Health

Emulsifiers Make Food Appetizing yet Bring Health Dangers

Published

4 weeks ago

April 12, 2024

April 12, 2024 — Creamy, thick, and velvety: Without emulsifiers, your favorite ice cream or muffin might not taste the same. Yet research warns that there is a darker side to these substances, from polysorbate-80 to carrageenan. Evidence links emulsifiers with upset gut microbiome, inflammation, and several conditions, from heart attacks to breast cancer.

What’s more, emulsifiersdon’t necessarily equal junk food. Such substances can be found in many foods that are often considered healthy, such as some low-fat Greek yogurts, trail mix bars, or oat milk.

There are over 100 different emulsifiers that can be added to foods. They prevent separation of oil and water, improving texture. A 2023 study found emulsifiers in as many as 95% of British supermarket pastries and cakes, 55% of breads, and 36% of meat products.

Certain goods that contain emulsifiers may not fit neatly into traditional dietary categories. Reduced-fat dairy products are a good example, said Benoit Chassaing, PhD, a microbiologist at the French National Institute of Health and Medical Research (INSERM). “If [producers] remove fat, they need to replace it with something else. So very often, if you buy fat-free or low-fat cream or cream cheese, it will be loaded with dietary emulsifiers,” he said.

From a health perspective, that’s bad news. In 2024, Chassaing and his colleagues published a study based on 92,000 French adults who provided detailed records of foods they ate, brand names included. The results revealed that people who ate the highest levels of emulsifiers had a significantly elevated risk of cancer. For carrageenans, which are emulsifiers derived from seaweed, the risk of breast cancer went up by 32%. Another type of emulsifier, mono- and diglycerides of fatty acids, upped the risk of prostate cancer by 46%. A related 2023 study linked the dietary intake of emulsifiers with an increased risk of cardiovascular disease. Among the worst offenders were microcrystalline cellulose and carboxymethylcellulose (CMC), which may be found in ice cream or processed cheese.

While population studies suggest a link between food emulsifiers and poor health, they do not prove that the additives directly cause the negative health outcomes. What can help are lab studies. For such experiments, researchers often use a human gut simulator, a machine that may resemble a row of old-school milk bottles connected via tubes to a telephone switchboard. The bottles contain gut microbiota taken from human stool, to which scientists add various emulsifiers (admittedly, the lab may smell pretty bad). In one such study published in 2024, researchers from Belgium showed that polysorbate 80, a synthetic emulsifier often used in dairy products and salad dressings, decreases the numbers of friendly gut bacteria, such as Faecalibacterium prausnitzii, while increasing the numbers of those associated with inflammation.

Andrew Gewirtz, PhD, a microbiologist at Georgia State University, said emulsifiers have long been considered safe for consumption because many of them pass through the body unabsorbed. It was “presumed that therefore they can’t possibly do anything negative,” he said. This view began to shift as we recognized the importance of gut microbiota for health. Now the fact that emulsifiers could reach the gut almost unchanged made them “prime suspects involved in perturbing the microbiota,” Gewirtz said.

When you eat something that contains emulsifiers, the nutrients and water in the food will be absorbed along your digestive tract. Various additives, however, will stay relatively intact. “We think that they can reach higher concentration in the gut,” Chassaing said. Once there, some emulsifiers can change microbiota composition and function, prompting gut bacteria to give off pro-inflammatory molecules. This, in turn, could lead to a variety of chronic inflammatory diseases, from diabetes to cardiovascular disease.

One of the strongest arguments for the negative effects of food emulsifiers came from a 2022 trial conducted by Gewirtz, Chassaing, and their colleagues. For that experiment, 16 volunteers were randomized to either eat an emulsifier-free diet or one containing high doses of CMC. For 11 days the participants were housed at a local hospital and fed an identical diet, with one exception: some of them received desserts made with CMC. The results showed that eating the emulsifier was linked with more complaints of abdominal discomfort, as well as the loss of health-promoting metabolites released by gut microbes such as the short-chain fatty acids.

“It did confirm the notion that emulsifiers are impacting gut microbiota, changing the species composition,” Gewirtz said.

For two of the participants, things got particularly bad — their gut bacteria invaded the normally sterile inner mucus layer of the gut, a condition which may lead to Crohn’s disease or ulcerative colitis. A 2024 follow up study revealed that this was likely due to the composition of the two participants’ gut microbiome.

