Evaluation of Select Food Additive Exposures in Children with Crohn's Disease
Swan, C Kaiulani
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University of Washington Abstract Evaluation of Select Food Additive Exposures in Children with Crohn’s Disease C Kaiulani Swan Chair of the Supervisory Committee: Johanna Lampe, University of Washington Research Professor Epidemiology Crohn’s Disease (CD) is a chronic, debilitating inflammatory bowel disease and recent research has revealed the possibility that environmental exposures such as diet may play a role in CD etiology and disease activity. Several food additives (e.g. carboxymethylcellulose, carrageenan, maltodextrin) have been shown to cause intestinal inflammation, mucosal barrier alterations, and microbiome dysbiosis in animal models, therefore it has been hypothesized that these additives may be associated with disease activity in children with CD. This project evaluated food additive exposure in children with CD in an effort to understand additive intake among this population and to establish a methodology for future studies. A cohort of 135 children (ages 8-21) enrolled in a Philadelphia Children’s Hospital trial evaluating bone health completed 24-hour dietary recalls at baseline, 6, 12, and 24 months. All recorded foods from the baseline visit were compiled into a database and organized into 31 distinct food groupings, and 4,965 unique foods were examined for the presence of soy lecithin, carboxymethylcellulose, xanthan gum, maltodextrin, titanium dioxide, carrageenan, aluminosilicates, and polysorbate-80 by evaluating ingredient labels. The additives with the highest number of mean exposures per day were soy lecithin (2.71 ± 1.34), xanthan gum (0.96 ± 0.72), maltodextrin (0.95 ± 0.77), and carrageenan (0.58 ± 0.63). The foods with the fewest mean exposures per day included titanium dioxide (0.09 ± 0.21), polysorbate-80 (0.07 ± 0.16) and carboxymethylcellulose (0.05 ± 0.13), while no exposures to aluminosilicates were found. Of the eight additives of interest, participants were exposed to an average of 2.7 different additives per recall day and experienced an average of 5.4 total additive exposures per recall day. In evaluating the 24-hour dietary recall results, grouping foods, and determining food additive content, unique recommendations were created for future studies assessing food additive exposure and the relationship to CD disease activity, including more precise 24-hour recall intake and utilizing available ingredient databases.
- Nutritional sciences