High Intake Of Several Food Additives Linked To Increased Risk Of Cardiovascular Disease

Industrially processed foods use several types of emulsifiers and other food additives to make the product more appealing and extend the shelf life of what they are producing. The use of these additives in the modern industrialized food supply chain is ubiquitous, being used in thousands of widely consumed ultra-processed foods and foods of convenience.

Emulsifiers are added to processed and packaged food alike, such as pastries, cakes, ice cream, chocolate, bread, desserts, margarine, and ready-to-eat meals to extend their shelf life while making their taste, texture, and appearance more appealing to the consumer. Additives include celluloses, mono- and diglycerides of fatty acids, modified starches, lecithins, carrageenans, gums, pectins, and phosphates. 

The safety of emulsifiers is based on the availability of scientific evidence, yet some recent research suggests that these emulsifiers can disrupt gut bacteria and increase inflammation which can potentially lead to increased susceptibility to unwanted cardiovascular issues. To explore this further the researchers set out to assess the associations between exposure to emulsifiers and the risk of CVD, including cerebrovascular disease and coronary heart disease.

The researchers analyzed data from 95,442 adults with an average age of 43 years old with no history of heart disease who were enrolled in the NutriNet-Sante Cohort Study between 2009 and 2021. Participants reported any CVD event, which was validated by an expert committee after reviewing medical records. Participants also completed at least 3 and as many as 21 dietary records during the first two years of follow-up, each food and beverage consumed was matched at brand level against 3 databases to identify the presence and dose of food additives, and laboratory testing was conducted to provide quantitative data. Deaths linked to CVD were recorded using the national death register, and the researchers took into account several well-known risk factors for heart disease. 

Higher intake of total celluloses (E460-E468), cellulose (E460), and carboxymethylcellulose (E466) were found to be associated with a higher risk of cardiovascular disease and specifically coronary heart disease after an average follow-up of 7 years. Higher intake of monoglycerides and diglycerides of fatty acids (E471 and E472) were found to be associated with higher risks of all studied outcomes. 

Higher intake of the emulsifiers, lactic ester of monoglycerides and diglycerides of fatty acids (E472b) was associated with higher risks of CVD and cerebrovascular diseases, and citric acid ester of monoglycerides and diglycerides of fatty acids (E472c) was associated with higher risks of CVD and coronary heart disease. Additionally, a higher intake of trisodium phosphate (E339) was also associated with an increased risk of coronary heart disease.

Due to the nature of observational research, this study can not establish cause, and the researchers acknowledged some limitations to the study that may limit the generalizability of their results, and they state that these results need to be replicated in other large-scale studies. Despite this, the researchers are confident in their findings, because the study sample was large, and they were able to adjust for a wide range of potentially influential factors while using unique detailed brand-specific data on additives. Additionally, their results were unchanged after further testing which suggests that their findings are robust. 

The researchers concluded that their findings “contribute to the re-evaluation of regulations around food additive usage in the food industry to protect consumers.” 

“Meanwhile, several public health authorities recommend limiting the consumption of ultra-processed foods as a way of limiting exposure to non-essential controversial food additives,” they add.