They had “microbiota that were highly sensitive to the perturbation,” Chassaing said. If you transfer gut bacteria from such patients to mice, “you can drive very strong colitis,” he said. However, the trial was small, and, as Aaron Bancil, MD, a gastroenterologist at King’s College London, said, the participants were fed quite high doses of CMC: 15 grams per day. While some people may indeed ingest these kinds of doses with their regular diet, “it’s not going to be something that’s consumed often,” he said.

Other research suggests, meanwhile, that emulsifiers may impact human gut directly. When researchers from Italy applied dietary emulsifiers to human cells derived from colon cancer, they found that it made such cells proliferate faster. This could point to a role of emulsifiers in cancers of the gastrointestinal tract, confirming the results of the French population studies. Emulsifiers could also act as a gateway for other potentially harmful chemicals. In experiments conducted on both human cell lines and on rats, polysorbate 80 damaged the mucus barrier in the intestine, leading to its increased permeability — the infamous “leaky gut.” This helped phthalates, chemical compounds that are commonly added to plastics and which, once ingested, can be transformed into endocrine disruptors, to be easier absorbed by the body.

Animal research shows that consuming emulsifiers could also lead to anxiety. Mice fed CMC and polysorbate 80 showed changes in the brain areas responsible for the stress response, such as the amygdala. And if emulsifiers are fed to mice during pregnancy, such effects may be transferred to their offspring, too. However, according to Bancil, while animal models are informative, “we can’t fully translate those things over to humans.”

What’s more, not all emulsifiers appear equally harmful. When Chassaing, Gewirtz, and their colleagues tested 20 common dietary emulsifiers, they found that some, such as carrageenans, guar gum, and xanthan gum, had striking detrimental effects, while others, such as lecithin, were less damaging. Lecithin is a natural emulsifier, commonly derived from eggs and soy. As such, Gewirtz said, it doesn’t reach the gut unabsorbed the way synthetic emulsifiers do. On the other hand, “polysorbate 80, carrageenans, and also a lot of the gums, xanthan gum, guar gum — those ones are really, really aggressive for the microbiota,” Chassaing said.

There may be ways to protect the gut microbiome from harmful effects of dietary emulsifiers. When researchers fed mice mucus-fortifying bacteria, Akkermansia muciniphila, it prevented the damage caused by eating CMC and polysorbate 80. Yet Gewirtz warned that this doesn’t mean we should all rush to stock on akkermansia pills, since such supplements are “just not really well tested.”

The safest bet to keep your gut healthy would be to eat homemade foods and shy away from emulsifiers altogether. However, Bancil said, for some people, especially those with a busy lifestyle, this may be tricky to do. As such, checking out labels might be a better approach. “Very often there is an alternative,” Chassaing said. “You have a lot of dietary emulsifiers in ice cream, but you can find some brands that will be doing emulsifier-free ice cream,” he said.

Counterintuitively, cheaper foods are sometimes less loaded with emulsifiers than are pricier options. “There might be a branded ketchup, and there might be a supermarket’s own brand. The branded one, which might be more expensive, might have emulsifiers in it, but the own brand might not have emulsifiers,” Bancil said.

Same goes for foods marketed as healthy, said Megan Rossi, PhD, a nutritionist at King’s College London. “Let’s just be cautious and not automatically assume that they’re better for you,” she said.

Yet studying labels is not without its challenges. That’s because “emulsifiers might be labelled as different things,” Bancil said. So carboxymethylcellulose could appear on a label as CMC, cellulose gum, modified cellulose or, in Europe, as E466. Carrageenan could be called Irish moss, Eucheuma extract, or E407.

According to Gewirtz, considering the results of animal research and in vitro studies, as well as of the preliminary human trials, the food industry should be encouraged to look for safer alternatives, particularly to synthetic emulsifiers. Chassaing hopes that “in the future we’ll be able to select and to favor the use of additives that are much more well tolerated by the microbiota.” However, he said, “this is not yet the case.”

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Health

Anorexia: The Body Neglected

Published

8 hours ago

May 7, 2024

Charlotte E. Grayson Mathis, MD

Anorexia nervosa takes an enormous toll on the body. But that’s not all. It has the highest death rate of any mental illness. Between 5% and 20% of people who develop the disease eventually die from it. The longer you have it, the more likely you will die from it. Even for those who survive, the disorder can damage almost every body system.

