Clinical nutrition ESPEN · 2026
Feasibility assessment of an emulsifier-free diet in healthy subjects - A sub-analysis of the FOAM trial.
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Wellens Judith, Luppens Martijn, Hoekx Sien, Vanderstappen Julie, Van Elst Lies, Vissers Eva, Ferrante Marc, Verstockt Bram, Verbeke Kristin, Matthys Christophe, Vermeire Séverine, Sabino João
Аннотация
BACKGROUND & AIMS: Dietary emulsifiers are omnipresent in our diet and have been associated with intestinal inflammation. Therefore, an Emulsifier-Free Diet (EFD) represents a desirable intervention in Inflammatory Bowel Diseases (IBD). We aimed to assess the feasibility of an EFD in healthy volunteers.
METHODS: Sixty healthy subjects were recruited to a six-week dietary intervention. After one week of their habitual diet, participants followed an EFD for six weeks with bi-weekly questionnaires on acceptability, feasibility, and barriers. Adherence, emulsifier, and ultra-processed food (UPF) intake was assessed through daily food logs including photographs starting at baseline.
RESULTS: Two subjects were excluded due to NSAID use, and one for nutritional analysis due to implausible food logs. During the EFD, emulsifier intake decreased by 96.6% (IQR 85.6-100%, baseline vs. week 2; p = 9 × 10-11, baseline vs. week 6; p = 9 × 10-11), whereas UPF consumption decreased by 37.1 % (IQR 15.4-65.8%, baseline vs. week 2; p = 2 × 10-7, baseline vs. week 6; p = 1 × 10-9). Median adherence was 88.1% (IQR 75.6-94.9%). During the EFD, participants consumed a median of six emulsifier servings (IQR 2-13) for a median of three different products (1-5), mostly from the categories of dairy-like, meat, and bakery products. By the end of the trial, the diet was acceptable, feasible, tasty, and easy to follow for 72.4%, 72.6%, 70.7% and 50.0% of participants, respectively.
CONCLUSIONS: An EFD was acceptable and feasible with high adherence rates, meanwhile, an inadvertent and stable decrease in UPF intake was noted. These results show promise in the applicability of an EFD in IBD management and prevention (NCT06552156).
METHODS: Sixty healthy subjects were recruited to a six-week dietary intervention. After one week of their habitual diet, participants followed an EFD for six weeks with bi-weekly questionnaires on acceptability, feasibility, and barriers. Adherence, emulsifier, and ultra-processed food (UPF) intake was assessed through daily food logs including photographs starting at baseline.
RESULTS: Two subjects were excluded due to NSAID use, and one for nutritional analysis due to implausible food logs. During the EFD, emulsifier intake decreased by 96.6% (IQR 85.6-100%, baseline vs. week 2; p = 9 × 10-11, baseline vs. week 6; p = 9 × 10-11), whereas UPF consumption decreased by 37.1 % (IQR 15.4-65.8%, baseline vs. week 2; p = 2 × 10-7, baseline vs. week 6; p = 1 × 10-9). Median adherence was 88.1% (IQR 75.6-94.9%). During the EFD, participants consumed a median of six emulsifier servings (IQR 2-13) for a median of three different products (1-5), mostly from the categories of dairy-like, meat, and bakery products. By the end of the trial, the diet was acceptable, feasible, tasty, and easy to follow for 72.4%, 72.6%, 70.7% and 50.0% of participants, respectively.
CONCLUSIONS: An EFD was acceptable and feasible with high adherence rates, meanwhile, an inadvertent and stable decrease in UPF intake was noted. These results show promise in the applicability of an EFD in IBD management and prevention (NCT06552156).