Your Microbes Read the Label, Not the Macros | The Angry Gut, Chapter 15

Emulsifiers in food · Gut health

Emulsifiers in Food: What No Test Can Measure About You

Emulsifiers in food reach you as a mixture of lecithins, mono- and diglycerides, carrageenan and phosphates, eaten several times a day for years, and no test in ordinary practice measures how much of it you have eaten.

Your macros can be fine while your microbes only ever see the ingredient list. Nothing sold as a test can measure that exposure, which makes the next question what can be measured.

Emulsifiers in food are the second diet most people are eating without knowing it. The first diet is the one on the nutrition label, where the calories and the protein look reasonable. The second is the ingredient list underneath, and your bacteria are the ones reading it.

The video Your Microbes Read the Label, Not the Macros follows a woman of forty-one whose week of food photographs would pass any dietitian’s review, until the labels were read aloud. It belongs to The Angry Gut, by Dr. Gurpreet Singh Padda, MD, MBA, MHP, and Ami Michelle Grimes. Measura [Cardiometabolic and Autonomic Health Analysis] is a testing service, and no test in its library measures what additives you have eaten, because no such measurement exists in ordinary practice.

Emulsifiers in food are a mixture, not a chemical

Among 106,489 French adults, forty-eight additives were eaten by more than 10% of people surveyed. Lecithins reached 86.6% of consumers, mono- and diglycerides of fatty acids 78.1%, carrageenan 77.5%, and the phosphate group 70.1%. People did not meet these compounds one at a time either; they arrived in recognizable clusters, several times a day, for years.

That matters for anyone hunting a single culprit. The compound most of the laboratory work studies is carboxymethylcellulose, sold on labels as cellulose gum. It is not the exposure. The exposure is the whole cluster, eaten by a body nobody asked.

The wall these compounds meet is thinner than advertised

Before anything can be said to strip a gut lining, someone has to measure the lining. The figures in wide circulation, around 830 microns of colonic mucus gel with roughly 116 microns firmly attached, were measured in rats. Human sigmoid biopsies gave a mean inner mucus thickness of 19.4 microns, with a standard deviation of 9.9 and a range from 6.2 to 45.6.

Two honest caveats come with those human numbers. The loose outer layer was missing from every biopsy, because bowel preparation washes it away in 96% of prepared subjects, and in paired animal samples the choice of preservative alone changed the measured thickness. Every human mucus number came out of a specimen jar. The wall is real; it is also a fraction of the number people quote, and it is the surface your first brain keeps between itself and everything you swallow, while the second brain in your skull never meets any of it.

How do emulsifiers affect gut bacteria?

Dr. Padda explained this the easy way for years: emulsifiers are detergents, dish soap on the lining. He now says that version was half right and it was the wrong half. In mice raised with no gut bacteria at all, neither compound thinned the mucus, and beads the size of bacteria stayed as far from the tissue as they had started. In animals carrying only a small defined set of bacteria, nothing happened either.

Grow a human microbial community outside a body, add cellulose gum, and its inflammatory potential rises while the roster of species present does not significantly change. Read that twice, because it decides what testing can see. The population held still and the behavior changed, so a stool census would have reported that nothing happened. When twenty common emulsifiers were screened this way, the starkest damage came from the carrageenans and the gums, two of which were on that patient’s labels.

What happened when healthy people ate an emulsifier?

Only one randomized trial has fed a purified emulsifier to healthy humans. Its sixteen adults spent eleven days on a diet stripped of other emulsifiers, with 15 g of cellulose gum a day added for seven of them. The distance between bacteria and the intestinal wall, the measure the trial was built to detect, did not change. Encroachment turned up in 2 of 7 treated volunteers and 0 of 9 controls. What did move was the composition of the microbiota, the chemistry of the stool, and abdominal discomfort after meals.

That is a modest result, and the reason matters more than the verdict. One additive, on a background diet scrubbed of the rest, in metabolically healthy volunteers, for eleven days. Trials remove the complicated patient to get a clean answer, and the complicated patient is the one reading labels in the kitchen.

What can a test measure instead of emulsifiers?

There is a real measurement in this literature, and it is about the body rather than the shelf. In 42 people having colonoscopy, people with type 2 diabetes had their bacteria sitting almost 3-fold closer to the nearest lining cell. It tracked hemoglobin A1c at an r-squared of 0.51 and fasting glucose at 0.46, but body mass index only at 0.16. Obesity by itself did nothing, and removing the subjects with diabetes erased the difference entirely.