What happens exactly? Here’s a look at what anorexia does to the human body.

The first victim of anorexia is often the bones. The disease usually develops in adolescence — right at the time when young people are supposed to be putting down the critical bone mass that will sustain them through adulthood.

“There’s a narrow window of time to accrue bone mass to last a lifetime,” says Diane Mickley, MD, co-president of the National Eating Disorders Association and the founder and director of the Wilkins Center for Eating Disorders in Greenwich, Conn. “You’re supposed to be pouring in bone, and you’re losing it instead.” Such bone loss can set in as soon as six months after anorexic behavior begins, and is one of the most irreversible complications of the disease.

But the most life-threatening damage is usually the havoc wreaked on the heart. As the body loses muscle mass, it loses heart muscle at a preferential rate — so the heart gets smaller and weaker. “It gets worse at increasing your circulation in response to exercise, and your pulse and your blood pressure get lower,” says Mickley. “The cardiac tolls are acute and significant, and set in quickly.” Heart damage, which ultimately killed singer Karen Carpenter, is the most common reason for hospitalization in most people with anorexia.

Although the heart and the bones often take the brunt of the damage, anorexia is a multisystem disease. Virtually no part of the body escapes its effects. About half of all anorexics have low white-blood-cell counts, and about a third are anemic. Both conditions can lower the immune system’s resistance to disease, leaving a person vulnerable to infections.

Even before a person with anorexia starts to look “too thin,” these medical consequences have begun.

Many young women who begin eating a severely restricted diet stop menstruating well before serious weight loss sets in. Since so many people with anorexia are teenage girls and young women, this can have long-term consequences on their ability to bear children.

“In truly, fully recovered anorexics and bulimics, it looks like the rate, frequency and number of pregnancies is normal,” says Mickley. “However, if you look at infertility clinics, and those patients in the clinics who have infrequent or absent periods, the majority of them appear to have occult eating disorders. They may think they’re fully recovered, but they haven’t gotten their weight up high enough.”

Many women with anorexia would rather seek fertility treatment than treatment for their eating disorder, Mickley says. And even among women who have fully recovered from their anorexia and bulimia, there may be a slightly higher rate of miscarriages and caesarean sections. “There also may be up to a 30% higher incidence of postpartum depression as compared to other women,” she says.

Bulimia, which often goes hand in hand with anorexia, does its own unique health damage. Bulimics who purge by vomiting wreak havoc on their digestive tracts by chronically bathing them in stomach acid, which can lead to digestive disorders like reflux esophagitis.

“It feels like I’ve been drinking Draino,” said one woman who posted to a forum on digestive diseases about the consequences of her lifelong anorexia and bulimia. Some reported cases suggest bulimia may have led to a condition called Barrett’s esophagus, which may can lead to esophageal cancer.

The good news: Many of these complications can be reversible — if the person returns to a normal weight. “The real focus has to be on weight restoration if you want to reverse outcomes,” says Rebecka Peebles, MD, a specialist in adolescent medicine at the Lucile Packard Children’s Hospital in Palo Alto, Calif. “That’s the most essential part of treatment. You can’t wait around for it to happen. It really is an essential first step in treatment and recovery.”

Unfortunately, say experts, too many people believe that anorexia is strictly a psychological disorder, and ignore its medical complications unless the patient becomes visibly, dangerously thin. “A lot of people — parents, and even some doctors — think that medical complications of anorexia only happen when you’re so thin you’re wasting away,” says Peebles. “Practitioners need to understand that a good therapist is only part of the treatment for anorexia and other eating disorders, and that these patients need treatment from a medical doctor as well.”

Studies have found that many people who need treatment for anorexia aren’t getting it. In large part, this may be due to cost. Inpatient treatment can cost more than $30,000 per month, while outpatient treatment can run as much as $100,000 per year.

Melissa Román, a Miami woman who’s been in recovery from anorexia for several years, pays $800 per month out of pocket for therapy sessions that insurance won’t cover. According to the National Eating Disorders Coalition, health insurance companies pay for an average of 10 to 15 treatment sessions for people with eating disorders, when more long-term care — as many as 40 sessions — may be needed for true recovery.

