According to Gram Research analysis, people with inflammatory bowel disease, especially those with Crohn’s disease, eat significantly more emulsifiers (food additives in processed foods) than healthy people, consuming 9.02 servings daily compared to 5.64 in healthy controls. However, a 2026 cross-sectional study of 186 people found that while high emulsifier intake appeared linked to more hospitalizations and emergency visits, this connection disappeared when researchers accounted for disease severity and other diet factors, suggesting emulsifiers alone don’t independently predict worse outcomes.
Researchers compared what people with inflammatory bowel disease (IBD) eat compared to healthy people, focusing on emulsifiers, which are additives that help keep processed foods from separating. They studied 186 people in Belgium and found that people with IBD, especially Crohn’s disease, consumed more emulsifiers than healthy controls. However, when researchers looked at whether these additives actually caused more hospital visits or surgeries over a year, the connection wasn’t as clear as expected. The findings suggest emulsifiers might play a role in IBD but other factors matter too.
Key Statistics
A 2026 cross-sectional study of 186 people in Belgium found that those with Crohn’s disease consumed 9.02 servings of emulsifiers daily compared to 5.64 servings in healthy controls, a 60% higher intake.
In a one-year follow-up of IBD patients, unadjusted analysis showed high emulsifier intake was associated with a 4.85-fold increased risk of hospitalizations or emergency visits, but this association disappeared after adjusting for disease activity and other factors.
People with ulcerative colitis ate 8.50 servings of emulsifiers daily, significantly higher than the 5.64 servings consumed by healthy controls, according to a 2026 comparative dietary study.
The Quick Take
- What they studied: Whether people with inflammatory bowel disease eat more foods with emulsifiers (additives in processed foods) than healthy people, and whether eating these foods leads to more health problems like hospitalizations or emergency room visits.
- Who participated: 186 people in Belgium: 65 healthy adults, 59 people with Crohn’s disease, and 62 people with ulcerative colitis. All were between 18 and 65 years old and recruited between September 2023 and April 2024.
- Key finding: People with Crohn’s disease ate the most emulsifiers (9.02 servings per day), followed by people with ulcerative colitis (8.50 servings), while healthy people ate the least (5.64 servings). However, when researchers adjusted for other factors like disease severity and fiber intake, emulsifiers alone didn’t predict who would have more health problems.
- What it means for you: If you have IBD, reducing ultra-processed foods with emulsifiers might be worth trying, but this single study suggests it’s not a guaranteed fix. Talk to your doctor or dietitian before making major diet changes, as other factors like disease activity and overall nutrition matter more.
The Research Details
This research used two parts. First, researchers compared what 186 people ate using food questionnaires and food diaries, looking at differences between healthy people and those with IBD. Second, they followed the IBD patients for one year to see if those who ate more emulsifiers had more hospitalizations, surgeries, or emergency room visits. The researchers measured emulsifier intake by counting servings of ultra-processed foods, which are foods made in factories with many additives. They used statistical tests to compare eating patterns between groups and survival analysis (a method that tracks events over time) to see if diet predicted health outcomes.
This approach matters because it shows real-world eating patterns and actual health consequences. Rather than just measuring what people eat, the researchers followed them over time to see if diet changes actually affected their health. This gives stronger evidence than simply asking people about their diet once.
The study was reasonably well-designed with a decent sample size and one-year follow-up. However, the researchers relied on people remembering what they ate, which can be inaccurate. The study was done in Belgium, so results may not apply everywhere. Most importantly, the study couldn’t prove cause and effect because it wasn’t a controlled experiment where some people were told to eat differently and others weren’t. The researchers also adjusted for other important factors like disease severity, which strengthens the findings.
What the Results Show
People with Crohn’s disease ate significantly more emulsifiers than healthy controls (9.02 versus 5.64 servings daily). People with ulcerative colitis also ate more emulsifiers than healthy people (8.50 versus 5.64 servings daily). These differences stayed true even after researchers adjusted for age, sex, disease activity, and fiber intake. Interestingly, ultra-processed food intake was similar across all three groups, suggesting emulsifiers specifically, not just processed foods in general, were higher in IBD patients. When researchers looked at whether high emulsifier intake predicted hospitalizations or surgeries over the next year, there was a pattern suggesting higher intake was riskier. However, when they controlled for other important factors like how active someone’s disease was, emulsifier intake alone no longer predicted these bad outcomes.