The wall tracked blood sugar, not waist size. That is why the useful tests here measure metabolic state:

Laboratory panels put current numbers on blood sugar, lipids and inflammatory markers, which is where metaflammation stops being a word and becomes a result.
Bioimpedance body composition separates fat from muscle, which matters because body mass index was the weakest of the three measures above.

Neither test measures additives, mucus or bacteria, and neither diagnoses a gut disease. They describe the state your body is in while it meets that mixture daily, and the findings go to your physician. Good metabolic health is rare: under 12.2% of adults on NHANES 2009-2016, and under 7% on the tighter post-2021 criteria.

How can you cut back on emulsifiers?

The prescription is shorter than the science. Fewer items with ingredient lists, more items with none. People can actually do this, and somebody measured it: in stable Crohn’s disease, a low-emulsifier diet cut the frequency of additive-carrying foods by 94.6%.

Read your own labels for a week before changing anything, and count how many distinct additives you meet in a day.
Remember that engineered food does two things at once. It adds the compounds and removes the fermentable fiber, and in mice deprived of fiber the mucus layer thinned five- to six-fold while the bacteria turned on the wall itself for food.
Expect the calories to argue back. Twenty adults fed matched macronutrients ate 508 kcal a day more on the ultra-processed menu and gained weight on it, while losing weight on the unprocessed one.
Do not stop a prescribed medication or a therapeutic diet on your own. Bring any restriction plan to your own physician first.

The full trial numbers, including what each study could not show, sit in the book’s Deep Dive companion. The fuel those same bacteria are supposed to be making is covered in what a flagged butyrate result really samples, and the metabolic pattern behind the wall measurement above is in what insulin resistance looks like before diabetes.

Frequently asked questions

Is there a test that shows my emulsifier exposure?

No, and that includes Measura. Exposure in the research is estimated from food records or labels, not from a sample of you, and the mouse work suggests the action sits in the mucus layer that stool sequencing cannot reach. Reading your own labels for a week is closer to a real exposure measurement than any panel currently sold. What Measura actually measures.

Are emulsifiers causing my symptoms?

Possibly contributing, and the honest answer stops short of proof. Because the effect is routed through gut bacteria, how much it matters varies with the microbes a person carries and how inflamed their metabolism already is. In healthy volunteers fed one purified emulsifier for eleven days, the main barrier measure did not move, while abdominal discomfort after meals did. Understanding your results.

Which additive should I cut first?

Cut items rather than chemicals. The exposure arrives as a cluster several times a day, and the compounds with the strongest laboratory signal are not the ones the large population studies name. Carrageenans and gums did the worst damage to microbial behavior in the screening work, and both turn up in ordinary yogurt, dressings and low-fat desserts. Who should be tested.

My weight is stable, so is my gut wall fine?

Weight is the weakest of the three signals measured. In the colonoscopy study, bacteria sat closer to the lining in step with hemoglobin A1c and fasting glucose, while obesity alone showed nothing and body mass index explained the least. That is an argument for measuring what your weight is made of rather than what it says. Body composition is not the same as weight.

What should I ask my own physician?

Ask whether your inflammatory markers, A1c and triglycerides suggest the inflamed baseline that the clean trials excluded, and how you would tell whether a change in food helped because the additives came out or because the fiber went in. Both moved together in every study, and they are separable at your kitchen table. Questions worth asking your doctor.

What are the most common emulsifiers in food?

In a study of 106,489 French adults, the most widely eaten were lecithins, reaching 86.6% of people, mono- and diglycerides of fatty acids at 78.1%, carrageenan at 77.5% and the phosphate group at 70.1%. They rarely arrive alone. People met them in recognizable clusters, several times a day, for years, so the real exposure is the whole mixture rather than any one chemical.

Which foods are high in emulsifiers?

Items with ingredient lists are where they live, and items with none are the way out. Carrageenans and gums, the compounds that did the worst damage to microbial behavior in laboratory screening, turn up in ordinary yogurt, dressings and low-fat desserts. Reading your own labels for a week, and counting the distinct additives you meet in a day, shows where your exposure actually comes from.

Are emulsifiers in food bad for you?

The harm runs through your bacteria, not straight through the chemical. In mice with no gut bacteria, emulsifiers did not thin the mucus, while a cultured human microbial community grew more inflammatory once cellulose gum was added. In the one human trial, healthy volunteers kept their barrier distance but their microbes, stool chemistry and after-meal comfort changed. How much it matters depends on the body meeting it.

Measure the body that meets the label

If your diet looks good on paper and you still feel inflamed, ask about Measura metabolic and body composition testing, with the findings sent to your own physician.