“Access to care is a huge issue,” says Mickley. “Eating disorders aren’t staged the way cancer is, so we don’t have the way to convince insurance companies that a low potassium level can be like a small metastasis. It’s only recently that we’ve begun to understand the genetic and neurochemical basis of anorexia and say that this is a real illness, not a whim of spoiled rich girls. It’s been treated like it’s voluntary and willful as opposed to what it is: a serious, life-threatening psychiatric and medical illness.”

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Health

Your child’s pee: An ultimate guide – CHOC

Published

16 hours ago

May 7, 2024

CHOC

Advice for parents about their child’s urine colors, hydration and health

Although it may sound silly, here at CHOC, we encourage you to take a periodic peek inside the toilet bowl! The color, odor and nature of your child’s urine (pee) can tell you a lot about their hydration — and overall health.

Here, Dr. Monica Molina, a pediatrician in CHOC’s Primary Care Network, provides an ultimate guide to your child’s urine. Get answers about the common urine hues and smells, how much water your child should be drinking and when to seek help if your child complains of pain while peeing.

What can my child’s pee color tell me about their health?

Typically, the color of your child’s urine depends on how hydrated they are, says Dr. Molina. Babies, kids and teens will have urine colors ranging from clear to amber color.

By keeping the occasional pulse on your child’s urine color, you may be able to monitor their water intake, spot signs of potential infection and seek help from your doctor when needed.

CHOC’s Pee Palette: How to decode your child’s urine colors

CHOC Pee Palette graphic - What does the color of my urine mean?

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Common urine colors for babies, kids and teens

Clear. When urine appears clear, it’s most often a result of drinking a lot of water. Babies will often have similar urine colors to kids and teens, but it’s common for their urine to be pale or colorless for the first few days after birth. Then, as babies start to feed, their urine will become more concentrated and turn pale yellow.
Pale Yellow. This is the ideal color for urine. It indicates that the body is well-hydrated and functioning properly. You can tell your kids that this color means they are drinking enough water.
Dark Yellow: If urine is darker than pale yellow, it might mean that your kids need to drink more water. It could indicate mild dehydration. With increased hydration, your child’s urine color should become paler after a few hours.
Amber or honey: If urine appears amber or honey-colored, it’s a sign of dehydration. Encourage your child to drink water immediately.
Orange: Orange urine can be caused by certain medications or foods, but it can also indicate dehydration or liver problems. Encourage your child to drink water and monitor their urine color.

Less common urine colors in babies, kids and teens

Pink or red: Although foods and drinks may cause urine to appear red or pink, it could also be a sign of blood in the urine, which could indicate a health issue. If your child’s urine is pink or red, they should see a doctor right away.
Blue or green: Sometimes, certain foods or medications can cause urine to appear blue or green. While this is usually harmless, it’s a good idea to mention it to a doctor if it persists.
Cloudy or foamy: Cloudy or foamy urine might indicate a urinary tract infection (UTI). If your child’s urine appears consistently cloudy or foamy, they should see a doctor.

Share this pee palette with your kids and encourage them to peek at the toilet bowl every so often (since they probably already do anyway!) so they are more aware of their bodies and health. Always reassure them that it’s normal to talk about bodily functions and that it’s important to let an adult know if something seems unusual or uncomfortable.

For more toilet bowl tips, visit CHOC’s ultimate guide to your child’s poop.

Why does my child’s pee smell?

Urine does have a slightly “nutty” or “ammonia-like” odor, which is entirely normal. It’s usually mild, but sometimes, other factors may change the smell of urine, like:

Diet. Foods like asparagus, certain spices and coffee can cause urine to have a stronger odor. Dehydration can also concentrate the waste products in urine, making the odor more noticeable.
Medications. Some medications, like antibiotics, may change the smell of your child’s urine temporarily.
Health conditions. Certain conditions like urinary tract infections (UTIs), diabetes, liver or kidney problems and metabolic disorders can cause changes in the smell of urine. For example, UTIs often produce a stronger, foul odor.

In most cases, a slight odor in your child’s urine is not cause for concern and should be resolved on its own. However, if your child’s urine has a strong, foul smell that lasts multiple days and is accompanied by other symptoms like pain, fever or changes in urine color, call your doctor.

My child is complaining that it hurts when they pee. What should I do?

Pain while peeing can be caused by different things. Most commonly, it’s caused by UTIs.

Irritation or injury of the genital area or kidney stones (small masses of minerals) in the urinary tract may also cause pain while peeing.

