Food additive emulsifiers and risk of cardiovascular disease in the NutriNet-Santé cohort: prospective cohort study

作者：Laury Sellem, Bernard Srour, Guillaume Javaux, Eloi Chazelas, Benoît Chassaing, Émilie Viennois, Charlotte Debras, Clara Salamé, Nathalie Druesne‐Pecollo, Younes Esseddik, Fabien Szabo de Edelenyi, Cédric Agaësse, Alexandre De, Rebecca Lutchia, Erwan Louveau, Inge Huybrechts, F. Pierre, Xavier Coumoul, Léopold Fezeu, Chantal Julia, Emmanuelle Kesse‐Guyot, Benjamin Allès, Pilar Galán, Serge Herçberg, Mélanie Deschasaux, Mathilde Touvier · 发表于：BMJ · 年份：2023 · DOI：10.1136/bmj-2023-076058 · 被引用次数：68 · 研究领域：Proteins in Food Systems、Consumer Attitudes and Food Labeling、Biochemical Analysis and Sensing Techniques

OBJECTIVE: To assess the associations between exposure to food additive emulsifiers and risk of cardiovascular disease (CVD). DESIGN: Prospective cohort study. SETTING: French NutriNet-Santé study, 2009-21. PARTICIPANTS: 95 442 adults (>18 years) without prevalent CVD who completed at least three 24 hour dietary records during the first two years of follow-up. MAIN OUTCOME MEASURES: Associations between intake of food additive emulsifiers (continuous (mg/day)) and risk of CVD, coronary heart disease, and cerebrovascular disease characterised using multivariable proportional hazard Cox models to compute hazard ratios for each additional standard deviation (SD) of emulsifier intake, along with 95% confidence intervals. RESULTS: Mean age was 43.1 (SD 14.5) years, and 79.0% (n=75 390) of participants were women. During follow-up (median 7.4 years), 1995 incident CVD, 1044 coronary heart disease, and 974 cerebrovascular disease events were diagnosed. Higher intake of celluloses (E460-E468) was found to be positively associated with higher risks of CVD (hazard ratio for an increase of 1 standard deviation 1.05, 95% confidence interval 1.02 to 1.09, P=0.003) and coronary heart disease (1.07, 1.02 to 1.12, P=0.004). Specifically, higher cellulose E460 intake was linked to higher risks of CVD (1.05, 1.01 to 1.09, P=0.007) and coronary heart disease (1.07, 1.02 to 1.12, P=0.005), and higher intake of carboxymethylcellulose (E466) was associated with higher risks of CVD (1.03, 1.01 to 1...