Food Emulsifiers and the Microbiome

Peanut butter, once a staple in every American child’s diet, has become something of a food villain. Many families and schools now avoid it due to the rapidly rising number of kids with peanut allergies and gut disorders. 

But peanut butter is a highly nutritious, affordable food that many people like. So what happened? To understand why avoiding processed foods has become so important, let’s take a closer look at this once-favorite spread.

The REAL Truth About Peanut Butter

Real peanut butter separates. Prior to eating it, you have to mix the peanut solids and oil together. But for some individuals, that may be inconvenient; they prefer their peanut butter premixed. To cater to this preference, the food industry has figured out ways to stabilize a liquid into another substance in which it is not soluble. These are called emulsions, which simply mean a suspension of small globules of one liquid into a second liquid with which the first one does not mix.

Compounds that aid in the stability of an emulsion are called emulsifiers. Soap and egg yolks are recognizable examples of emulsifiers, which are detergent-like molecules. A look at the labels of foods with emulsifiers added to processed foods identifies different categories of emulsifiers, including the following:

• Synthesized emulsifiers (20 identified) such as the polysorbates (P80)
• Carboxymethylcellulose (CMC) 
• Natural emulsifiers (5 identified) such as lecithin  

A complete list of common emulsifiers and the foods in which they are used can be found here.

The list of packaged foods that contain emulsifiers reads like a Who’s Who of foods typically consumed in the US: Ice cream, various spreads, processed meats, chocolates, salad dressings, coffee creamers, and even infant formula! A study published in Nature found that these compounds may impact our health by affecting the intestinal lining of our guts and the microbiome. Can this be partly to blame for the national crisis of gut disorders and their sequelae?

A Quick Dip into the Science

It has become clear that a disruption of the microbiome-host relationship is associated with a vast number of chronic inflammatory diseases. While the microbiome provides the host with many benefits, the host also has to be protected from microbes. The design of this protection is via a mucous layer that covers the intestinal lining, keeping the microbes at a safe distance. Emulsifiers (which act like detergents) can disrupt this mucus layer and induce not only inflammation but obesity, metabolic syndrome, and colitis.

In the Nature study mentioned above, mice were fed emulsifiers in their water at the same concentration found in the human diet. As a result, several concerning issues were noted:

1. Compromised mucus layers of the gut allow bacteria to access the top layer of cells (epithelial cells)
2. Increased leaky gut and colitis 
3. Decrease in microbial diversity, with a reduced number of Bacteroidales (found in healthy guts) and an increased number of Proteobacteria (found in inflamed guts)
4. Weight gain, obesity, and higher fasting glucose levels

What is significant about this study is that it describes the change in the microbial composition as the root cause of the negative health effects the mice experienced. This was demonstrated by performing a fecal transplant from a mouse fed emulsifiers to a mouse that was not given the emulsifiers (control mouse).  For a more detailed conversation with Dr. Andrew Gewirtz, lead author of this ground-breaking research, listen here and learn whether Dr. Gewirtz changed his own diet as a result of his research. 

More Research Findings

Another recently published paper further clarifies how the mucus barrier is impacted by emulsifiers. When exposing rats to P80 and CMC, there was a decrease in both the thickness and the amount of mucus as well as an increased speed of E. coli (a potential pathogen) through the mucus. Mucus enhancers and protectors included:

• Lipids 
• Calcium
• Polyphenols found in green and black teas 
• Fruit and grain dietary fiber 

This study again demonstrates the importance of diet advice for health maintenance of our patients’ gut function.

Do You Need a Ph.D. to Read Labels?  

An added challenge for the non-scientist is navigating food labels. The emulsifier CMC (Carboxymethyl cellulose), for example, can cause an overgrowth of certain pathogens in the microbiome. Such overgrowth may be linked to SIBO (Small intestine Bacterial Overgrowth), a common condition that is often difficult to diagnose. But what you will likely find on the food packaging label is ‘‘cellulose gum’’ or perhaps “‘dietary fiber,’’ which is misleading at best. If practitioners are struggling with label navigation, one can only imagine the difficulty facing a layperson. You shouldn’t need a degree to read a label!

Time for a Change 

One of the key elements of improving intestinal/microbiome health is the elimination of processed foods from the diet. Medical practitioners have recognized this need and have created a processed foods questionnaire (PFQ) to serve as a reliable and successful tool for patients with certain gastrointestinal disorders, such as inflammatory bowel diseases. Why not provide this type of questionnaire to other medical evaluations? This is an excellent addition to medical practice, and there may be other standard protocols and procedures that may need reevaluation in our medical system.  

Although not the focus of this article, another relevant issue for practitioners involves bowel prep advice for patients prior to having a colonoscopy. The routine bowel prep that is administered contains polyethylene glycol (PEG, an emulsifier). There is scant literature on the potential effects of the administration of colon prep on the microbiome. My own preferences steer clear of PEG. Other considerations include PEG-free magnesium citrate/saline laxatives. There are also homemade drinks one can make using ingredients such as the following:

• Celtic sea salt
• Orange juice 
• Epsom salt, and
• Cream of Tartar 

Mineral balance and hydration are also factored in when using this type of homemade formula. This is an example of how understanding the effects of emulsifiers could positively impact how we care for our patients as well as for ourselves.

The Cost of Convenience

Eliminating emulsifiers and processed foods from our diets are excellent first steps in the restoration of health for our patients. However, an equally important measure is the incorporation of an organic diet free from pesticides. Many herbicide combinations are glyphosate-based but also contain inert substances such as surfactants (which act as detergents and break down fats). 

The toxicity from many pesticides is found in substances that potentiate the toxicity of the active ingredient, such as the surfactants often hidden in “proprietary” formulas which don’t reveal their chemical makeup. The importance of this issue is that this pesticide formulation can cause similar disruptions via the same mechanisms of action described above from emulsifiers. 

As a side note, evaluating this potential source of toxicity is now possible. In a recent study, Drs. Antoniou and Mesange describe a method for measuring surfactants in urine, opening a pathway for the evaluation and biomonitoring of these hazardous substances. The logical next steps would be the incorporation of the above-mentioned cutting-edge technology; forward-thinking processed food questionnaires; comprehensive dietary intake evaluations; and counseling from our clinics to our kitchens.  

Despite best intentions, diets go awry. Travel, meals on the go, and long or stressful days at work may sabotage our microbial well-being. Proflora™4R can help support the microbial balance, promoting beneficial microbes (e.g., Akkermansia muciniphila) and downregulating inflammation to improve gut health. It is a blend of “sporebiotics” (that can resist breakdown by an acidic stomach pH) and soothing herbs (marshmallow root, Aloe vera, and quercetin). An important beneficial byproduct of Proflora4R is the production of K2 and nattokinase, which is receiving a lot of attention in its role with issues such as Long COVID. 

A new product to help restore gut health is G.I. InnerCalm™, a clinician-crafted, easy-to-use gut powder that supports gut mucosa and gut barrier integrity. It’s packed with researched ingredients to assist in protecting and restoring intestinal epithelial cells. Aloe, chamomile, lemon balm, and GutGard®  – a patented Deglycyrrhizinated Licorice (DGL) – soothe and calm an inflamed gut. Glycine, zinc carnosine, quercetin, and aloe contribute to tight junction health. Glycine also protects enterocytes by supporting the production of glutathione and collagen. G.I. InnerCalm™ mixes with water for a delicious lemon-ginger drink, which encourages patient compliance.

The bottom line is that true healing begins when health becomes a more important consideration than convenience. As we move away from consuming processed foods and non-nutritive additives, we may even invite peanut butter back into our kitchens and lunch boxes once again.