Transcript: Titanium Dioxide & Inflammatory Bowel Disease
The latest review on diet and the risk of inflammatory bowel disease, such as ulcerative colitis and Crohn's disease, suggests that of all dietary factors, animal protein from meat and fish was found most associated with a higher risk of inflammatory bowel disease. They think it might be the blood in meat which is degraded to carbon monoxide, or some of the toxins created by cooking muscle or added to processed meats, and then of course there's the arachidonic acid, the pro-inflammatory omega 6s, and meat contains huge amounts of certain bacteria that have been linked to inflammation, the antibiotics in meat could be mucking with people's intestinal flora. Who knows, either way, " A diet high in animal protein, may be associated with not only increased risk of getting inflammatory bowel disease in the first place but relapsing back if you already have it, consistent with the data I presented last year that even just a semi-vegetarian diet was highly effective in preventing relapses in Crohn's, for example. But one potential risk factor that I never heard of was micro or nanoparticles. Foodstuffs in developed countries contain increasing quantities of microparticles such as titanium dioxide, used by the millions of tons as a whitening/brightening pigment mostly to make white-colored paint, but also used as a food additive to make white-colored food. So much so that people eating conventional diets may be ingesting a trillion particles of titanium dioxide every day. Why care, though? Well a few years ago researchers found evidence of micro and nanoparticles in all 18 out of 18 samples of diseased colons they looked at—either colon cancer or inflammatory bowel, but none in the 3 healthy colons they looked at from folks who died in a car accident or from a heart attack. That's a tiny sample but it got people thinking, and more importantly putting it to the test. They took intestinal biopsies from people and added some titanium dioxide to see if it would cause inflammation. Here's the level of secretion of an inflammatory cytokine at baseline in the biopsy specimen, and here's after you add the titanium dioxide they use in food. Nothing. No inflammation. Maybe they got like dead tissue or something? So they tried adding a little or a lot of bacterial endotoxin. All right that worked. That got an inflammatory response. Before declaring the food additive safe though, they tried one last thing. What if you combined these together, the titanium dioxide and a little bit of endotoxin mixed together. Presumably you'd still be down here somewhere but instead got this. So their thinking was that while titanium dioxide itself is inert, nontoxic in the gut, it may act as a "transporters of inflammatory substances like the endotoxins from the inside of your gut into the gut wall. kind of a ‘Trojan horse’ mechanism. What happens in a petri dish may not happen in a person, though. How are you going to test the theory in people though—you can't go around trying to give people inflammation. So they took people actively suffering from Crohn's took microparticles out of their diet and saw if they got better. 18 patients with active Crohn’s; 9 stayed on their regular diet; 9 were placed on a low microparticle diet, and within a month those on the low microparticle diet had a significant decrease in disease severity and by the end 7 of the 9 were in remission, whereas none were in remission in the regular diet group. In addition to removing things they expected to contain titanium dioxide--coffee whitener, white cheese, powdered sugar--they also removed processed meats and fish, fearing that there were microparticles in them too, but that complicates things, because just cutting down on meat alone is one of the most powerful Crohn's interventions so maybe that's why they got better and the titanium dioxide had nothing to do with it, and indeed a larger trial in which both groups were told to cut down on processed meat and seafood found no difference between the two groups, which is consistent with this study that did not find that Crohn’s patients were eating significantly more white foods—like the crispy shell chewing gums, marshmallows, powdered doughnuts. So where are we now? Well high concentrations of dietary microparticles should not be completely ruled out as potential contributors to intestinal inflammation, but there's just not that much evidence suggesting they’re harmful. If you look at the most concentrated sources, though, out of nearly 100 products tested none of them are any good for you so if you want another excuse to avoid Hostess donuts well then there you go.
To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring watch the above video. This is just an approximation of the audio contributed by Jonathan Hodgson.
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