You might be aware of your IBS food triggers like FODMAPs or alcohol, but what about hidden ingredients that you don't take notice of?

This week I'm talking about

• High fructose corn syrup
• Sugar alcohols
• Inulin and FOS
• Emulsifiers and thickeners
• Artificial sweeteners

I'll discuss where these ingredients are commonly found, how they might affect your digestive system, and why they might be the hidden culprits behind your flare ups.

Please rate and review my podcast if you've learnt something from this episode, thanks very much :)

Listen to these episodes for more details:

• Ep 25 - Sorbitol
• Ep 26 - Mannitol
• Ep 28 - Fructose

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The information in this podcast is not medical advice and is not designed to treat, diagnose or provide personalised health advice. This podcast content is information only and any changes you make are at the user's own risk. Please consult with your doctor or healthcare provider before implementing any new treatment.

If you've had IBS for a while, you

might be well aware of your common

2

food triggers, maybe things like dairy,

certain fruits and vegetables, or grains.

3

But did you know some foods

contain hidden ingredients that

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can trigger an IBS flare up?

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From artificial sweeteners,

emulsifiers, to thickening agents

6

and preservatives, these ingredients

can lead to bloating, diarrhoea

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and abdominal pain in some people.

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Often, if you don't even

realise that they're in there.

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In this episode, I'm going to

explore five specific food additives

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that you could watch out for.

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I'll discuss where these ingredients are

commonly found, how they might affect your

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digestive system, and why they might be

the hidden culprits behind your flare ups.

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Welcome to episode 54 of the Inside

Knowledge podcast for people with IBS.

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I'm Anna Mapson.

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This episode is going to highlight a

couple of things that you might be seeing

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in your food ingredient listings that

could be contributing to your IBS flares.

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Now, definitely the emphasis is on

could be, because not all of these

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things will be a problem for everybody.

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Just the same as when we go through the

FODMAP triggers, looking at different

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sorts of things that could potentially

cause your bloating, discomfort,

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diarrhoea, constipation, et cetera.

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The same thing applies to these.

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They won't be a problem for everybody.

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So the other thing I wanted to

make sure, just thinking about the

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actual amount of this ingredients.

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in the food that you eat.

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So what I mean by that is, if you eat

a product that has got a tiny amount of

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this kind of food additive in it, is it

really going to give you a problem or not?

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Like, we need to look at the

quantity that is in the food.

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When you're reading food ingredient

listings, They have to put the ingredients

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with the largest amount in the product

first, and it goes in descending order.

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So, if there is an ingredient listed in

your food product right at the end, it's

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probably going to be a very small amount.

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Now, it doesn't necessarily mean it

won't affect you, but the likelihood

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decreases as the ingredient that you're

worried about goes further down the list.

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If it's right at the top, and it's like

the second ingredient listings then maybe

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it's going to be more of an issue for you.

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I've got five I'm going to go

through today, but there are lots of

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other things that could potentially

be a problem for you as well, so

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this is not an exhaustive list.

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Firstly, I want to start off

with high fructose corn syrup.

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So fructose, as you may

well know, is a FODMAP.

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This means it can cause

irritation and IBS symptoms.

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In people who are sensitive,

so not in everyone, but some

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people who are sensitive who have

IBS, fructose can be a problem.

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The reason it's a problem is because it

draws water into the small intestine.

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It's all down to the way that fructose

is absorbed in our digestive system.

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We're actually not that

good at absorbing fructose.

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It gets best absorbed when it

is in conjunction with glucose.

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So most people don't absorb huge

amounts of fructose because it's not

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a very efficient way to absorb it.

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Like there's a transporter that kind

of holds the fructose and takes it

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into your cell there's not very many

of these transporters available.

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So what happens is when there's glucose

as well, the glucose, you can think

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about it, is holding the hand of fructose

and it kind of drags the fructose in.

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Whilst it's getting in through

the glucose gate into our

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cells and then it can be used.

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So what's important to know

though is that we don't really

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eat fructose often on its own.

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Fructose is nearly always with glucose

even in high fructose corn syrup.

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which you might think is

mostly just fructose, there's

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actually a lot of glucose.

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in high fructose corn syrup as well.

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There is two types of high fructose

corn syrup, one of which is 55 percent

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fructose and 42 percent glucose, and then

there's another sort which is actually 55

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percent glucose and 42 percent fructose.

