Titanium dioxide is a substance used in many food items. Recently researchers from the University of Zurich have shown that this substance can increase inflammation and damage to the intestinal walls of mice. This indicates that this substance could have the same effect on humans which could be quite problematic for people with colitis. Based on this information, researchers have recommended that people which have colitis avoid eating food with titanium dioxide particles. There is a lot of information on various issues that circulates through the internet. Some of this information is based on one or two research studies that are not nearly sufficient to form a strong conclusion about the issue.
Check the label on the following products to see if they contain titanium dioxide (E171):
- Chewing gum
- Packaged cake frosting
- Powdered sugar
- Prepackaged baked goods
- Prepackaged cookies
- Prepackaged mozzarella and cottage cheese
- Lemon curd
- Prepared horseradish sauces
- Packaged dairy drinks
- Vitamin supplements
People with IBD, especially colitis, know that managing the illness can be very difficult and life consuming. A lot of times this requires regulating or weeding things out of the normal diet. Sometimes this is effective in easing the symptoms and other times it is not. So, if information surfaces that suggests patients should remove yet another type of food, they will want to know how challenging this will be and if it is actually likely to help. When there is a small substance such as titanium dioxide that is present in many packaged foods, this can be particularly stressing. It becomes necessary to read the labels of everything. In addition, dietary changes may be necessary depending on the types of surgeries patients may have had. If someone has had an operation that removes all or part of their large intestine, digesting fruits, vegetables, and things with fiber can be very uncomfortable and difficult. This may mean that patients eat more processed foods to keep on weight. This will likely increase the chance that they are eating food that contains titanium dioxide.
Irritable bowel disease
In western countries, inflammatory bowel diseases (IBD) such as Crohn’s and ulcerative colitis have been on the rise. These illnesses are autoimmune. This means that the body’s own immune system attacks the digestive system. Crohn’s Disease can affect the entire digestive tract from the mouth to the anus while ulcerative colitis just affects the large intestine. Like many illnesses it occurs due to a multitude of factors. Genetics, environment, and nutrition play an important role in the development and progression of IBD. There are many medical treatments available. In addition to this lifestyle changes can be effective, but these changes vary from person to person.
What is titanium dioxide?
Titanium dioxide is a white pigment that is used in many medications, cosmetics, and toothpaste. It has also been added to food products with more frequency as of late. In food it is labeled E171. Examples of food products that may have E171 are chewing gum, marshmallows, and icing. There are not current restrictions on its use in food products. As of now the FDA is still maintaining that using titanium dioxide in food products is safe. Additionally, the FDA has set a limit of one percent for the use of this substance in food products. The substance is naturally occurring in a few types of rocks and is mined from the earth and then processed into the product that is used in food or other things such as sunscreen. The FDA may never decide that titanium dioxide is harmful for our health, or if they do it may be years before they make that information public.
At the University of Zurich Gerhard Rogler, the professor of gastroenterology and hepatology has shown what effect titanium dioxide particles can have on the intestines. This substance can amplify the inflammatory reaction that is already happening in patients with IBD. The research focused on a protein complex in cells call the NLRP3 inflammasome. This protein complex is part of the non-specific immune system. The non-specific immune system detects danger signals in the body and then triggers inflammation in order to fight off whatever is invading. Bacteria is one way that this inflammation pathway can be triggered. The NLRP can also be triggered by small particles that are not bacteria and come from an outside source. This can lead to situations that could be damaging to the intestinal wall. One example is uric acid crystals forming inside of cells. This can lead to gout which is a type of arthritis that causes a burning pain, stiffness, and swelling in a joint.
The research studies first looked at the substance in cell cultures. This showed that titanium dioxide can enter intestinal epithelial cells and other cells that play a role in the functioning of the immune system. Titanium dioxide can then stay in the cells and build up there. Inflammatory proteins then saw these titanium dioxide particles as dangerous invaders and thus initiated the inflammatory reaction. They also noted during their research that patients who have ulcerative colitis, and thus an already damaged intestinal wall, have a higher concentration of titanium dioxide in their blood. This finding indicates that patients with certain diseases could have an increased chance of absorbing titanium dioxide, meaning it enters the blood stream.
After this study, the researchers fed titanium dioxide to a group of mice. These specific mice physiologically mimicked humans who have IBD. In this study they observed that the titanium dioxide particles continued to activate the protein complexes that participate in the inflammation reaction. The subsequent observation showed that this caused an increase in damage to the intestinal wall of the mice. The spleens of the mice revealed the presence of titanium dioxide particles as well.
So, what can you do?
As with the beginning of many research studies, a lot still needs to be done for there to be a definitive conclusion made and patient recommendations developed. At this moment however, these researchers are advising people to avoid foods that contain titanium dioxide. Rogler specifically advises patients with IBD to avoid this substance so that they can lessen their risk of intestinal damage. There has not yet been a conclusion about this product in the medical community.
When medical providers have not come together and made a uniform decision on what they want to tell patients, it can be difficult to know where to get your advice. A good place to start is by talking to your provider about your concerns and thoughts. Do your own research and then bring that information to him/her so that he/she can help you understand what it means for you specifically. If you have a positive and trusting relationship with him/her they can help you make an educated decision.
It may also benefit you to look at your diet and analyze what types of foods you eat. Knowing what is in these foods is also important. Doing this prior to your visit with your healthcare provider can help you both look at what things may need to be changed in your diet. If it’s easier and more comfortable for you avoid this substance you can do that too. It is used in many packaged foods such as Oreo filling, so at the very least, cutting it out of your diet could lead to a healthier life style. We know it can be hard to maintain adequate nutrition with IBD. Ensuring that you are consuming foods that are healthy for your body is a good place to start.