What’s Really Driving Your Gut Discomfort?
A Closer Look at Food Emulsifiers and Digestive Health
By Christie Amadio, Naturopath
Digestive complaints are incredibly common. Many people experience bloating, abdominal discomfort, reflux, irregular bowel habits, or the sense that their digestion simply isn’t functioning as well as it should.
When patients come into clinic with these symptoms, the conversation often focuses on familiar drivers — stress, food intolerances, dysbiosis, or hormonal changes. All of these are valid contributors. However, there is another factor that is increasingly gaining attention in scientific research and clinical practice: food additives, particularly emulsifiers.
For many years, emulsifiers were considered metabolically inactive — meaning they were not thought to significantly influence human physiology. More recently, scientists have begun exploring whether some of these compounds may interact with the gut microbiome and the intestinal barrier, both of which play vital roles in digestion, immunity, and inflammation regulation.
Recently I came across the ADDapt trial, and that research helped clarify the answer.
The ADDapt Trial represents the first large randomised, double-blind placebo-controlled trial designed to investigate the effects of a low-emulsifier diet in humans.
Researchers recruited 154 people with Crohn’s disease from 19 medical centres across the UK to take part in an 8-week clinical trial.
113 participants (73%) completed the full study.
The aim was to see whether reducing emulsifiers in the diet (a Low Emulsifier Diet – LED) could improve Crohn’s disease and compared two dietary patterns over the 8-week period
A low-emulsifier diet
A control diet that included added emulsifiers
The findings were clinically significant,
Participants following the low-emulsifier diet experienced:
Three times greater likelihood of symptom improvement
More than double the rate of symptomatic remission
Approximately a 50% reduction in faecal calprotectin, a marker of intestinal inflammation
For practitioners working with patients experiencing digestive discomfort or Crohns disease, these findings are particularly relevant.
They suggest that dietary exposure to emulsifiers may play a meaningful role in gut symptoms for some individuals.
What Are Emulsifiers?
Emulsifiers are food additives designed to improve texture, stability, and shelf life.
They allow ingredients that normally separate — such as oil and water — to remain mixed together. This is what gives many processed foods their smooth, uniform consistency.
Large population studies suggest that individuals may consume around 12 different emulsifiers per day, often without realising it. One large French cohort study estimated an average intake of approximately 4,200 mg of emulsifiers daily.
The largest contributors to emulsifier intake tend to be:
Bakery products
Dairy products
Processed meats
Desserts
Sauces and condiments
The Emulsifiers Most Often Encountered
Some of the emulsifiers most commonly seen on ingredient lists include:
Carboxymethylcellulose (CMC)
Polysorbate-80 (P80)
Lecithins
Carrageenan
Propylene glycol alginate
Xanthan gum
Guar gum
Maltodextrin
Agar agar
Glycerol monolaurate
Rhamnolipids and sophorolipids
While these compounds serve for manufacturing purposes, research is increasingly examining how they behave within the complex ecosystem of the gut microbiome.
Why Researchers Are Investigating Emulsifiers
Some scientists now hypothesise that certain emulsifiers may interact with the gut microbiota and the intestinal barrier, potentially influencing inflammation and metabolic health.
One proposed mechanism involves changes in intestinal permeability.
When the protective mucosal barrier of the intestine becomes compromised, bacteria and bacterial fragments may move across the intestinal lining. This process is known as bacterial translocation.
This can lead to the movement of compounds such as:
Lipopolysaccharides (LPS)
Tryptophan-derived metabolites
into circulation, which may contribute to metabolic endotoxaemia and chronic low-grade inflammation.
Importantly, these effects do not appear to occur uniformly in all individuals. The gut microbiome is highly individual, and responses vary widely depending on existing microbial balance, diet, and overall health status.
Supporting the gut is rarely about one single intervention. It is about creating an environment where the microbiome, intestinal barrier, and digestive processes can function optimally — and sometimes that begins with simply removing what does not belong there in the first place.
Journal of Crohn's and Colitis, Volume 19, Issue Supplement_1, January 2025, Page i262, https://doi.org/10.1093/ecco-jcc/jjae190.0136
"Correlation between human gut microbiome and diseases": https://www.sciencedirect.com/science/article/pii/S2772431X22000375