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So both of these are actually pretty

close to 50 50, which is the same as

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Sucrose, normal table sugar that we have.

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So it's not very far off.

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High fructose corn syrup is

not actually that much higher

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in fructose than normal sugar.

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But there's quite a lot of hoo ha

about it in, um, whether it's a

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good additive, to have in our foods.

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When you do have fructose that's higher

than the glucose, there is more chance

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for that little bit of extra fructose to

cause problems in your digestive tract.

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The one I wanted to highlight

today is agave syrup.

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Now, a lot of people will think, oh,

that's much more healthy than normal

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sugar because it is more natural.

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I mean, there's lots of things you can

unpack about that because generally

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when it comes down to the molecular

structure, sugar is sugar, whether it's

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coconut sugar or brown sugar or white

sugar, there's really relatively little

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difference in how they actually Absorb.

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But the one thing that is interesting

though is agave syrup is very high

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in fructose, and this is more like

80% of the sugars are from fructose.

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So that is why agave syrup is

a very high FODMAP sweetener

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and may be a trigger for you.

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And this is the trap that

some people fall into.

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Like you're trying to be healthy,

you're trying to go for alternative

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things that aren't sugar.

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But.

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it can be a issue.

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The other thing to look at is high

fructose corn syrup as an additive

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to foods is normally in things like

processed snacks, like ultra processed

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foods, basically sweetened yogurts, maybe

breakfast cereals, as well as soft drinks.

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So a lot of fizzy drinks will include

high fructose corn syrup, but it's

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also in things like cereal bars,

biscuits, cakes, like any sort of

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packaged ultra processed sweet food.

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The next one to move on to looking

in your ingredients listings

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is all the sugar alcohols.

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So these might have names like

sorbitol, mannitol, and xylitol.

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They will be found in things that are

classified sugar free often, so sugar

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free chewing gum, sugar free sweets, diet

foods as well, especially because they're

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sugar free, like low Calorie and some

kind of medications as well, actually.

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So, again, similar to fructose, but these

sugar alcohols are not fully absorbed

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in your small intestine, leading to

fermentation by gut bacteria and also

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gas production by the gut bacteria.

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I have actually got some podcast

episodes specifically about these sugars.

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So there's episode 25 about

sorbitol, 26 about mannitol,

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and episode 28 about fructose.

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So if you're interested in learning

a little bit more about how these

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all affect your digestion, those

specific podcast episodes really

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dive into those in a detailed way.

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The third ingredient I want

to talk about is inulin.

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This is a type of fiber that is highly

fermentable and can cause bloating

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and gas and a lot of discomfort in

people when you eat a lot of it.

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One of the ways you might see it written

down on an ingredients listing is chicory

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root or chicory because inulin, when it's

taken from The chicory root is very, very

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sweet, and so it's sometimes used as a

sugar free way to add prebiotic fiber to

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the product and reduce down the sugar.

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So, Overall, it sounds great,

but then for people with IBS,

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sometimes it can be a real trigger.

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You might also see

fructo-oligosaccharides, or FOS for short.

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FOS and inulin are quite similar, but

inulin has got a longer chain of different

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carbohydrates stuck together, whereas

FOS, the fructo-oligosaccharides is like

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short chain carbohydrates, so molecular.

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structure of them is a little bit

different, but they're used in a

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similar way, often to add prebiotic

fibers and to sweeten your foods.

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Now the types of foods they're most

commonly seen in is things like cereal

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bars, protein bars sometimes as well,

any low carb I quite often see them

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in like a sugar free Granola or things

like that, and you may also see them

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in, like yogurt products or dairy

alternatives, that sort of thing.

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Because of the way it is a prebiotic,

inulin has been studied quite a

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lot for increasing the good gut

bacteria, protecting the gut.

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Specifically, bifidobacteria, and

there's also lots of studies, really,

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showing that people who take high doses

of fructooligosaccharides or inulin,

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may be able to reduce down body fat,

so it's thought that by increasing

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these good bacteria, that's the

bifidobacterium, it might then increase

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the products that these bacteria make.

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So when our gut bacteria come into contact

with fibres and foods that we can't

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digest as humans, then it will come to the

large intestine, and these bacteria make

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something called short chain fatty acids.

