目的:评估食品添加剂乳化剂暴露与心血管疾病(CVD)风险之间的关系。
方法:前瞻性队列研究。
方法:法国NutriNet-Santé研究,2009-21.
方法:95442名没有流行心血管疾病的成年人(>18岁),他们在最初两年的随访中完成了至少3个24小时的饮食记录。
方法:摄入食品添加剂乳化剂(连续(mg/天))与CVD风险之间的关联,冠心病,和脑血管疾病使用多变量比例风险Cox模型来计算乳化剂摄入量的每个额外标准偏差(SD)的风险比,以及95%的置信区间。
结果:平均年龄为43.1(SD14.5)岁,79.0%(n=75390)的参与者是女性。在随访期间(中位数为7.4年),1995年CVD事件,1044冠心病,共诊断出974例脑血管疾病事件。发现较高的纤维素摄入量(E460-E468)与较高的CVD风险(风险比增加1标准差1.05,95%置信区间1.02至1.09,P=0.003)和冠心病(1.07,1.02至1.12,P=0.004)呈正相关。具体来说,较高的纤维素E460摄入量与心血管疾病(1.05,1.01至1.09,P=0.007)和冠心病(1.07,1.02至1.12,P=0.005)的风险更高。和较高的羧甲基纤维素(E466)摄入量与较高的心血管疾病(1.03,1.01至1.05,P=0.004)和冠心病(1.04,1.02至1.06,P=0.001)的风险相关。此外,较高的脂肪酸单酸甘油酯和甘油二酯(E471和E472)摄入量与较高的所有结局风险相关.在这些乳化剂中,脂肪酸的甘油单酯和甘油二酯的乳酸酯(E472b)与CVD(1.06,1.02至1.10,P=0.002)和脑血管疾病(1.11,1.06至1.16,P<0.001)的高风险有关,柠檬酸单甘油酯和脂肪酸甘油二酯(E472c)与心血管疾病(1.04,1.02至1.07,P=0.004)和冠心病(1.06,1.03至1.09,P<0.001)的高风险相关。高摄入磷酸三钠(E339)与冠心病风险增加相关(1.06,1.00至1.12,P=0.03)。敏感性分析显示出一致的关联。
结论:这项研究发现,心血管疾病的风险与5个个体和2组广泛用于工业食品的食品添加剂乳化剂的摄入量呈正相关。
背景:ClinicalTrials.govNCT03335644。
To assess the associations between exposure to food additive emulsifiers and risk of cardiovascular disease (CVD).
Prospective cohort
study.
French NutriNet-Santé
study, 2009-21.
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.
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.
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 1.05, P=0.004) and coronary heart disease (1.04, 1.02 to 1.06, P=0.001). Additionally, higher intakes of monoglycerides and
diglycerides of fatty acids (E471 and E472) were associated with higher risks of all outcomes. Among these emulsifiers, lactic ester of monoglycerides and
diglycerides of fatty acids (E472b) was associated with higher risks of CVD (1.06, 1.02 to 1.10, P=0.002) and cerebrovascular disease (1.11, 1.06 to 1.16, P<0.001), and citric acid ester of monoglycerides and
diglycerides of fatty acids (E472c) was associated with higher risks of CVD (1.04, 1.02 to 1.07, P=0.004) and coronary heart disease (1.06, 1.03 to 1.09, P<0.001). High intake of trisodium phosphate (E339) was associated with an increased risk of coronary heart disease (1.06, 1.00 to 1.12, P=0.03). Sensitivity analyses showed consistent associations.
This
study found positive associations between risk of CVD and intake of five individual and two groups of food additive emulsifiers widely used in industrial foods.
ClinicalTrials.gov NCT03335644.