Emulsifiers are among the most widely used additives in the food industry. They make it possible to improve the texturetexture food and prolong their durationduration conservation. A French research team looked at the consequences of consuming food emulsifiers on cardiovascular health. Having analyzed the health data of 95,442 adults participating in the French NutriNet-Santé cohort study with regard to their overall consumption of this type of food additives, the results suggest an association between dietary intake of emulsifying additives and a increased risk of cardiovascular diseases. They are the subject of a publication in the British Medical Journal.
In Europe and North America, 30 to 60% of adults' dietary energy intake comes from ultra-processed foods. Recent epidemiological studies have established a link between high consumption of ultra-processed foods and an increased risk of obesity, mortality and chronic diseases (cardiovascular diseases, type 2 diabetes, cancers, etc.).
What additives are commonly used in the food industry?
Emulsifiers are among the most commonly used additives in industrial foods. They are often added to processed and packaged foods such as certain pastries, industrial cakes and desserts, ice creams, chocolate bars, industrial breads, margarines and prepared meals, to improve their appearance, taste, texture and shelf life. They understand the cellulosescellulosesmono- and diglycerides of fatty acids, starchesstarches modified, lecithins, carrageenans, phosphatesphosphateserasers and pectinspectins.
As with all food additives, the safety of emulsifiers is regularly evaluated based on the scientific evidence available at any given time. However, some recent research suggests that emulsifiers may disrupt the microbiotamicrobiota intestinal and increase the risk of inflammation, leading to a potentially increased susceptibility to cardiovascular problems.
To explore this question further, researchers from Inserm, Inrae, Sorbonne Paris Nord University, Paris Cité University and Cnam, within the Nutritional Epidemiology Research Team (Eren-Cress ), set out to evaluate the links between exposure to emulsifiers and the risk of cardiovascular diseases, including coronary heart disease and cerebrovascular disease, i.e. pathologiespathologies affecting blood circulation and blood vessels in the heart and brainbrain.
What are the impacts noted by the study?
Their conclusions are based on the analysis of data from 95,442 French adults (mean age 43 years; 79% women) without a history of cardiovascular disease who voluntarily participated in the NutriNet-Santé cohort study between 2009 and 2021.
Did you know ?
The NutriNet-Santé study is a public health study coordinated by the Nutritional Epidemiology Research Team (EREN-CRESS, Inserm/INRAE/Cnam/Université Sorbonne Paris Nord/Université Paris Cité), which, thanks to the commitment and the loyalty of more than 170,000 nutrinauts, advances research on the links between nutrition (diet, physical activity, nutritional status) and health. Launched in 2009, the study has already given rise to more than 270 international scientific publications. A call for the recruitment of new nutrinauts is always launched in order to continue to advance research on the relationships between nutrition and health.
By spending a few minutes a month responding, via Internet, on the secure platform etude-nutrinet-sante.fr with various questionnaires relating to diet, physical activity and health, participants contribute to advancing knowledge on the relationships between diet and health .
During the first two years of follow-up, participants completed at least three (and up to 21) days of dietary records online. Each food or drink consumed was then cross-referenced with data basedata base in order to identify the presence and dose of food additives, including emulsifiers. Of the dosagesdosages laboratory tests were also carried out to provide quantitative data. Participants were asked to report any major cardiovascular events, such as heart attackheart attack or one strokestroke, which were validated by a committee of experts after examination of their medical files. Cardiovascular disease-related deaths were also recorded using the French national death register.
Several risk factorsrisk factors well-known for heart disease, including age, gender, weight (BMIBMI), education level, family history, smoking and activity levels physicalphysicalas well as the overall quality of the diet (for example, intake of sugarsugarin salt, in energyenergy and in alcoholalcohol) were taken into account.
After an average follow-up of 7 years, scientists found that higher intakes of total cellulose (food additives corresponding to codes E460* to E468) were associated with higher risks of cardiovascular disease. In particular, this association was specifically observed for intakes of E460 (microcrystalline cellulose, powdered cellulose) and E466 (carboxymethylcellulose).
On the other hand, higher intakes of monoglycerides and diglycerides of fatty acids (E471 and E472) were associated with higher risks for all the pathologies studied. Among these emulsifiers,esterester lactic acid of monoglycerides and diglycerides of fatty acids (E472b) was associated with higher risks of cardiovascular diseases and cerebrovascular diseases, and citric ester of monoglycerides and diglycerides of fatty acids (E472c) was associated with higher risks cardiovascular diseases and coronary heart diseases.
High consumption of trisodium phosphate (E339) was also associated with an increased risk of coronary heart disease. No association was detected in this study between other emulsifiers and the occurrence of cardiovascular diseases.
Limitations of the study
This is a single observational study, which therefore cannot establish causality on its own, and scientists recognize certain limitations to this study. For example, the high proportion of women, higher education level, and overall more health-conscious behaviors among NutriNet-Santé study participants compared to the general French population may limit the generalizability of the results.
Nonetheless, the study sample was large and the authors were able to account for a wide range of potentially confounding factors, while using detailed and unique data on food additives, down to the brand of products consumed. . Furthermore, the results remained unchanged after multiple sensitivity analyses, thus reinforcing their robustness.
“ If these results are to be reproduced in other studies around the world, they bring key new knowledge to the debate on the reassessment of regulations relating to the use of additives in the food industry, in order to better protect consumers », Explain Mathilde Touvier, research director at Inserm, and Bernard Srour, junior professor at INRAE, main authors of the study.
Food additives are identified in the list of ingredients by a code set at European level which consists of the letter “E”, followed by a number allowing the category to be easily identified. For example, E100 for colorings, E200 for preservatives, E400 for emulsifiers and texturing agents.
*Food additives are identified in the list of ingredients by a code set at European level which consists of the letter “E”, followed by a number allowing the category to be easily identified. For example, E100 for colorings, E200 for preservatives, E400 for emulsifiers and texturing agents.