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Now these are beneficial for our gut

health, they help to fuel the colon

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cells and they're also anti inflammatory

and they can travel around the body

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just doing their good, so we want good

amounts of short chain fatty acids,

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and they may, in some of them, reduce

appetite, which may be why people who

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are taking a lot of these prebiotics

may have an impact on their weight,

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because they're just eating a little

bit less, because they are less hungry.

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This is one of the ways where

eating a high fibre diet can

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help with weight management.

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So just again, the reminder though, that

if the inulin is a very, very small part

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of a product that you absolutely love

and you're not sure whether it's causing

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your problems, then it might still be

worth just omitting it from your diet

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for a week or two and see if you have any

change in your symptoms by removing out

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this highly fermentable type of fibre.

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Like I've said before, it's not that

this is bad for you, this is a prebiotic,

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Helping the beneficial gut bacteria.

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It's a good thing to include in your diet.

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But, if you're someone who's very,

very sensitive to these things,

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it may be increasing the amount

of, gas and bloating and maybe

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like sensitivity in your digestive

system because the gut bacteria are

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increasing, eating away at this inulin.

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Another consideration is that maybe

the increase in this prebiotic fibres

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is feeding the bad bacteria as well.

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And that is potentially why you might feel

your symptoms worsen when you increase

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fibre but over time it's more likely

that you will feed up more of the good

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bacteria and crowd out these bad bacteria.

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Obviously each individual dietary change,

you know, has to be managed within

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your symptoms, what you're finding

tolerable, and what works for you.

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But it is worth thinking about

gradually increasing up these fibers.

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The fourth additive that you might want

to pay attention to is emulsifiers.

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So these are commonly found in

dairy alternatives to make the

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product taste creamy thick when

it doesn't have any dairy in it.

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It's also found in low fat products where

they've taken out a lot of the fat that

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gives it that sort of nice mouth feel of

having more creamy element to your food.

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So you might find it in, , your soya milk,

your almond milk, maybe even in oat milks.

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It's also found in things like ice cream,

mayonnaise, or sometimes also in like

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packaged baked goods like biscuits or

cakes that you might buy in the shop.

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Now there are different types of

emulsifiers and thickeners and they're

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used for different reasons, but some

of these might trigger a little bit of

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inflammation in your digestive tract.

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Now, I want to be careful around

this because there is quite mixed

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evidence, or there is a sort of a lack

of evidence, I would say, in people.

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It's these particular elements of the

processed food that is causing problems.

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So where we have, a difference,

I suppose, in the way we've eaten.

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You know, the change in our diets over

the years, say a hundred years ago,

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people were just not consuming this

high level of processed packaged foods.

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So we've seen a massive increase

in additives in our foods

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over the last hundred years.

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And we've also seen a real

rise in problems like IBS.

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But doesn't necessarily mean

that it is down to these

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particular elements of your food.

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It could be around our change in

lifestyle, you know, with change

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in our eating habits, so many

things about the way we live.

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For example, we rarely now

sit down and have three family

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mealtimes around the kitchen table.

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We eat, like I said, a lot less fruits

and vegetables, a lot less variety.

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We eat a lot of the foods on repeat.

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We tend to have much more time together.

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stressful lives in terms of we're

always on, we don't have much downtime.

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And a lot less time in nature.

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Life has changed massively

over the last hundred years.

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And so it's not necessarily just down to

the inclusion of thickeners in your food.

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However, there is some kind of evidence

this is not something that's massively

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been replicated in people, but when

they have given rats very high doses

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of some of these thickeners, then they

have had Irritation to their gut lining,

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and when they have done it in a Petri

dish, so just looking at these cells or

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they've used a model of the gut that's

not actually related to a person, then

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you can see a breakdown in the cells

and irritation to the gut lining.

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Some of these emulsifiers I'm

talking about, you might see them

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listed as things like polysorbate,

carboxymethylcellulose, or carrageenan.

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Carrageenan is actually an

interesting one as well.

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It is made from seaweed derivative,

and some of the confusion around this

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lies that in Some trials, in order

to induce gut inflammation, they use

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a type of carrageenan in rat models.

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So sometimes they will give them very,

very high doses of carrageenan in order

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to simulate a gut that's got inflammation

in it, so they can do some tests on it.

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That doesn't necessarily mean that the

food grade carrageenan that might be

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in your gut Soya milk, for example,

is going to have the same effects.

