Quantifying artificial sweeteners and emulsifiers in Crohn’s disease and its relationship with disease activity: the ENIGMA study – a novel and targeted approach

Gut 2026 Open access

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Authors: Jingwan Zhang, Jielun Hu, Xinyi Tang, Yanjiao Ruan, Fangjia Hao, Wenqing Zhang, Gina Trakman, Amy L. Hamilton, Winnie Y. Lin, Yang Sun, Jessica Y L Ching, Jing Jie Teh
+11 more Seungha Kang, Amy Wilson-O’ Brien, Annalise Stanley, Lin Zhang, Joseph J.Y. Sung, Jun Yu, Yinglei Miao, Francis K.L. Chan, Mark Morrison, Michael A. Kamm, Siew C. Ng
DOI: 10.1136/gutjnl-2024-333999
Cited by: 2
References: 30

Abstract

BACKGROUND: Food additives have been linked to increased Crohn's disease (CD) risk and activity, but their human quantification has not been explored. OBJECTIVE: We aimed to measure artificial sweeteners and emulsifier polysorbate-80 (P-80) in patients with CD and assess their associations with disease activity. DESIGN: 1461 biosamples from 487 subjects (245 CD and 242 controls) across Australia, Hong Kong and Chinese Mainland were analysed for aspartame, sucralose, saccharin and P-80 levels in stool, urine and serum. CD activity was assessed using Crohn's Disease Activity Index and faecal calprotectin. A generalised linear model (GLM) with P-80 and sweeteners distinguished active CD from inactive CD. RESULTS: Patients with CD had higher sweetener levels compared with controls across cohorts (all p

Fields of Study & Subjects

Inflammatory Bowel Disease Autoimmune and Inflammatory Disorders Eosinophilic Esophagitis

Publication details

Journal / source
Gut
Publisher
BMJ
Volume
75
Issue
9
Pages
1695–1710
Publication date
8 April 2026
Language
EN