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Flowchart of included participants from the NutriNet-Santé cohort, 2009–2021 (n = 92,000). Cas No. 2052-15-5
Baseline characteristics of study participants from the NutriNet-Santé cohort, 2009–2021 (N = 92,000).
Dietary sources of total and groups of emulsifier intakes among study participants from the NutriNet-Santé cohort, 2009–2021 (N = 92,000).a,b FAs, fatty acids.
aGroups of emulsifiers were defined as follows (European codes): total phosphates (E339, E340, E341, E343, E450, E451, E452), total lactylates (E481, E482), total polyglycerol esters of FAs (E475, E476), total mono and diglycerides of FAs (E471, E472, E472a, E472b, E472c, E472e), total celluloses (E460, E461, E464, E466, E468), total carrageenans (E407, E407a), total alginates (E400, E401, E402, E404, E405), and total modified starches (E14xx). bDetailed % are presented in eTable A in S1 Appendix.
Contribution of individual emulsifiers to total emulsifier intakes (%) among study participants from the NutriNet-Santé cohort, 2009–2021 (N = 92,000).a FAs, fatty acidsa.
Other emulsifiers included (ordered by descending contributions): triphosphates (E451), gum arabic (E414), polyphosphates (E452), carob bean gum (E410), cellulose (E460), tricalcium phosphate (E341), mono and diacetyl tartaric acid esters of mono- and diglycerides of FAs (E472e), hydroxypropyl methyl cellulose (E464), polyglycerol esters of FAs (E475), lactic acid esters of mono- and diglycerides of FAs (E472b), sodium stearoyl-2-lactylate (E481), sodium alginate (E401), ammonium salts of phosphatidic acid (E442), esters of mono- and diglycerides of FAs (E472), polyglycerol esters of interesterified ricinoleic acid (E476), citric acid esters of mono- and diglycerides of FAs (E472c), silicon dioxide (E551), tripotassium phosphate (E340), methyl cellulose (E461), carboxymethylcellulose (E466), trisodium phosphate (E339), acetic acid esters of mono- and diglycerides of FAs (E472a), agar (E406), sucrose esters of FAs (E473), propylene glycol esters of FAs (E477), gellan gum (E418), sorbitan tristearate (E492), processed Euchema seaweed (E407a), beeswax (E901), potassium alginate (E402), maltitol (E965), triethyl citrate (E1505), xylitol (E967), glycerol esters of rosin (E445), polyoxyethylene sorbitan monooleate (E433), potassium dihydrogen citrate (E332), calcium alginate (E404), calcium stearoyl-2-lactylate (E482), konjac flour (E425), cross-linked sodium carboxymethylcellulose (E468), sucrose acetate isobutyrate (E444), sodium tartarate (E335), polyoxyethylene sorbitan monostearate (E435), sorbitan monostearate (E491), alginic acid (E400), propylene glycol (E1520), quillaia extract (E999), sodium aluminium phosphate (E541), magnesium hydrogen phosphate (E343), propylene glycol alginate (E405), and dimethyl polysiloxane (E900).
Daily emulsifier intakes among study participants from the NutriNet-Santé cohort, 2009–2021 (N = 92,000).
Associations between selected emulsifier intakes and cancer risks among study participants from the NutriNet-Santé cohort, 2009–2021 (N = 92,000).a,b DAG, diglyceride of fatty acid; FAs, fatty acids; HR, hazard ratio; MAG, monoglyceride of fatty acid.
aEmulsifiers with at least 1 statistically significant association with cancer risk are represented here. The detail of all investigated associations between emulsifier intakes and cancer risk with corresponding HRs and 95% CIs is provided in eTable D, as well as cut-offs for categories of emulsifier intakes, and number of cancer cases per category of emulsifier intakes. Mean values for emulsifier intake within each category is presented in eTable B. Groups of emulsifiers were defined as follows (European codes): total carrageenans (E407, E407a). The following emulsifiers were coded as sex-specific tertiles: total carrageenans, E407, E412, E415, E440, E450, E471, and E500. Due to a higher proportion of non-consumers among the included participants, the following emulsifiers were coded as non-consumers (first category), low consumers (second category), and high consumers (third category), with low- and high-consumptions defined according to sex-specific median intakes among consumers: E340, E410, E414, E475, and E901. bMultivariable Cox proportional hazard models were adjusted for age (time-scale), sex, BMI (continuous, kg/m2), height (continuous, cm), physical activity (categorical IPAQ variable: high, moderate, low), smoking status (never smoked, former smoker, current smokers), number of smoked cigarettes in pack-years (continuous), educational level (less than high school degree, <2 y after high school degree, ≥2 y after high school degree), number of dietary records (continuous), family history of cancer (yes/no), energy intake without alcohol (continuous, kcal/d), daily intakes of alcohol (continuous, g/d), lipids (continuous, g/d), sugars (continuous, g/d), sodium (continuous, g/d), fibre (continuous, g/d), consumption levels of fruits and vegetables (continuous, g/d), red and processed meats (continuous, g/d), and dairy products (continuous, g/d). Breast cancer models were additionally adjusted for oral contraception (yes/no, in total and premenopausal models only), age at menarche (never, <12 y, ≥12 y), number of biological children (continuous), age at first biological child (no child, <30 y, ≥30 y), menopausal status at baseline (premenopausal, postmenopausal, in total models only), hormonal treatment for menopause (yes/no, in total and postmenopausal models only).
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