Edited to “Is the food additive maltodextrin associated with unresolved gut inflammation?” makes the question more accurate as to the underlying issue at play.
Short answer: extremely preliminary research suggests maltodextrin may not directly induce gut-associated disease but may instead impair gut barrier function and gut antimicrobial responses, and may foster colonization of disease-associated microbes in Crohn’s disease. In other words, it may be associated with unresolved gut inflammation.
This answer briefly explains
- Why inflammation is normal but unresolved inflammation isn’t.
- Zoom in look at maltodextrin: Gist of what as-yet quite limited research shows about the effect of food additive maltodextrin on gut health.
- Zoom out perspective: How the food industry systematically exploited a loophole in the 1958 GRAS (generally regarded as safe) regulation to introduce tens of thousands of new food additives into the American food supply even as both their short- and long-terms effects on human gut health and overall physiology remain largely unknown.
Why inflammation is normal but unresolved inflammation isn’t
Inflammation gets a bad rap and is consistently woefully misrepresented in popular culture when in actuality it is part of normal physiology and as such value-neutral.
Even unresolved inflammation isn’t so much a problem as is whatever provokes and sustains such inflammation in the first place. A dynamic process, not an outcome or state, unresolved inflammation is merely a beacon alerting the body and its observer to some underlying ongoing health issue.
Gut inflammation every now and then should be an expected part and parcel of normal gut physiology since the gut interacts with input (food) from the outside world and harbors a teeming dynamic microbial population that can change rapidly in response to such input. Normally, such inflammation resolves itself within a short time. However, unresolved inflammation isn’t normal.
Maltodextrin: Extremely preliminary research suggests its ubiquity in foods may be problematic, especially for those with underlying genetic risk factors for some gut-associated diseases
Maltodextrin (MDX) is obtained from hydrolyzing cereal starches such as wheat, rice, maize, tapioca, potato, oats, etc. (by treating them with strong acids and/or enzymes). Its many qualities make it attractive in industrial food manufacturing, explaining its wide presence in all kinds of food and drinks (see below from 1, emphasis mine).
“Since the mid-1950s, MDX has been added to foods as a filler, thickener, texturizer, or coating agent10 and is generally recognized as safe (GRAS) by the Federal Drug Agency (FDA).11 We found in a survey of grocery store food items that »60% of all packaged items had “maltodextrin” or “modified (corn, wheat, etc.) starch” included in their ingredients list.
Furthermore, results of a food frequency questionnaire indicated that 98.6% (210/213) of respondents routinely consume food items containing MDX, with an average consumption of 2.6 MDX-containing items per day. These surveys demonstrate that MDX is currently a ubiquitous and frequently consumed dietary polysaccharide additive in the general population.”
- Maltodextrin is a dietary fiber that’s normally either undigested or only partially digested during its transit through the small intestine and instead fermented by microbes in the colon, the classic profile of a dietary fiber.
- It is also known to help the effect of probiotics (2). It thus finds value in their industrial manufacture as well (3).
- So ubiquitous is use of maltodextrin as a filler or bulking agent to package other food additives, dozens, maybe even hundreds, of clinical studies have used it as a placebo to compare the effect of substances such as sucralose, aspartame and pre- or probiotics.
- That’s a Titanic-sized blind spot in nutrition studies, which have automatically assumed maltodextrin to be inert and safe, even though it only entered the human food chain in the mid-1950s and has yet to be examined at length for its effect on gut and overall health both short- and long-term!
Only in recent years have a mere handful of mainly mouse model studies systematically assessed the effect of maltodextrin separately on the GI tract (1, 4, 5, 6).
- Such studies suggest maltodextrin may impair gut barrier function, may impede gut antimicrobial responses and may foster growth of disease-associated microbes in the gut.
- Only one led by Christine McDonald of the Cleveland Clinic includes studies on human biopsy material (6). It showed mucosa-associated microbiota found in the ileum of Crohn’s disease patients were better able to break down maltodextrin compared to microbiota found in those without Crohn’s.
- This implies that Crohn’s disease patients who consume maltodextrin-containing foods and drinks may be inadvertently encouraging the maintenance of disease-associated microbiota in their ileum.
