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A woman examines the nutrition label of a box of crackers. Sugar polyol compounds float in background.

Food Additives and What to Avoid

People with irritable bowel syndrome (IBS) may find that some foods make their symptoms worse. More than half of those with IBS say they have food intolerances and worsening of symptoms with certain foods. While research is still examining the role of certain foods and ingredients in IBS symptoms, diet is known to affect the management of IBS.1

There is not much research on food additives in relation to IBS. However, several food additives have been proven to cause gut side effects. The most well-known food additive to have gut side effects include sugar polyols. They are typically used as artificial sweeteners.2

What are food additives?

Food additives are substances that are added to a food during the processing or making of that food. There are several kinds of food additives:2,3

  • Direct – typically added during processing
  • Adds nutrients
  • Keeps food fresh
  • Can be man-made or natural
  • Natural
  • Herbs or spices to add flavor
  • Vinegar for pickling
  • Salt to preserve meats
  • Indirect – substances that may be found in food during or after processing that aren’t put there on purpose

What do food additives do?

Food additives have 5 main functions:3

  • Give food smooth or consistent texture
  • Improve or preserve nutrient value
  • Maintain the integrity of the food
  • Control the acid-base balance of foods to get certain flavors or colors, and help baked goods rise
  • Enhance flavor and give color

Additives can help keep food on the shelves longer and keep bacteria from forming. Additives also provide improved nutrients.3

More on this topic

Additives you may be familiar with include:4

  • Nitrates
  • Nitrites
  • Artificial sweeteners like aspartame
  • Phosphates
  • Sorbitol

What food additives should I avoid?

Additives can sometimes cause gut side effects. Knowing what additives to avoid can help you manage your diet and IBS symptoms.

Sugar polyols

The additives best known for gut side effects are sugar polyols. They are typically used as artificial sweeteners. They include:2

  • Sorbitol
  • Mannitol
  • Isomalt
  • Maltitol
  • Lactitol
  • Xylitol

Some sugar polyols are known to have a laxative-like effect, even in people who do not have IBS. This is because they cause extra water to be drawn into the gut, which can cause diarrhea. It is also because they are poorly absorbed by the small intestine. This can cause symptoms like bloating, cramps, stomach pain, or gas.2

Trehalose

Trehalose, another food additive, is an artificial sweetener that also helps preserve the shelflife of foods. It can be found in food like:4

  • Cereals
  • Frozen shrimp
  • Baked goods
  • Fish in pouches

When large amounts are eaten, the enzymes that break it down are overwhelmed. Eating a lot of trehalose can encourage the growth of the bacteria C.difficile, which causes inflammation of the colon, as well as diarrhea.4

Carrageenan

Carrageenan is a food additive that is a stabilizer and added to some plant milks or yogurts to make it creamier. The cell structure of this additive is unfamiliar to human cells. This causes inflammation that usually affects the digestive system. This can make IBS symptoms worse.4

How can I avoid these additives?

Read the food labels of all of the foods you buy. Check your medications to make sure none of the sugar polyols are in the drugs. If they are, talk with your pharmacist and doctor to see if there are other formulas of the medication that do not have the additives.2

Also try to mainly eat fresh, minimally processed foods. These are less likely to contain food additives.2

Some people with IBS find the FODMAP diet to be helpful. FODMAPs are types of sugars that cannot be completely digested or absorbed by the intestines. When these sugars go into the large intestine, they are fermented by gut bacteria. This causes the gas to stretch the intestine, causing pain or discomfort.5

A FODMAP diet is for those who have been medically diagnosed with IBS. It can help reduce pain or bloating, improve bowel habits, and improve quality of life. The diet involves several weeks of significant restrictions and then gradually allows certain foods to be reintroduced to the diet. It works best under the supervision of a dietitian or healthcare professional who specializes in IBS and FODMAPs.5

In the early stage of a FODMAP diet, foods naturally high in sorbitol and mannitol should be avoided. Processed foods that have any sugar polyols should also be avoided. When your IBS symptoms are better controlled, your healthcare provider monitoring your diet may suggest the next phase of the FODMAP diet. The step introduces some foods that naturally contain sugar polyols. You can try these foods and see how your body responds.2

Things to consider

Talk with your doctor and/or dietitian about your diet and IBS before making any changes, even if you aren’t doing the FODMAP diet. They might have suggestions for you about which additives to avoid or reduce in your diet to help your symptoms.

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