OP33 Mechanistic insights on the role of ultra processed foods as a trigger/fuel for IBD

Abstract

Abstract Background Ultra processed foods (UPFs) are a heterogeneous category of products that contain food additives and/or have undergone several industrial processes. The higher intake of UPFs seen in industrialized countries has been associated with increased incidence of inflammatory bowel diseases (IBD), mainly Crohn’s disease (CD). However, the specific mechanisms through which the UPFs can induce or maintain intestinal inflammation are still unknown. Therefore, most dietary interventions for IBD essentially exclude all UPFs from the menu, increasing the difficulty of long-term compliance of these diets. The main focus of my research is the study of which components may be detrimental in UPFs, in the hope that we can limit the number of UPFs that we need to exclude from our diets. Methods To understand the mechanism of action of UPFs, a translational approach is needed with complementary pre-clinical and clinical studies. We used organoid cultures from patients with CD to test the impact of food additives on the intestinal epithelium (e.g. permeability, pro-inflammatory effect). These organoid cultures are more physiologically relevant than immortalized cell lines, which lack several important aspects (e.g. genetic background, complex assembly of different cells). The results of the first tests with this platform have been submitted to ECCO (EC24-1418). Additionally, we established several protocols and collaborations to run well designed dietary intervention studies to explore the mechanisms of action of these food additives in humans. In the FOAM study, we explored the effects of 5 emulsifiers in an double blind randomized placebo controlled trial. The results of the FOAM study have also been submitted to ECCO (EC24-0858). We also explored the acceptance, feasibility, and compliance of an emulsifier free diet in healthy volunteers (EC24-1181). Results Our results support the need to better understand the role of food additives and UPFs in IBD, and the need for better evidence supporting the detrimental role of food additives. Conclusion Compliance is an important issue to consider in all dietary interventions, more than in pharmacological interventions. Strategies focusing on improving the compliance of dietary interventions can have a big impact in the applicability of these interventions in therapeutic and/or prophylactic settings. However, the current knowledge on the possible detrimental role of UPFs does not allow to pinpoint which UPFs are detrimental and which might have no effect on intestinal inflammation. Hence, there is an unmet need for pre-clinical and clinical studies focusing on the mechanisms through which these UPFs might play a role in intestinal inflammation.