GRAS loophole in US law = not just maltodextrin but thousands of new food additives in just the past ~60 years
The GRAS loophole in US law has enabled a vast, extremely rapid, unnoticed expansion of thousands of new food ingredients within just the last 60 years or so. Some occur naturally in foods, others are extracted while some are even synthesized.
Maltodextrin is only one of thousands of such ingredients that are now part and parcel of modern diets in many industrialized countries even as they are making heavy inroads into other countries.
GRAS also means a whole bunch of untested assumptions about the inertness and safety of such substances have escaped scrutiny and systematic scientific study even as they have come to occupy central positions in industrial food (see below from 7).
“In the past five decades, the number of food additives has skyrocketed — from about 800 to more than 10,000. They are added to everything from baked goods and breakfast cereals to energy bars and carbonated drinks…
Under today’s system, manufacturers that establish that an ingredient is safe for a specific use can either submit their safety evaluation to the FDA for a cursory review or keep their determination private. The FDA encourages companies to choose the former option, but companies more often choose the latter.
The NRDC estimates that about 1,000 ingredients have been added to food without FDA review since 1958. They dubbed the process “generally recognized as secret.”
Two industry consultants told Center for Public Integrity reporters that two-thirds of their safety reviews are never sent to regulators. An international food company told the GAO that it introduces five new ingredients yearly without telling the FDA.”
Low-digestible carbohydrates such as maltodextrin have become such a firmament in the food landscape within the blink of an eye that a 2008 paper by a registered dietitian and her assistant even felt it necessary to walk other registered dietitians through this alphabet soup of food ingredients! In the process it also inadvertently revealed the key role consumers themselves have played in stoking such chemicalization of food (below from 8, emphasis mine),
“RDs promote fruits, vegetables, and whole grains as sources of fiber and suggest patients limit their consumption of convenience foods and other processed or refined foods, which are often high in added sugar and low in fiber. Consumers, however, want the benefits of a high-fiber, low-sugar diet without having to change their eating habits. The food industry has responded by adding low-digestible carbohydrates to various products to increase the fiber content and/or decrease the sugar content of these foods.”
It may be that many or even most of these ingredients pass muster and are indeed safe and inert as currently used in all manner of foods but the fact is at present we just don’t know for sure one way or the other.
Bibliography
1. Nickerson, Kourtney P., Rachael Chanin, and Christine McDonald. “Deregulation of intestinal anti-microbial defense by the dietary additive, maltodextrin.” Gut microbes 6.1 (2015): 78-83. https://www.tandfonline.com/doi/…
2. Bomba, A., et al. “Improvement of the probiotic effect of micro-organisms by their combination with maltodextrins, fructo-oligosaccharides and polyunsaturated fatty acids.” British Journal of Nutrition 88.S1 (2002): S95-S99. http://www.inproco-bio.com/pdf/i…
3. Liong, M. T., and Nagendra E. Shah. “Optimization of growth of Lactobacillus casei ASCC 292 and production of organic acids in the presence of fructooligosaccharide and maltodextrin.” Journal of food science 70.2 (2005): M113-M120.
4. Nickerson, Kourtney P., et al. “The dietary polysaccharide maltodextrin promotes Salmonella survival and mucosal colonization in mice.” PloS one 9.7 (2014): e101789. The Dietary Polysaccharide Maltodextrin Promotes Salmonella Survival and Mucosal Colonization in Mice
5. Laudisi, Federica, et al. “The food additive maltodextrin promotes endoplasmic reticulum stress–driven mucus depletion and exacerbates intestinal inflammation.” Cellular and molecular gastroenterology and hepatology 7.2 (2019): 457-473. ScienceDirect
6. Nickerson, Kourtney P., and Christine McDonald. “Crohn’s disease-associated adherent-invasive Escherichia coli adhesion is enhanced by exposure to the ubiquitous dietary polysaccharide maltodextrin.” PloS one 7.12 (2012): e52132. Crohn’s Disease-Associated Adherent-Invasive Escherichia coli Adhesion Is Enhanced by Exposure to the Ubiquitous Dietary Polysaccharide Maltodextrin
7. Why the FDA doesn’t really know what’s in your food – Center for Public Integrity
8. Grabitske, Hollie A., and Joanne L. Slavin. “Low-digestible carbohydrates in practice.” Journal of the American Dietetic Association 108.10 (2008): 1677-1681.