Study details and key findings

For the study, researchers analyzed data from 92,000 adult participants who had participated in the French NutriNet-Santé study between 2009 and 2021. The average age of participants was 45 years, and 79% were women.

Participants completed five questionnaires that asked about their dietary intake, health, anthropometric data, physical activity, sociodemographic data, and lifestyle data. Researchers followed the participants for an average of seven years and used three or more 24-hour dietary records to estimate their intake of emulsifiers.

Emulsifiers are common food additives used in ready meals, cakes, cookies, and breads to improve their texture, taste, and shelf life. Based on participants' dietary records, researchers identified 60 emulsifying salts or emulsifiers and divided them into seven groups: lactylates, phosphates, polyglycerol ester molecules of fatty acids (FAs, monoglycerides, and diglycerides), carrageenans, celluloses, alginates, and modified starches.

Overall, 2,604 cases of cancers were diagnosed among the participants between 2009 and 2021, including 90 lymphomas, 110 squamous cell carcinomas, 124 lung cancers, 162 melanomas, 207 colorectal cancers, 322 prostate cancers, and 750 breast cancers.

According to the researchers, participants who had a higher dietary intake of mono- and diglycerides of fatty acids (E471) and carrageenan (E407) had an increased risk of developing cancer than those with lower intakes.

In particular, higher intakes of E471 were associated with a 24% increased risk of breast cancer and a 46% increased risk of prostate cancer. Higher E407 intake was associated with a 32% increased risk of breast cancer among women.

Commentary

Currently, over half of Americans' daily energy intake comes from ultra-processed foods, which often contain preservatives, sweeteners, emulsifiers, and other additives. As these foods become more commonplace, there is a growing body of evidence that suggests they may increase risks for obesity, cardiovascular disease, diabetes, and other health conditions.

The study's correlative findings do not necessarily imply causation, but they help strengthen the idea that common additives in ultra-processed foods could have a negative impact on people's health.

"While these findings need to be replicated in other studies worldwide, they bring new key knowledge to the debate on re-evaluating the regulations around the use of additives in the food industry, in order to better protect consumers," said the study's lead authors, Mathilde Touvier, research director at the French National Institute of Health and Medical Research, and Bernard Srour, a junior professor at the National Institute of Agronomic Research.

Currently, researchers are still assessing the impact of ultra-processed foods and their ingredients. The U.S. government has also asked a scientific advisory committee to consider how diets with varying amounts of ultra-processed foods can influence body composition and obesity risk as new dietary guidelines are being developed. (Dewan, Newsweek, 2/20; Paharia, News-Medical, 2/19; Bear-McGuinness, Technology Networks, 2/21;  Sellam et al., PLoS Medicine, 2/13)

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