Emulsifier intake and heart disease risk in French adults
What it found
Higher intakes of certain emulsifiers were linked to a small rise in heart and blood vessel disease over about seven years.
The findings come from tracking over 95 000 French adults.
What they found
Studies in people
Cellulose emulsifiers and heart disease
People eating more cellulose additives (E460 to E468) had slightly higher rates of overall heart disease and coronary problems. Specifically, more E460 and E466 were each tied to small increases in these risks.
Fatty acid esters and vessels
Eating more E471 and E472 type additives was linked to higher rates of all three outcomes measured: overall heart disease, coronary problems, and brain blood vessel issues. Within this group, E472b was tied to more overall heart disease and brain vessel events, while E472c was tied to more overall heart disease and coronary problems.
Phosphate additive and coronaries
A high intake of trisodium phosphate (E339) was linked to a small increase in coronary heart disease risk. This link did not hold up after the researchers adjusted their numbers to account for testing many different additives at once.
Other findings
Where emulsifiers are found
The biggest sources of these additives in the diet were processed fruit and vegetables like dried soups (18.8%), cakes and biscuits (14.7%), and dairy products (9.9%). Modified starches made up 33.5% of total emulsifier intake.
What the authors conclude
- They say that eating more of certain emulsifiers is linked to a higher chance of developing heart and blood vessel disease.
- Their results point to a need for future studies to confirm these links and to figure out exactly how these additives might affect the body.
- They note that because these additives are used in thousands of everyday processed foods, even small increases in risk matter for public health.
How it was done
In Europe and North America, ultra-processed foods provide 30-60% of adult energy intake, and more than 53.8% of industrial food products contain at least one emulsifier. Recent lab studies suggest some emulsifiers might harm gut bacteria and cause gut inflammation, which could affect the heart.
Researchers followed 95 442 French adults without existing heart disease for a median of 7.4 years. Participants filled out detailed online food diaries so scientists could estimate how much of each emulsifier they ate daily. Doctors then checked medical records to see who developed heart or blood vessel problems.
What it can’t tell you
- Because this study only watched people over time rather than randomly assigning diets, it cannot prove that emulsifiers directly cause heart disease.
- The group was mostly women with higher education levels than the general French population, so the results might not apply equally to everyone.
- Some people may have underreported what they ate, meaning the actual amounts of emulsifiers consumed could be different from what was recorded.
Who paid
- Funding
- Funded by World Health Organization (from the PubMed record).
- Conflicts
- Competing interests: All authors have completed the ICMJE uniform disclosure form at https://www.icmje.org/disclosure-of-interest/ and declare: the funders are named above; no support from any for profit organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.
- Authors work at
- Université Sorbonne Paris Nord and Université Paris Cité, France; " Université Paris Cité, France; Université de Paris, France
The paper
- Title
- Food additive emulsifiers and risk of cardiovascular disease in the NutriNet-Santé cohort: prospective cohort study
- Type
- Study
- Evidence
- Studies in people
- Summarised from
- Full text
- Cite
- Sellem L, Srour B, Javaux G, et al (2023). Food additive emulsifiers and risk of cardiovascular disease in the NutriNet-Santé cohort: prospective cohort study. BMJ (Clinical research ed.). doi:10.1136/bmj-2023-076058Free full textPubMed 37673430DOI
Summary written 30 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error