

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The incidence of inflammatory bowel disease (IBD) is increasing (Hanauer, 2006) alongside dietary intakes of food additives resulting from societies’ demand for palatable convenience foods (Lerner and Matthias, 2015). Exploration into this association has uncovered a novel mechanistic pathway by which some food additives, specifically synthetic emulsifiers, may trigger colitis. (Roberts et al, 2013 and Csaki, 2011) Moreover, convincing evidence in support of this emerging hypothesis demonstrated that mice fed common emulsifiers, carboxymethylcellulose and polysorbate-80, at relatively low doses induced significant colitis in those predisposed to IBD (Chassaing, 2015). This landmark study, published in Nature, has raised serious concerns behind the safety of additive emulsifiers, warranting investigation in humans.

Consequently, aim of this project was to identify from the literature which emulsifiers have been associated with IBD and develop the methodology in order to quantify and qualify emulsifier intakes in patients with IBD, in order to compare them to the intakes of healthy controls and assess the health risk posed to potentially vulnerable groups. 

I conducted a literature review of published research relating to IBD and emulsifier consumption. Emulsifiers in the UK market were quantified using FoodMaestro®. Patients with IBD were recruited and completed a seven-day un-weighed food record. Three patients were analysed further using Nutritics® and their emulsifier intakes was quantified.

The literature results showed that Carrageenan (E407), Polysorbate 80 (E433) and Carboxy methyl cellulose (E466) is associated to IBD. Of the n=94,286 foods in UK Market, 30% contained any emulsifier. The distribution in food subcategories as organised by manufacturers varied greatly. Intakes of the three patients were not consistent, however sources were derived primarily from confectionary and processed meats.

The quantification of emulsifiers was limited as manufacturers are not obliged to provide the amount (mg) of emulsifiers used in food products in the same way as in carbohydrates (g). In addition, the European Commission allows the use of some emulsifiers as per quantum satis (= the amount required), without specifying an upper limit. I attempted to resolve this limitation by contacting manufacturers directly, liaising with the European Food Safety Authority and the Food Additives and Ingredients Association to obtain usage data. None of the information provided was adequate to quantify use of the three selected emulsifiers.

This is a very interesting area of research and additional studies with a larger sample size are required to be able to make any associations between intakes of additive emulsifiers and IBD in humans.

The best aspect of my Summer studentship experience:

Working alongside a team of leading professionals in the area of gut health was one of the best aspects of this project. I specifically enjoyed my meetings with my supervisors as they allowed me to organise my thoughts and experience how it is to be part of a research team. During the meetings I was able to get an insight on the way they work and the research they are conducting and understand how much hard work goes into completing a project. 

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International Congress of Dietetics ENDietS Conference – Granada, Spain 6th September 2016

A highlight of my SS experience was the opportunity to present the outcomes of my project at the International Congress of Dietetics, ENDietS conference in Granada Spain. This required me to prepare an engaging presentation that would present my eight-week project in a ten-minute presentation. I really enjoyed this experience and I understood how much hard work is required to deliver complex information in a simple and engaging way.

The most challenging part of my studentship:

Due to the nature of my project, I was constantly re-evaluating the aims of my project based on the available data. This at times was very challenging mentally and psychologically as I had to completely disregard work I had spent many hours completing. What this taught me though, was that nutrition research is not a straight forward process and it is these changes that evidently led me my results. 

The one thing I learnt that is transferable to future work:

The Nutrition Society SS was an invaluable funding opportunity that not only supported my interest in IBD, but provided me with first-hand insight into a career in nutrition research.  I was able to develop many research skills, including recruiting, re-evaluating goals, time management, data collection, food data analysis, planning a research presentation and presenting. These are skills that will be invaluable for my future academic development and in particular my dissertation next year.

Tips for anyone who is interested in applying for the NS – SS or a similar fellowship:

My top three tips would be:

  1. Take your time to explore several areas of interest. Try to read a paper each day to stay up to date and familiarise with different topics can be useful. Speak to your lecturers and express your interest, this will evidently allow you to decide on an area that will interest you. 
  2. When you decide on a topic – Make sure to be passionate about your topic. Not only does this mean you will learn new things about a topic of your interest it also means you will enjoy your project. This is essential, particularly if you will be spending long hours working on it…  
  3. Take your time to complete your application. A targeted, well organised and structured application is likely to be successful! Explore different funding opportunities and don’t give up if you don’t succeed on your first application. 

Conducting research is a challenging project but one that will give you a lot insight into what it means to do research, organising your own time and being efficient so make the most out of this experience. While working on your project will be your main focus, make sure to speak to other researchers and learn about their areas of interest.

Good luck to everyone that wishes to apply for a research project this summer! 

Am I interested to do more research in the future?

As I have mentioned before I strongly believe research is the way forward in the nutrition science. Studying at KCL we are trained by leading scientist in the field of nutrition. Our training is based on the most recent evidence-based science and I would be definitely interested in conducting further research in the future. Currently, my interest is primarely on gut health, however the more I read on other topics I realise there are a large number of topics that interest me. Renal, oncology and cardiovascular health being some of them. 

The Nutrition Society (NS) offers a unique funding opportunity to a limited number of students to undertake a research project during the summer months. The Summer Studentship Series is a collaboration with six students that took part in the 2016 NS Summer Studentship (NS-SS). I decided to ask everyone a couple of questions related to their projects and general experience, in an attempt to give you an idea of the variety of projects we completed and the interesting elements of each project. My hope is to inspire more students to do research and provide useful information and tips for those who may be interested in applying for the NS Summer Studentship or other similar research projects. I firmly believe research is the way forward in nutrition and I hope these series inspires more of you to get involved in research projects. This year’s Nutrition Society Summer Studentship application is now open and you can find it here.

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