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And also just remembering the quantity

of that product that you have, and

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the quantity of the overall ingredient

in that product, makes a difference.

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So if there is a very small amount

of carrageenan in, say, your almond

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milk, and you only have almond milk in

your tea, a small amount, the actual

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amount of carrageenan that you're going

to be ingesting is very, very small.

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Now, if you were downing, like, two

litres of this almond milk a day,

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then maybe you might start to notice

more of an a pattern, but I would

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also say that's probably not healthy,

and no one's suggesting anything.

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You should go ahead and drink two

litres of almond milk a day anyway,

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because there are also other reasons

why that might not be so good for you.

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So, putting it into context

is really important.

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Now, the very final one is artificial

sweeteners, and you might see these

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listed As aspartame or sucralose.

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These are the most common

ones that people worry about.

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Now there has been quite a lot of research

into whether these artificial sweeteners

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will disrupt the gut microbiome.

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And that is the main concern that

people have around ingestion.

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So it's not necessarily that it

will give you an upset stomach

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and it would kick off your IBS.

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It's just that more over time, there

is sort of one train of thought

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that potentially these artificial

sweeteners could cause an upset stomach.

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upset to our gut microbes that

is not beneficial, that is, you

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know, encouraging the bad bacteria.

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The thing is there isn't really

enough evidence in people that shows

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us that this definitely happens and

this is where it always falls down.

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The studies that have shown some negative

responses from very large amounts of

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artificial sweeteners to rats just

might not be transferable to people

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and the doses that they give them are

like over a hundred times the safety

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maximum limit for people to ingest.

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So if you're worried about artificial

sweeteners, I would say don't drink,

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liters of fizzy drinks that have got

loads of artificial sweeteners in them.

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However, drinking one every now and again

you is not going to upset your microbiome.

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There is some evidence sort of

worry that drinking sucralose could

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potentially speed up your gut motility.

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And I suppose as an anecdote, I do

have a client who was drinking, a fizzy

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drink with one of these in every day.

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And when she cut it out, things radically

improved in terms of diarrhoea, cramps,

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and just general gut sensitivity.

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So she did have a definite

sensitivity to sucralose.

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This is not a FODMAP as well, so we'd

already done the FODMAP diet with her,

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and then we were talking about what else

she was drinking or eating that could

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have potentially caused the problem

she was still getting, and it didn't.

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Probably came down to this two

types of drinks that she was having

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that had sucralose in them and

she was having them regularly.

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These artificial sweeteners are

generally quite new to humans and we

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don't have masses of studies that show

that there isn't an impact on IBS.

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We do have some that show that there

might be in rats at huge doses.

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So, depending on your sensitivity level,

the way that you digest things, it's

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possible that you will react to them

as an individual, but for the majority

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of people, having a small amount of

artificial sweetness should be manageable.

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I wanted to just close out this episode

by talking overall about our percentage

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of ultra processed foods that we have in

our diet, and how if you're eating a diet

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that's mostly food that you've cooked

yourself., that is, based on vegetables,

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fruits, whole grains, proteins, then

it's unlikely that small exposures to

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these kinds of foods that I've been

talking about will be a problem for you.

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Your overall dietary pattern is much,

much more important than whether

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you have an ice cream once or twice

a week, or whether you do enjoy a

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fizzy drink every now and again.

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These things can be okay as part

of a balanced diet, but what's

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really helpful to know is just,

What the things are in the different

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ingredients that could trip people up.

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And what I've also had before with

clients is that they've been taking

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supplements that include some of

these things and haven't realized.

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So they've been taking supplements

that they thought would be good for

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them and once we remove them from their

diet, made their symptoms go away.

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So it's not always just food.

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These are the things to watch out

for in anything that you take.

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If you've enjoyed this episode, I would

love it if you could do a review for

287

me, or please leave me, a good rating.

288

It really helps me to

get my podcast out there.

289

If you're interested in working with me

one to one on your diet and digestion, I

290

run a three month Gut Reset Program that

You can do from wherever you are in the

291

world because it's online and I give you

loads of education about gut health and

292

diet and digestion as well as individual

one to one calls so we can tailor all of

293

that education to you and your position

and make sure that you are getting

294

control of unpredictable and painful gut

symptoms that are so common with IBS.

295

Okay, that's it for this week.

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Thank you very much for listening to

this episode of the Inside Knowledge.

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Better digestion for everyone.