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References

Chazelas, E., Druesne-Pecollo, N., Esseddik, Y., de Edelenyi, F. S., Agaesse, C., De Sa, A., Lutchia, R., Rebouillat, P., Srour, B., Debras, C., Wendeu-Foyet, G., Huybrechts, I., Pierre, F., Coumoul, X., Julia, C., Kesse-Guyot, E., Alles, B., Galan, P., Hercberg, S., … Touvier, M. (2021). Exposure to food additive mixtures in 106,000 French adults from the NutriNet-Sante cohort. Scientific Reports, 11(1), 19680. https://doi.org/10.1038/s41598-021-98496-6
Jawhara, M., Sorensen, S. B., Heitmann, B. L., Halldorsson, T. I., Pedersen, A. K., & Andersen, V. (2020). The relation between red meat and whole-grain intake and the colonic mucosal barrier: A cross-sectional study. Nutrients, 12(6), 1765. https://doi.org/10.3390/nu12061765
Chassaing, B., Raja, S. M., Lewis, J. D., Srinivasan, S., & Gewirtz, A. T. (2017a). Colonic microbiota encroachment correlates with dysglycemia in humans. Cellular and Molecular Gastroenterology and Hepatology, 4(2), 205-221. https://doi.org/10.1016/j.jcmgh.2017.04.001
Chassaing, B., Van de Wiele, T., De Bodt, J., Marzorati, M., & Gewirtz, A. T. (2017b). Dietary emulsifiers directly alter human microbiota composition and gene expression ex vivo potentiating intestinal inflammation. Gut, 66(8), 1414-1427. https://doi.org/10.1136/gutjnl-2016-313099
Chassaing, B., Compher, C., Bonhomme, B., Liu, Q., Tian, Y., Walters, W., Nessel, L., Delaroque, C., Hao, F., Gershuni, V., Chau, L., Ni, J., Bewtra, M., Albenberg, L., Bretin, A., McKeever, L., Ley, R. E., Patterson, A. D., Wu, G. D., … Lewis, J. D. (2022). Randomized controlled-feeding study of dietary emulsifier carboxymethylcellulose reveals detrimental impacts on the gut microbiota and metabolome. Gastroenterology, 162(3), 743-756. https://doi.org/10.1053/j.gastro.2021.11.006
Chassaing, B., Koren, O., Goodrich, J. K., Poole, A. C., Srinivasan, S., Ley, R. E., & Gewirtz, A. T. (2015). Dietary emulsifiers impact the mouse gut microbiota promoting colitis and metabolic syndrome. Nature, 519(7541), 92-96. https://doi.org/10.1038/nature14232
Hall, K. D., Ayuketah, A., Brychta, R., Cai, H., Cassimatis, T., Chen, K. Y., Chung, S. T., Costa, E., Courville, A., Darcey, V., Fletcher, L. A., Forde, C. G., Gharib, A. M., Guo, J., Howard, R., Joseph, P. V., McGehee, S., Ouwerkerk, R., Raisinger, K., … Zhou, M. (2019). Ultra-processed diets cause excess calorie intake and weight gain: An inpatient randomized controlled trial of ad libitum food intake. Cell Metabolism, 30(1), 67-77.e3. https://doi.org/10.1016/j.cmet.2019.05.008
Desai, M. S., Seekatz, A. M., Koropatkin, N. M., Kamada, N., Hickey, C. A., Wolter, M., Pudlo, N. A., Kitamoto, S., Terrapon, N., Muller, A., Young, V. B., Henrissat, B., Wilmes, P., Stappenbeck, T. S., Nunez, G., & Martens, E. C. (2016). A dietary fiber-deprived gut microbiota degrades the colonic mucus barrier and enhances pathogen susceptibility. Cell, 167(5), 1339-1353.e21. https://doi.org/10.1016/j.cell.2016.10.043
Salame, C., Javaux, G., Sellem, L., Viennois, E., de Edelenyi, F. S., Agaesse, C., De Sa, A., Huybrechts, I., Pierre, F., Coumoul, X., Julia, C., Kesse-Guyot, E., Alles, B., Fezeu, L. K., Hercberg, S., Deschasaux-Tanguy, M., Cosson, E., Tatulashvili, S., Chassaing, B., … Touvier, M. (2024). Food additive emulsifiers and the risk of type 2 diabetes: analysis of data from the NutriNet-Sante prospective cohort study. The Lancet Diabetes & Endocrinology, 12(5), 339-349. https://doi.org/10.1016/S2213-8587(24)00086-X