Encourage your child to drink water and keep an eye out for other symptoms of infection like fever, abdominal pain or changes in urine color or odor.

If your child experiences these symptoms, or the pain persists, call your doctor.

How much water should my child be drinking?

At CHOC, we recommend that kids drink the amounts of water below according to their age, says Dr. Molina. It is important to note that children should drink the number of 8-ounce cups of water equal to their age, with a minimum of 64 ounces of water for children over the age of 8.

Get more hydration tips for kids from CHOC experts.

Keeping track of the nature of your child’s pee can be a helpful way to make sure they are staying hydrated and feeling well. So don’t be afraid to investigate the toilet bowl and encourage your kids to report anything unusual to you. Your child’s pee can provide helpful clues to dehydration and infection prevention!

For more health and wellness resources from the pediatric experts at CHOC, sign up for the Kids Health newsletter.

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From babies to teens, pediatricians from CHOC’s Primary Care Network partner with parents to offer immunizations, sick visits, sports physicals and more.

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Health

How Mindfulness Reshapes Lives – Teaching Children Meditation

Published

20 hours ago

May 7, 2024

lorraine

Transformative stories

For two decades, navigating the twists and turns of my own business journey has been a profound experience. Yet, amidst the challenges and victories, some moments touch the soul. Take, for instance, the story of a freshly certified Connected Kids Meditation Tutor in the Middle East.

Working within an orphanage, they became a beacon of hope and resilience for a 13-year-old girl, imparting mindful skills that lit up her world with possibility. These moments infuse every struggle with purpose and make the journey truly meaningful.

Our tutors are trained to help children of all abilities and needs, including trauma. I hope this demonstrates the journey that helps us create powerful, mindful healing sessions for the children we connect with.

I have permission to share what happened…

Our trainee tutor taught 13-year-old ‘Zara’ (name changed to protect her identity) in 3 sessions.

In the first healing, meditation session, Zara was a little resistant. The tutor helped her connect to her breath and her body and Zara started to relax “I feel comfortable, nice feeling, maybe I will like it”. After the session Zara felt sleepy.

In the 2nd healing, meditation session, more mindful movement while connecting her to her breath. The tutor focussed on helping her gently move her body to release energy that connected to trauma. Zara felt sleepy again, wanted to cry at some moments but was quiet. She didn’t go to play afterwards (as normal) but took herself to her room and spent the time drawing. The tutor used her skills to support her through this.

In the 3rd healing, meditation session, she guided Zara to work with the energy system of the chakras to balance and release using meditation – using mindful movement and guided meditation. After this Zara told the tutor “I love it, I feel happy, my body is light, my heart feels nice.” She hugged the tutor and thanked her.

The tutor noticed the progression for Zara and gave her some home practice to help her stay connected.

Above are photos of the bracelets and necklaces she started to create after the above sessions.

Our tutor share’s her observations of Zara’s mindful journey.

Zara’s journey

“Zara came later to the orphanage. She experienced many difficult things and feelings: sadness, frustration, fear in trying to understand and cope with the new situation. She talks about her sadness. I feel she feels lost. She is a nice, kind girl and paints and colours in a beautiful way.

After sitting talking with Zara, and doing my (CK) heart meditation to connect to her energy, I felt my intention was to help her feel safe with her feelings and to help ground her energy and connect to the new situation and life (the orphanage); she needed to find and build internal self strength. So with her, I built a little program of daily practice. I was with her, step by step at first, until she could do it herself.

After 3 to 4 sessions, I can see how Zara could touch her own feelings and deal with them in a better way. She feels more safe and grounded than before and sleeps better.

Zara now shares simple mindful movement exercises with children younger than her. I knew she likes to make bracelets by beads so an idea came to me to help her use this to heal. I encouraged her and to sell them to friends, staff etc) in the orphanage. She is creative and doing that helps her in many ways (like feeling she can do something valuable) and I felt it grounded her and helped her heal emotions even indirectly. It seems that Zara has some strength now. There are still many things that need deep healing, but she is on her own life journey, and she now has some key life skills.”

Becoming a Meditation Teacher

For adults seeking to train professionally to offer meditation skills to children, the Connected Kids Professional Course offers a comprehensive and accredited learning experience. This certificated course provides professional tools and strategies to train you as a meditation teacher for children and teens.

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