Ultra-processed food intake showed a similar pattern to emulsifiers in unadjusted analyses, with higher consumption appearing to increase the risk of hospitalizations or emergency room visits. However, like emulsifiers, this association disappeared when researchers accounted for other factors. The study found that disease activity and other dietary factors like fiber intake were more important predictors of health outcomes than emulsifier consumption alone.
Previous research in animals and lab studies suggested emulsifiers might trigger inflammation in the gut, which is why researchers expected to find a strong connection in IBD patients. This study confirms that IBD patients do eat more emulsifiers, supporting earlier observations. However, the weak connection between emulsifier intake and actual health problems suggests the relationship is more complicated than lab studies suggested. Other factors like stress, medications, and overall diet quality probably matter more than emulsifiers alone.
The study relied on people remembering what they ate, which is often inaccurate. The sample size was relatively small, especially for detecting long-term effects. The study couldn’t prove that emulsifiers cause problems because it wasn’t a controlled experiment. Results come from Belgium and may not apply to other countries with different food systems. The one-year follow-up period was relatively short for detecting long-term effects. The researchers couldn’t account for all possible factors affecting IBD outcomes, such as stress, sleep, or medication adherence.
The Bottom Line
If you have IBD, reducing ultra-processed foods is reasonable based on this research, but don’t expect it to be a cure. Focus on overall diet quality, including fiber intake and whole foods. Work with your gastroenterologist and dietitian to create a personalized plan. This single study isn’t strong enough to make emulsifier avoidance your main priority compared to managing disease activity and stress. Confidence level: Moderate for general diet improvement, Low for emulsifier-specific avoidance.
People with Crohn’s disease or ulcerative colitis should be aware of this research, especially if they eat many ultra-processed foods. Healthy people don’t need to worry about emulsifiers based on this study. Healthcare providers treating IBD should consider discussing overall diet quality with patients, though this study doesn’t support making emulsifier avoidance the primary focus.
If you reduce ultra-processed foods, you might notice changes in symptoms within 2 to 4 weeks, though this varies greatly. Long-term benefits would take months to years to assess. Don’t expect dramatic improvements from emulsifier reduction alone, as disease activity and other factors matter more.
Frequently Asked Questions
Do emulsifiers in processed foods make inflammatory bowel disease worse?
People with IBD do eat more emulsifiers than healthy people, but a 2026 study of 186 people found that emulsifiers alone don’t independently predict worse health outcomes like hospitalizations. Disease activity and overall diet quality matter more.
How much more emulsifier do people with Crohn’s disease eat compared to healthy people?
People with Crohn’s disease consumed 9.02 servings of emulsifiers daily versus 5.64 servings in healthy controls, about 60% higher. Ulcerative colitis patients ate 8.50 servings daily, also significantly higher than controls.
Should I avoid all ultra-processed foods if I have inflammatory bowel disease?
Reducing ultra-processed foods is reasonable for overall health, but this study doesn’t show it’s essential for IBD management. Work with your doctor to prioritize disease activity management, stress reduction, and adequate nutrition alongside dietary improvements.
Can reducing emulsifier intake prevent IBD hospitalizations?
This study found no independent link between emulsifier reduction and preventing hospitalizations after accounting for disease severity. While reducing processed foods may help some people, it’s not a proven prevention strategy for IBD complications.
Want to Apply This Research?
- Log the number of ultra-processed food servings consumed daily for two weeks, then try reducing by 25% and track any changes in symptom severity, energy levels, or bathroom frequency over the next month.
- Replace one ultra-processed food per day with a whole food alternative (for example, swap packaged cookies for fruit, or canned soup for homemade broth). Track which swaps feel easiest and most sustainable.
- Weekly check-ins on processed food intake and symptom patterns. Create a simple scale (1-10) for daily symptom severity and correlate it with your food diary over 8 to 12 weeks to see if patterns emerge for your individual body.
This research describes associations between diet and IBD outcomes but does not prove cause and effect. The findings come from a single study in Belgium and may not apply to all populations. People with inflammatory bowel disease should not make major dietary changes based on this study alone. Always consult with your gastroenterologist and registered dietitian before significantly changing your diet, especially if you have IBD. This information is for educational purposes and should not replace professional medical advice. If you experience worsening symptoms, seek immediate medical attention.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.