They're Everywhere, But Do Emulsifiers Cause Heart Disease?
The data is not definitive, but the concern and potential health consequences are huge.
Mustard is one of many natural emulsifiers, and there is zero evidence that it is bad for your heart or any other organ. If you have ever struggled to mix oil and vinegar in a salad dressing, it is a golden ticket. Other single-source natural emulsifiers are egg yolks, milk, cream, and chickpea water (aquafaba).
But emulsifiers in prepared snacks, baked goods, and hundreds of other things you can buy at the store are a far cry from these natural ingredients. Even the words describing them sound more like a list of chemicals from a mad scientist’s factory than real foods.
How about some Polysorbates, Mono- and Diglycerides, and Sorbitan Esters? Or would you like some Polyglycerol Polyricinoleate with your chocolate bar? Did you know your store-bought ice cream tastes extra creamy because Carboxymethyl Cellulose and Methyl Cellulose were added?
Lately, much-deserved attention has been focused on ultra-processed foods (UPFs). And to be clear, many UPFs share a company with chemical emulsifiers. Most UPFs contain one or more unnatural emulsifiers. Artificial or chemical, emulsifiers have been implicated in inflammatory bowel disease, Type 2 diabetes, allergy and other immune disorders. There is also growing evidence that they are bad for your heart and blood vessels.
Artificial Emulsifiers And The Cardiovascular System
A 2023 study suggests that harm exists. The study was done in France as part of the NutriNet-Santé study. Here are the researcher’s conclusions.
This study found positive associations between the risk of CVD and the intake of five individual food-additive emulsifiers and two groups of food-additive emulsifiers widely used in industrial foods.
Higher intakes of two emulsifier groups (total celluloses and total monoglycerides and diglycerides of fatty acids), and in particular four emulsifiers (E460, E466, E472b, E472c) were independently and positively associated with risk of CVD.
These results suggest that food-additive emulsifiers are associated with an increased risk of CVD in humans.
Given that these food additives are used ubiquitously in thousands of widely consumed ultra-processed food products, these findings have important public health implications.
My first thought was, how does one even know which synthetic emulsifiers they ate? It’s not like you can record in a food diary that on Saturday, I ate two eggs, a cup of whole milk and a piece of toast with a pat of butter. This is their answer:
We quantified the intakes of food additives on the basis of data provided in the participants’ dietary records, in which the commercial brand or name of the industrial products consumed were recorded.
Briefly, for qualitative assessment, we matched each food item consumed and reported in a specific dietary record against three databases to identify the presence of any food additive…
Fair enough. And then there is this. The number of emulsifying agents or emulsifier salts consumed was alarming.
Among the available food additives quantified from the participants’ dietary records, we identified 61 food additives classified as emulsifiers or emulsifying salts from the 261 additives under the functional class “emulsifier” or “emulsifying salt”…
The participants were followed for a mean of 7.4 years after enrollment. Cardiovascular events, such as a stroke or heart attack, were recorded.
1,995 incident CVD, 1044 coronary heart disease, and 974 cerebrovascular disease events were diagnosed. Higher intake of cellulose was found to be positively associated with higher risks of CVD.
Several emulsifiers associated with a higher risk of CV disease were cellulose, mono- and diglycerides, and trisodium phosphates. Correlation does not equal causation, and it is quite possible that people who ingested more artificial emulsifiers also ate more UPFs, consumed less fiber and took in more calories. However, the researchers attempted to account for these so-called “confounding factors.”
Study Limitations
There were significantly more women than men in the study. Since the study was based on a diet diary database, it relies heavily on individuals’ ability to accurately record what they eat. There are problems inherent in this method.
Additionally, this study was applied only to the French people. It might be difficult to compare the findings with those of other European populations or with populations in the UK, the USA, Latin America, Asia, and the rest of the developed world. Indeed, the UK, the USA, South Africa, and Australia account for the largest share of total calories from UPFs worldwide. France seems to be in the “middle of the pack,” with 31–35% of adult calories coming from UPFs.
Takeaways
This is what we already know.
Emulsifiers are food additives widely used in industrially processed UPF foods to improve texture and extend shelf life. The food’s shelf-lives may improve, but that of the people eating them might not.
Research in healthy individuals suggests that food-additive emulsifiers have deleterious effects on the intestinal microbiota (bacteria) and the microbiome.
Such effects can lead to chronic intestinal inflammation and increased susceptibility to carcinogenesis, and potentially cardiovascular disease (CVD).
The above study adds the following.
Higher intakes of two emulsifier groups (total celluloses and total monoglycerides and diglycerides of fatty acids), and in particular four other emulsifiers, were independently and positively associated with risk of CVD.
These results suggest that food-additive emulsifiers are associated with an increased risk of CVD in humans.
Given that these food additives are used everywhere in thousands of widely consumed ultra-processed food products, these findings have important public health implications.
More research will be done. Since emulsifiers are so common in UPFs, and the latter are consumed with increasing frequency, there is legitimate concern about eating them and the risk for future cardiac disease.