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Food additives linked to higher risk of cardiovascular disease

A recent study published in the journal BMJ has found that consuming certain emulsifiers (part of the “E numbers” group of food additives) commonly used in ultra-processed foods (UPF) to improve texture and extend shelf-life has been associated with an elevated risk of cardiovascular issues, such as heart attacks and strokes. 

According to the experts, these findings could help protect consumers by highlighting the urgent need of reassessing current food industry regulations.

Potential health risks

The scientists examined the potential health risks of specific emulsifiers that are often included in various packaged goods, including bread, margarine, cakes, and other processed items. 

Previous studies have already argued that these food additives might disrupt the gut microbiome, induce inflammation, and thereby potentially exacerbate heart-related issues.

How the research was conducted 

The researchers conducted a comprehensive review of the diets and health of 95,442 French participants, none of whom had a prior record of cardiovascular disease. These individuals were part of the NutriNet-Sante research project from 2009 through 2021. The majority (79 percent) were female, with a median age of 43.

The participants were asked to share their food intake details by completing multiple online food diaries over a span of two years. The researchers then cross-referenced every consumed item with three distinct databases to identify and quantify any additives present in them. 

Major cardiovascular incidents were also recorded, along with cardiovascular-related mortalities from the French national death register, while factoring in other risk factors such as age, family medical history, and smoking habits.

What the researchers learned 

The analysis revealed a significant correlation between the increased consumption of specific emulsifying agents used to improve the texture of food – such as total celluloses (E460-E468), cellulose (E460), and carboxymethylcellulose (E466) – and the likelihood of cardiovascular and coronary diseases. 

Moreover, higher intakes of monoglycerides and diglycerides of fatty acids (E471 and E472) were also associated with higher risks of all studied outcomes. 

Among these food additives, lactic ester of monoglycerides and diglycerides of fatty acids (E472b) – which is used as an airing agent in pastries and cakes – was linked to higher risks of cardiovascular and cerebrovascular diseases, and citric acid ester of monoglycerides and diglycerides of fatty acids (E472c) was associated with higher risks of cardiovascular and coronary heart disease. 

Finally, high intake of the acidity regulator trisodium phosphate (E339) was also found to increase the risk of coronary heart disease.

Strong correlation 

Although the experts acknowledged that this study is observational and cannot conclusively establish a causal relation between intake of these substances and cardiovascular issues, it nevertheless highlights a strong correlation and thus calls for a more extensive investigation into the possible causality of this association. 

Since the cohort was large, the researchers were able to adjust for a wide range of potentially influential factors while using detailed brand-specific data on food industry, and the results were similar after further testing, these findings seem to be quite robust, implying the existence of a causal relationship.

Further research is needed 

“We need more research to properly understand the link between UPF and heart disease,” said Tracy Parker, a heart health dietitian at the British Heart Foundation (BHF), who was not involved in the study.

“While it would be hard to avoid UPF entirely in our diets, cutting down on food like cakes and biscuits and cooking more from scratch are already things we know can help improve our diets and, in doing so, lower our cardiovascular disease risk. It is also essential to create an environment that supports this, by implementing delayed policies that are already on the table to restrict the advertising and promotion of often highly processed foods which are high in fat, sugar, and salt.”

Studies with similar results

Interestingly, similar findings of two other studies were recently presented at the European Society of Cardiology Congress in Amsterdam. 

In the first one, a team of scientists from the University of Sydney who examined over 10,000 middle-aged women during a period of 15 years has found that 39 percent were more likely to develop high blood pressure than those consuming small quantities of ultra-processed foods. 

The second study, led by China’s Fourth Military Medical University, argued that people consuming more UPFs were 25 percent more likely to suffer from heart attacks, strokes, or angina.

Thus, although such results need replication in other large-scale studies, they could already contribute to a re-evaluation of food additive usage regulations in the food industry to protect customers. 

“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,” the authors concluded.

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