Food additive emulsifiers and cancer risk: Results from the French prospective NutriNet-Santé cohort.
<h4>Background</h4>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...
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Public Library of Science (PLoS)
2024-02-01
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| author | Laury Sellem Bernard Srour Guillaume Javaux Eloi Chazelas Benoit Chassaing Emilie Viennois Charlotte Debras Nathalie Druesne-Pecollo Younes Esseddik Fabien Szabo de Edelenyi Nathalie Arnault Cédric Agaësse Alexandre De Sa Rebecca Lutchia Inge Huybrechts Augustin Scalbert Fabrice Pierre Xavier Coumoul Chantal Julia Emmanuelle Kesse-Guyot Benjamin Allès Pilar Galan Serge Hercberg Mélanie Deschasaux-Tanguy Mathilde Touvier |
| author_facet | Laury Sellem Bernard Srour Guillaume Javaux Eloi Chazelas Benoit Chassaing Emilie Viennois Charlotte Debras Nathalie Druesne-Pecollo Younes Esseddik Fabien Szabo de Edelenyi Nathalie Arnault Cédric Agaësse Alexandre De Sa Rebecca Lutchia Inge Huybrechts Augustin Scalbert Fabrice Pierre Xavier Coumoul Chantal Julia Emmanuelle Kesse-Guyot Benjamin Allès Pilar Galan Serge Hercberg Mélanie Deschasaux-Tanguy Mathilde Touvier |
| author_sort | Laury Sellem |
| collection | DOAJ |
| description | <h4>Background</h4>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.<h4>Methods and findings</h4>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.<h4>Conclusions</h4>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.<h4>Trial registration</h4>ClinicalTrials.gov NCT03335644. |
| format | Article |
| id | doaj-art-ddf3dd229f454f1f8ffa6ec24af3aeb0 |
| institution | OA Journals |
| issn | 1549-1277 1549-1676 |
| language | English |
| publishDate | 2024-02-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Medicine |
| spelling | doaj-art-ddf3dd229f454f1f8ffa6ec24af3aeb02025-08-20T02:23:27ZengPublic Library of Science (PLoS)PLoS Medicine1549-12771549-16762024-02-01212e100433810.1371/journal.pmed.1004338Food additive emulsifiers and cancer risk: Results from the French prospective NutriNet-Santé cohort.Laury SellemBernard SrourGuillaume JavauxEloi ChazelasBenoit ChassaingEmilie ViennoisCharlotte DebrasNathalie Druesne-PecolloYounes EsseddikFabien Szabo de EdelenyiNathalie ArnaultCédric AgaësseAlexandre De SaRebecca LutchiaInge HuybrechtsAugustin ScalbertFabrice PierreXavier CoumoulChantal JuliaEmmanuelle Kesse-GuyotBenjamin AllèsPilar GalanSerge HercbergMélanie Deschasaux-TanguyMathilde Touvier<h4>Background</h4>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.<h4>Methods and findings</h4>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.<h4>Conclusions</h4>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.<h4>Trial registration</h4>ClinicalTrials.gov NCT03335644.https://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.1004338&type=printable |
| spellingShingle | Laury Sellem Bernard Srour Guillaume Javaux Eloi Chazelas Benoit Chassaing Emilie Viennois Charlotte Debras Nathalie Druesne-Pecollo Younes Esseddik Fabien Szabo de Edelenyi Nathalie Arnault Cédric Agaësse Alexandre De Sa Rebecca Lutchia Inge Huybrechts Augustin Scalbert Fabrice Pierre Xavier Coumoul Chantal Julia Emmanuelle Kesse-Guyot Benjamin Allès Pilar Galan Serge Hercberg Mélanie Deschasaux-Tanguy Mathilde Touvier Food additive emulsifiers and cancer risk: Results from the French prospective NutriNet-Santé cohort. PLoS Medicine |
| title | Food additive emulsifiers and cancer risk: Results from the French prospective NutriNet-Santé cohort. |
| title_full | Food additive emulsifiers and cancer risk: Results from the French prospective NutriNet-Santé cohort. |
| title_fullStr | Food additive emulsifiers and cancer risk: Results from the French prospective NutriNet-Santé cohort. |
| title_full_unstemmed | Food additive emulsifiers and cancer risk: Results from the French prospective NutriNet-Santé cohort. |
| title_short | Food additive emulsifiers and cancer risk: Results from the French prospective NutriNet-Santé cohort. |
| title_sort | food additive emulsifiers and cancer risk results from the french prospective nutrinet sante cohort |
| url | https://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.1004338&type=printable |
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