Journal Article

Food additive emulsifiers and cancer risk: Results from the French prospective NutriNet-Santé cohort

Arnault, Nathalie, Agaësse, Cédric, Javaux, Guillaume, Srour, Bernard, Sellem, Laury, Viennois, Émilie, Chazelas, Eloi, Interactions microbiote/mucus dans les maladies inflammatoires chroniques = Mucosal microbiota in chronic inflammatory diseases, Réseau National Alimentation Cancer Recherche (réseau NACRe), Kesse-Guyot, Emmanuelle, Coumoul, Xavier, Druesne-Pecollo, Nathalie, Pierre, Fabrice, de Sa, Alexandre, Toxicité environnementale, cibles thérapeutiques, signalisation cellulaire (T3S - UMR_S 1124), Julia, Chantal, Allès, Benjamin, Huybrechts, Inge, Conservatoire National des Arts et Métiers (Cnam)-Université Sorbonne Paris Nord-Centre for Research in Epidemiology and Statistics | Centre de Recherche Épidémiologie et Statistiques (CRESS (U1153 / UMR_A 1125)), Esseddik, Younes, Szabo de Edelenyi, Fabien, Chassaing, Benoit, Hôpital Avicenne, Galan, Pilar, Hercberg, Serge, Lutchia, Rebecca, Prévention et promotion de la cancérogénèse par les aliments (ToxAlim-PPCA), Touvier, Mathilde, Deschasaux-Tanguy, Mélanie, Scalbert, Augustin, ToxAlim (T

2024

Overview

Background: Emulsifiers are widely used food additives in industrially processed foods to improve texture and enhance shelf-life. Experimental research suggests deleterious effects of emulsifiers on the intestinal microbiota and the metabolome, leading to chronic inflammation and increasing susceptibility to carcinogenesis. However, human epidemiological evidence investigating their association with cancer is nonexistent. This study aimed to assess associations between food additive emulsifiers and cancer risk in a large population-based prospective cohort.Methods and findings This study included 92,000 adults of the French NutriNet-Santé cohort without prevalent cancer at enrolment (44.5 y [SD: 14.5], 78.8% female, 2009 to 2021). They were followed for an average of 6.7 years [SD: 2.2]. Food additive emulsifier intakes were estimated for participants who provided at least 3 repeated 24-h dietary records linked to comprehensive, brand-specific food composition databases on food additives. Multivariable Cox regressions were conducted to estimate associations between emulsifiers and cancer incidence. Overall, 2,604 incident cancer cases were diagnosed during follow-up (including 750 breast, 322 prostate, and 207 colorectal cancers). Higher intakes of mono- and diglycerides of fatty acids (FAs) (E471) were associated with higher risks of overall cancer (HR high vs. low category = 1.15; 95% CI [1.04, 1.27], p-trend = 0.01), breast cancer (HR = 1.24; 95% CI [1.03, 1.51], p-trend = 0.04), and prostate cancer (HR = 1.46; 95% CI [1.09, 1.97], p-trend = 0.02). In addition, associations with breast cancer risk were observed for higher intakes of total carrageenans (E407 and E407a) (HR = 1.32; 95% CI [1.09, 1.60], p-trend = 0.009) and carrageenan (E407) (HR = 1.28; 95% CI [1.06, 1.56], p-trend = 0.01). No association was detected between any of the emulsifiers and colorectal cancer risk. Several associations with other emulsifiers were observed but were not robust throughout sensitivity analyses. Main limitations include possible exposure measurement errors in emulsifiers intake and potential residual confounding linked to the observational design.Conclusions In this large prospective cohort, we observed associations between higher intakes of carrageenans and mono- and diglycerides of fatty acids with overall, breast and prostate cancer risk. These results need replication in other populations. They provide new epidemiological evidence on the role of emulsifiers in cancer risk. Trial registration ClinicalTrials.gov NCT03335644 .

• Publisher: CCSD,Public Library of Science,Public Library of Science (PLoS)
• Subject: Additives / Adult / Analysis / Biology and Life Sciences / Breast cancer / Breast Neoplasms / Cancer / Carcinogenesis / Care and treatment / Carrageenans / Chronic illnesses / Colorectal cancer / Composition / Diagnosis / Diet / Diglycerides / Emulsifiers / Epidemiology / Exercise / Experimental research / Fatty Acids / Food Additives / Food Additives - adverse effects / Food composition / Food industry / Food processing / Food products / Food safety / Health aspects / Humans / Intestinal microflora / Life Sciences / Male / Medicine and Health Sciences / Metabolites / Microbiota / Microbiota (Symbiotic organisms) / Monoglycerides / Mortality / Nutrition / Physical Sciences / Processed foods / Prospective Studies / Prostate cancer / Prostatic Neoplasms / Questionnaires / Risk Factors / Santé publique et épidémiologie / Sensitivity analysis / Shelf life / Toxicology / Toxicology and food chain
• ISBN: 0012598319000