Food additive emulsifiers and risk of cardiovascular disease

https://doi.org/10.1136/bmj-2023-076058.

Introduction:

High intakes of ultra-processed foods are associated with higher risks of cardiovascular disease (CVD), type 2 diabetes, cancer, obesity and mortality. The cause is attributed to the detrimental qualities of additives in processed foods, specifically emulsifiers, which are added to foods to improve texture and increase the product’s shelf life. This study aimed at finding an association between intakes of food additive emulsifiers and CVD in French adults.

Previous research:

This study was conducted among French adults and found that the most consumed additives were all emulsifiers, such as modified starches, xanthan gum, pectins, monoglycerides and diglycerides of fatty acids,. The research conducted on healthy individuals suggested that food additives were harmful to the intestinal microbiota, which are living organisms existing in the intestines. The effect of these additives could lead to chronic inflammation of the intestine and potentially lead to CVD. The safety of food additives (emulsifiers included) is regularly assessed by food authorities, and necessary intakes are defined.

Summary:

The intake of food additives was quantified on the basis of participants’ dietary records, including the brand name of industrial products. Among available food additives from the records, 61 food additives were considered as emulsifiers or emulsifying salts specifically. Participants had no diagnoses of any prevalent CVD before the study was conducted. The association between regular intake of emulsifiers and risks of CVD was assessed. Those who had higher intakes of emulsifiers were younger and had higher body mass index (BMI). They had higher intakes of energy, saturated fats, sodium, sugars and fibre. They also consumed more red and processed meats along with ultra-processed foods in place of fruits, vegetables and whole-grain foods. The findings indicated that the emulsifiers caused low-grade inflammation that affected gut health and other organs. The proportion of emulsifiers present in their diets was adjusted by increasing the amount of ultra-processed food consumed by participants and reducing quantities of other foods that could be related to CVD (sugar, sodium, saturated fats). These measures were taken to identify whether there was a causation or correlation between emulsifiers and cardiovascular disease.

Conclusion:

The study found a positive correlation between certain cellulose emulsifiers and risks of cardiovascular disease. Higher intakes of other emulsifiers were found to have an association with risk of coronary heart disease, and some with cerebrovascular disease, which affects blood flow to the brain and the blood vessels. As the study involved a large sample size, the association was likely to have been studied accurately. A limitation of the study was that the women tended to have healthier diets, with a lower proportion of emulsifiers, and a lower risk of CVD in general. In conclusion, this study has public health implications as the food additives are ubiquitous in widely consumed ultra–processed foods.

Sources:

Sellem, L., Srour, B., Javaux, G., Chazelas, E., Chassaing, B., Viennois, E., Debras, C., Salamé, C., Druesne-Pecollo, N., Esseddik, Y., Edelenyi, F.S. de, Agaësse, C., Sa, A.D., Lutchia, R., Louveau, E., Huybrechts, I., Pierre, F., Coumoul, X., Fezeu, L.K. and Julia, C. (2023). Food additive emulsifiers and risk of cardiovascular disease in the NutriNet-Santé cohort: prospective cohort study. BMJ, [online] 382, p.e076058. doi:https://doi.org/10.1136/bmj-2023-076058.